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CLYDE, INC. CAFETERIA PLAN 401k Plan overview

Plan NameCLYDE, INC. CAFETERIA PLAN
Plan identification number 501

CLYDE, INC. CAFETERIA PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

CLYDES OF GEORGETOWN LLC has sponsored the creation of one or more 401k plans.

Company Name:CLYDES OF GEORGETOWN LLC
Employer identification number (EIN):521909629
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLYDE, INC. CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-07-01ANGELA BRIMAGE2024-02-25
5012021-07-01CHRISTINE LOBBAN2023-01-05
5012020-07-01CHRISTINE LOBBAN2021-12-22
5012019-07-01CHRISTINE LOBBAN2020-10-13

Plan Statistics for CLYDE, INC. CAFETERIA PLAN

401k plan membership statisitcs for CLYDE, INC. CAFETERIA PLAN

Measure Date Value
2022: CLYDE, INC. CAFETERIA PLAN 2022 401k membership
Total participants, beginning-of-year2022-07-01179
Total number of active participants reported on line 7a of the Form 55002022-07-011,825
Number of retired or separated participants receiving benefits2022-07-012
Number of other retired or separated participants entitled to future benefits2022-07-010
Total of all active and inactive participants2022-07-011,827
Number of employers contributing to the scheme2022-07-010
2021: CLYDE, INC. CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01141
Total number of active participants reported on line 7a of the Form 55002021-07-01175
Number of retired or separated participants receiving benefits2021-07-014
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01179
Number of employers contributing to the scheme2021-07-010
2020: CLYDE, INC. CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01253
Total number of active participants reported on line 7a of the Form 55002020-07-01138
Number of retired or separated participants receiving benefits2020-07-013
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01141
Number of employers contributing to the scheme2020-07-010
2019: CLYDE, INC. CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01242
Total number of active participants reported on line 7a of the Form 55002019-07-01248
Number of retired or separated participants receiving benefits2019-07-015
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01253
Number of employers contributing to the scheme2019-07-010

Form 5500 Responses for CLYDE, INC. CAFETERIA PLAN

2022: CLYDE, INC. CAFETERIA PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – InsuranceYes
2021: CLYDE, INC. CAFETERIA PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: CLYDE, INC. CAFETERIA PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: CLYDE, INC. CAFETERIA PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number956586
Policy instance 5
Insurance contract or identification number956586
Number of Individuals Covered168
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $3,563
Total amount of fees paid to insurance companyUSD $1,425
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $35,779
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,941
Amount paid for insurance broker fees1425
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 )
Policy contract number956588
Policy instance 4
Insurance contract or identification number956588
Number of Individuals Covered60
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $5,420
Total amount of fees paid to insurance companyUSD $1,083
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCRITICAL ILLNESS,HOSPITAL,ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $29,041
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,420
Amount paid for insurance broker fees1083
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
HEALTH ADVOCATE, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00
Policy instance 3
Insurance contract or identification number00
Number of Individuals Covered1825
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $24,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract number956591
Policy instance 2
Insurance contract or identification number956591
Number of Individuals Covered194
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $4,340
Total amount of fees paid to insurance companyUSD $3,858
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $96,443
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,411
Amount paid for insurance broker fees3858
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number22879
Policy instance 1
Insurance contract or identification number22879
Number of Individuals Covered245
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $57,856
Total amount of fees paid to insurance companyUSD $22,810
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,225,396
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $122,265
Amount paid for insurance broker fees22810
Additional information about fees paid to insurance brokerANNUAL BOB
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number501549
Policy instance 2
Insurance contract or identification number501549
Number of Individuals Covered175
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $7,266
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $141,080
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,903
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number22879
Policy instance 1
Insurance contract or identification number22879
Number of Individuals Covered257
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $54,532
Total amount of fees paid to insurance companyUSD $1,959
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,269,450
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,487
Amount paid for insurance broker fees4
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number1D037191
Policy instance 3
Insurance contract or identification number1D037191
Number of Individuals Covered193
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $16,092
Total amount of fees paid to insurance companyUSD $9,162
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $163,303
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,092
Amount paid for insurance broker fees8165
Additional information about fees paid to insurance brokerTPA FEE
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number501549
Policy instance 2
Insurance contract or identification number501549
Number of Individuals Covered68
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $2,149
Total amount of fees paid to insurance companyUSD $942
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $6,362
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $1,273
Amount paid for insurance broker fees942
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number22879
Policy instance 1
Insurance contract or identification number22879
Number of Individuals Covered280
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $59,325
Total amount of fees paid to insurance companyUSD $3,298
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,458,602
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,684
Amount paid for insurance broker fees3256
Additional information about fees paid to insurance brokerANNUAL BOB BONUS NON-MONETARY COMPENSATION
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number1D037191
Policy instance 3
Insurance contract or identification number1D037191
Number of Individuals Covered249
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $12,627
Total amount of fees paid to insurance companyUSD $35,660
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $170,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,627
Amount paid for insurance broker fees31376
Additional information about fees paid to insurance brokerFEES BROKER BONUS
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number501549
Policy instance 2
Insurance contract or identification number501549
Number of Individuals Covered242
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $6,997
Total amount of fees paid to insurance companyUSD $1,702
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $30,423
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,085
Amount paid for insurance broker fees1702
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number22879
Policy instance 1
Insurance contract or identification number22879
Number of Individuals Covered370
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $81,071
Total amount of fees paid to insurance companyUSD $49,004
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,594,339
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,822
Amount paid for insurance broker fees49004
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION BONUS ANNUAL BOB
Insurance broker organization code?3

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