401k Plan data: COBB THEATRES III, LLC HEALTHCARE PLAN plan

COBB THEATRES III, LLC HEALTHCARE PLAN 401k Plan overview

Plan Name	COBB THEATRES III, LLC HEALTHCARE PLAN
Plan identification number	501

COBB THEATRES III, LLC HEALTHCARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

COBB THEATRES III, LLC has sponsored the creation of one or more 401k plans.

Company Name: COBB THEATRES III, LLC

Employer identification number (EIN): 631263796

NAIC Classification: 512100
NAIC Description: Motion Picture and Video Industries

Additional information about COBB THEATRES III, LLC

Jurisdiction of Incorporation: Georgia Department of States Corporations Division

Incorporation Date:

Company Identification Number: 357954

More information about COBB THEATRES III, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COBB THEATRES III, LLC HEALTHCARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-12-01 JENNIFER GOSSETT 2019-07-15
501 2016-12-01
501 2016-12-01 JENNIFER GOSSETT 2019-07-16
501 2015-12-01 JENNIFER GOSSETT
501 2014-12-01 JENNIFER GOSSETT
501 2013-12-01 JENNIFER GOSSETT
501 2012-12-01 JENNIFER GOSSETT
501 2011-12-01 JENNIFER GOSSETT

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2017-12-01	JENNIFER GOSSETT	2019-07-15
501	2016-12-01
501	2016-12-01	JENNIFER GOSSETT	2019-07-16
501	2015-12-01	JENNIFER GOSSETT
501	2014-12-01	JENNIFER GOSSETT
501	2013-12-01	JENNIFER GOSSETT
501	2012-12-01	JENNIFER GOSSETT
501	2011-12-01	JENNIFER GOSSETT

Plan Statistics for COBB THEATRES III, LLC HEALTHCARE PLAN

401k plan membership statisitcs for COBB THEATRES III, LLC HEALTHCARE PLAN

Measure Date Value
2017: COBB THEATRES III, LLC HEALTHCARE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-12-01 145
Total number of active participants reported on line 7a of the Form 5500 2017-12-01 0
Number of retired or separated participants receiving benefits 2017-12-01 0
Number of other retired or separated participants entitled to future benefits 2017-12-01 0
Total of all active and inactive participants 2017-12-01 0
Number of employers contributing to the scheme 2017-12-01 0
2016: COBB THEATRES III, LLC HEALTHCARE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-12-01 145
Total number of active participants reported on line 7a of the Form 5500 2016-12-01 145
Number of retired or separated participants receiving benefits 2016-12-01 0
Number of other retired or separated participants entitled to future benefits 2016-12-01 0
Total of all active and inactive participants 2016-12-01 145
Number of employers contributing to the scheme 2016-12-01 0
2015: COBB THEATRES III, LLC HEALTHCARE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-12-01 133
Total number of active participants reported on line 7a of the Form 5500 2015-12-01 145
Number of retired or separated participants receiving benefits 2015-12-01 0
Number of other retired or separated participants entitled to future benefits 2015-12-01 0
Total of all active and inactive participants 2015-12-01 145
2014: COBB THEATRES III, LLC HEALTHCARE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-12-01 121
Total number of active participants reported on line 7a of the Form 5500 2014-12-01 133
Number of retired or separated participants receiving benefits 2014-12-01 0
Number of other retired or separated participants entitled to future benefits 2014-12-01 0
Total of all active and inactive participants 2014-12-01 133
2013: COBB THEATRES III, LLC HEALTHCARE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-12-01 110
Total number of active participants reported on line 7a of the Form 5500 2013-12-01 118
Number of retired or separated participants receiving benefits 2013-12-01 0
Number of other retired or separated participants entitled to future benefits 2013-12-01 0
Total of all active and inactive participants 2013-12-01 118
2012: COBB THEATRES III, LLC HEALTHCARE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-12-01 110
Total number of active participants reported on line 7a of the Form 5500 2012-12-01 118
Number of retired or separated participants receiving benefits 2012-12-01 0
Number of other retired or separated participants entitled to future benefits 2012-12-01 0
Total of all active and inactive participants 2012-12-01 118
2011: COBB THEATRES III, LLC HEALTHCARE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-12-01 103
Total number of active participants reported on line 7a of the Form 5500 2011-12-01 110
Number of retired or separated participants receiving benefits 2011-12-01 0
Number of other retired or separated participants entitled to future benefits 2011-12-01 0
Total of all active and inactive participants 2011-12-01 110

