401k Plan data: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN plan

PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 401k Plan overview

Plan Name	PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN
Plan identification number	501

PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

PALAFOX HOSPITALITY LTD has sponsored the creation of one or more 401k plans.

Company Name: PALAFOX HOSPITALITY LTD

Employer identification number (EIN): 752531873

NAIC Classification: 721110
NAIC Description: Hotels (except Casino Hotels) and Motels

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01 LYNDA JAMES 2023-09-28 LYNDA JAMES 2023-09-28
501 2021-01-01
501 2020-01-01
501 2019-01-01
501 2018-01-01
501 2017-01-01 LYNDA JAMES
501 2016-01-01 LYNDA JAMES
501 2015-01-01 LYNDA JAMES
501 2014-01-01 LYNDA JAMES
501 2013-01-01 LYNDA JAMES
501 2012-01-01 LYNDA JAMES
501 2011-01-01 LYNDA JAMES
501 2010-01-01 LYNDA JAMES
501 2009-01-01 LYNDA JAMES

Plan Statistics for PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN

401k plan membership statisitcs for PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN

Measure Date Value
2022: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 106
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 113
Total of all active and inactive participants 2022-01-01 113
Total participants 2022-01-01 113
2021: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 93
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 106
Total of all active and inactive participants 2021-01-01 106
Total participants 2021-01-01 106
2020: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 106
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 93
Total of all active and inactive participants 2020-01-01 93
Total participants 2020-01-01 93
2019: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 107
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 106
Total of all active and inactive participants 2019-01-01 106
Total participants 2019-01-01 106
2018: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 107
Total of all active and inactive participants 2018-01-01 107
Total participants 2018-01-01 107
2017: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 117
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 109
Total of all active and inactive participants 2017-01-01 109
Total participants 2017-01-01 109
2016: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 117
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 117
Total of all active and inactive participants 2016-01-01 117
Total participants 2016-01-01 117
2015: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 111
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 117
Total of all active and inactive participants 2015-01-01 117
Total participants 2015-01-01 0
2014: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 111
Total of all active and inactive participants 2014-01-01 111
Total participants 2014-01-01 0
2013: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 110
Total of all active and inactive participants 2013-01-01 110
Total participants 2013-01-01 0
2012: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 112
Total of all active and inactive participants 2012-01-01 112
Total participants 2012-01-01 0
2011: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 112
Total of all active and inactive participants 2011-01-01 112
Total participants 2011-01-01 112
2010: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 108
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 109
Total of all active and inactive participants 2010-01-01 109
Total participants 2010-01-01 109
2009: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 123
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 108
Total of all active and inactive participants 2009-01-01 108
Total participants 2009-01-01 108

Measure	Date	Value
2022: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	106
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	113
Total of all active and inactive participants	2022-01-01	113
Total participants	2022-01-01	113
2021: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	93
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	106
Total of all active and inactive participants	2021-01-01	106
Total participants	2021-01-01	106
2020: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	106
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	93
Total of all active and inactive participants	2020-01-01	93
Total participants	2020-01-01	93
2019: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	107
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	106
Total of all active and inactive participants	2019-01-01	106
Total participants	2019-01-01	106
2018: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	107
Total of all active and inactive participants	2018-01-01	107
Total participants	2018-01-01	107
2017: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	117
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	109
Total of all active and inactive participants	2017-01-01	109
Total participants	2017-01-01	109
2016: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	117
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	117
Total of all active and inactive participants	2016-01-01	117
Total participants	2016-01-01	117
2015: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	111
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	117
Total of all active and inactive participants	2015-01-01	117
Total participants	2015-01-01	0
2014: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	111
Total of all active and inactive participants	2014-01-01	111
Total participants	2014-01-01	0
2013: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	110
Total of all active and inactive participants	2013-01-01	110
Total participants	2013-01-01	0
2012: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	112
Total of all active and inactive participants	2012-01-01	112
Total participants	2012-01-01	0
2011: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	112
Total of all active and inactive participants	2011-01-01	112
Total participants	2011-01-01	112
2010: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	108
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	109
Total of all active and inactive participants	2010-01-01	109
Total participants	2010-01-01	109
2009: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	123
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	108
Total of all active and inactive participants	2009-01-01	108
Total participants	2009-01-01	108