Measure	Date	Value
2017: COBB THEATRES III, LLC HEALTHCARE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-12-01	145
Total number of active participants reported on line 7a of the Form 5500	2017-12-01	0
Number of retired or separated participants receiving benefits	2017-12-01	0
Number of other retired or separated participants entitled to future benefits	2017-12-01	0
Total of all active and inactive participants	2017-12-01	0
Number of employers contributing to the scheme	2017-12-01	0
2016: COBB THEATRES III, LLC HEALTHCARE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-12-01	145
Total number of active participants reported on line 7a of the Form 5500	2016-12-01	145
Number of retired or separated participants receiving benefits	2016-12-01	0
Number of other retired or separated participants entitled to future benefits	2016-12-01	0
Total of all active and inactive participants	2016-12-01	145
Number of employers contributing to the scheme	2016-12-01	0
2015: COBB THEATRES III, LLC HEALTHCARE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-12-01	133
Total number of active participants reported on line 7a of the Form 5500	2015-12-01	145
Number of retired or separated participants receiving benefits	2015-12-01	0
Number of other retired or separated participants entitled to future benefits	2015-12-01	0
Total of all active and inactive participants	2015-12-01	145
2014: COBB THEATRES III, LLC HEALTHCARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-12-01	121
Total number of active participants reported on line 7a of the Form 5500	2014-12-01	133
Number of retired or separated participants receiving benefits	2014-12-01	0
Number of other retired or separated participants entitled to future benefits	2014-12-01	0
Total of all active and inactive participants	2014-12-01	133
2013: COBB THEATRES III, LLC HEALTHCARE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-12-01	110
Total number of active participants reported on line 7a of the Form 5500	2013-12-01	118
Number of retired or separated participants receiving benefits	2013-12-01	0
Number of other retired or separated participants entitled to future benefits	2013-12-01	0
Total of all active and inactive participants	2013-12-01	118
2012: COBB THEATRES III, LLC HEALTHCARE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-12-01	110
Total number of active participants reported on line 7a of the Form 5500	2012-12-01	118
Number of retired or separated participants receiving benefits	2012-12-01	0
Number of other retired or separated participants entitled to future benefits	2012-12-01	0
Total of all active and inactive participants	2012-12-01	118
2011: COBB THEATRES III, LLC HEALTHCARE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-12-01	103
Total number of active participants reported on line 7a of the Form 5500	2011-12-01	110
Number of retired or separated participants receiving benefits	2011-12-01	0
Number of other retired or separated participants entitled to future benefits	2011-12-01	0
Total of all active and inactive participants	2011-12-01	110

Form 5500 Responses for COBB THEATRES III, LLC HEALTHCARE PLAN

2017: COBB THEATRES III, LLC HEALTHCARE PLAN 2017 form 5500 responses
2017-12-01	Type of plan entity	Single employer plan
2017-12-01	This submission is the final filing	Yes
2017-12-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2017-12-01	Plan funding arrangement – Insurance	Yes
2017-12-01	Plan benefit arrangement – Insurance	Yes
2016: COBB THEATRES III, LLC HEALTHCARE PLAN 2016 form 5500 responses
2016-12-01	Type of plan entity	Single employer plan
2016-12-01	Submission has been amended	Yes
2016-12-01	Plan funding arrangement – Insurance	Yes
2016-12-01	Plan benefit arrangement – Insurance	Yes
2015: COBB THEATRES III, LLC HEALTHCARE PLAN 2015 form 5500 responses
2015-12-01	Type of plan entity	Single employer plan
2015-12-01	Submission has been amended	No
2015-12-01	This submission is the final filing	No
2015-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-12-01	Plan is a collectively bargained plan	No
2015-12-01	Plan funding arrangement – Insurance	Yes
2015-12-01	Plan benefit arrangement – Insurance	Yes
2014: COBB THEATRES III, LLC HEALTHCARE PLAN 2014 form 5500 responses
2014-12-01	Type of plan entity	Single employer plan
2014-12-01	Submission has been amended	No
2014-12-01	This submission is the final filing	No
2014-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-12-01	Plan is a collectively bargained plan	No
2014-12-01	Plan funding arrangement – Insurance	Yes
2014-12-01	Plan benefit arrangement – Insurance	Yes
2013: COBB THEATRES III, LLC HEALTHCARE PLAN 2013 form 5500 responses
2013-12-01	Type of plan entity	Single employer plan
2013-12-01	Submission has been amended	No
2013-12-01	This submission is the final filing	No
2013-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-12-01	Plan is a collectively bargained plan	No
2013-12-01	Plan funding arrangement – Insurance	Yes
2013-12-01	Plan benefit arrangement – Insurance	Yes
2012: COBB THEATRES III, LLC HEALTHCARE PLAN 2012 form 5500 responses
2012-12-01	Type of plan entity	Single employer plan
2012-12-01	Submission has been amended	No
2012-12-01	This submission is the final filing	No
2012-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-12-01	Plan is a collectively bargained plan	No
2012-12-01	Plan funding arrangement – Insurance	Yes
2012-12-01	Plan benefit arrangement – Insurance	Yes
2011: COBB THEATRES III, LLC HEALTHCARE PLAN 2011 form 5500 responses
2011-12-01	Type of plan entity	Single employer plan
2011-12-01	First time form 5500 has been submitted	Yes
2011-12-01	Submission has been amended	No
2011-12-01	This submission is the final filing	No
2011-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-12-01	Plan is a collectively bargained plan	No
2011-12-01	Plan funding arrangement – Insurance	Yes
2011-12-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )

Policy contract number

47341

Policy instance

Insurance contract or identification number	47341
Number of Individuals Covered	145
Insurance policy start date	2017-12-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

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Company Name:	COBB THEATRES III, LLC
Employer identification number (EIN):	631263796
NAIC Classification:	512100
NAIC Description:	Motion Picture and Video Industries

Jurisdiction of Incorporation:	Georgia Department of States Corporations Division
Incorporation Date:
Company Identification Number:	357954