Financial Data on PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN

Measure	Date	Value
2019 : PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-12-31	$686,444
Total of all expenses incurred	2019-12-31	$686,444
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$615,119
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$686,444
Value of total assets at end of year	2019-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$71,325
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$28,773
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in pooled separate accounts at end of year	2019-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$615,119
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$657,671
Contract administrator fees	2019-12-31	$71,325
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2019-12-31	No
Did the plan have assets held for investment	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	No
Opinion of an independent qualified public accountant for this plan	2019-12-31	Unqualified
Accountancy firm name	2019-12-31	PATRICK BUZARELLOS KENDRICK, LLP
Accountancy firm EIN	2019-12-31	680197298
2018 : PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$631,238
Total of all expenses incurred	2018-12-31	$631,238
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$557,761
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$631,238
Value of total assets at end of year	2018-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$73,477
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$100,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$30,738
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in pooled separate accounts at end of year	2018-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$557,761
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$600,500
Contract administrator fees	2018-12-31	$73,477
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2018-12-31	No
Did the plan have assets held for investment	2018-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	No
Opinion of an independent qualified public accountant for this plan	2018-12-31	Unqualified
Accountancy firm name	2018-12-31	PATRICK BUZARELLOS KENDRICK, LLP
Accountancy firm EIN	2018-12-31	680197298
2017 : PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$921,764
Total of all expenses incurred	2017-12-31	$921,764
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$847,766
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$921,764
Value of total assets at end of year	2017-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$73,998
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$100,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$30,175
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in common/collective trusts at end of year	2017-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$847,766
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$891,589
Contract administrator fees	2017-12-31	$73,998
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	No
Did the plan have assets held for investment	2017-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	No
Opinion of an independent qualified public accountant for this plan	2017-12-31	Unqualified
Accountancy firm name	2017-12-31	PATRICK & BUZARELLOS, LLP
Accountancy firm EIN	2017-12-31	680197298
2016 : PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$827,105
Total of all expenses incurred	2016-12-31	$827,105
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$753,705
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$827,105
Value of total assets at end of year	2016-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$73,400
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$100,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$28,875
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in common/collective trusts at end of year	2016-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$753,705
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$798,230
Contract administrator fees	2016-12-31	$73,400
Did the plan have assets held for investment	2016-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	No
Opinion of an independent qualified public accountant for this plan	2016-12-31	Unqualified
Accountancy firm name	2016-12-31	PATRICK & BUZARELLOS, LLP
Accountancy firm EIN	2016-12-31	680197298
2015 : PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$711,596
Total of all expenses incurred	2015-12-31	$711,596
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$636,880
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$711,596
Value of total assets at end of year	2015-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$74,716
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$100,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$28,950
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in common/collective trusts at end of year	2015-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$636,880
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$682,646
Contract administrator fees	2015-12-31	$74,716
Did the plan have assets held for investment	2015-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	No
Opinion of an independent qualified public accountant for this plan	2015-12-31	Unqualified
Accountancy firm name	2015-12-31	PATRICK & BUZARELLOS, LLP
Accountancy firm EIN	2015-12-31	680197298
2014 : PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$627,923
Total of all expenses incurred	2014-12-31	$627,923
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$558,609
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$627,923
Value of total assets at end of year	2014-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$69,314
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$100,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$26,675
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in common/collective trusts at end of year	2014-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$558,609
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$601,248
Contract administrator fees	2014-12-31	$69,314
Did the plan have assets held for investment	2014-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	No
Opinion of an independent qualified public accountant for this plan	2014-12-31	Unqualified
Accountancy firm name	2014-12-31	PATRICK & BUZARELLOS, LLP
Accountancy firm EIN	2014-12-31	680197298
2013 : PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$543,530
Total of all expenses incurred	2013-12-31	$543,530
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$474,088
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$543,530
Value of total assets at end of year	2013-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$69,442
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$100,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$21,725
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in common/collective trusts at end of year	2013-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$474,088
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$521,805
Contract administrator fees	2013-12-31	$69,442
Did the plan have assets held for investment	2013-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Unqualified
Accountancy firm name	2013-12-31	PATRICK & BUZARELLOS, LLP
Accountancy firm EIN	2013-12-31	680197298
2012 : PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$368,132
Total of all expenses incurred	2012-12-31	$368,132
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$300,122
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$368,132
Value of total assets at end of year	2012-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$68,010
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$100,000
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$18,212
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in common/collective trusts at end of year	2012-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$300,122
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$349,920
Contract administrator fees	2012-12-31	$68,010
Did the plan have assets held for investment	2012-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	PATRICK & BUZARELLOS, LLP
Accountancy firm EIN	2012-12-31	680197298
2011 : PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$505,702
Total of all expenses incurred	2011-12-31	$505,702
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$438,046
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$505,702
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$67,656
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$100,000
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$16,562
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$438,046
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$489,140
Contract administrator fees	2011-12-31	$67,656
Did the plan have assets held for investment	2011-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	PATRICK & BUZARELLOS, LLP
Accountancy firm EIN	2011-12-31	680197298
2010 : PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$402,140
Total of all expenses incurred	2010-12-31	$405,379
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$342,744
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$402,140
Value of total assets at beginning of year	2010-12-31	$3,239
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$62,635
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$100,000
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$15,435
Total non interest bearing cash at beginning of year	2010-12-31	$3,239
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$-3,239
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$3,239
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$69,544
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$386,705
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$273,200
Contract administrator fees	2010-12-31	$62,635
Did the plan have assets held for investment	2010-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	PATRICK & BUZARELLOS, LLP
Accountancy firm EIN	2010-12-31	680197298

Form 5500 Responses for PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN

2022: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: PALAFOX HOSPITALITY LTD EMPLOYEE MEDICAL BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

83219

Policy instance

Insurance contract or identification number	83219
Number of Individuals Covered	113
Insurance policy start date	2022-04-01
Insurance policy end date	2023-03-31
Total amount of commissions paid to insurance broker	USD $7,525
Total amount of fees paid to insurance company	USD $5,122
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $297,837
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,525
Amount paid for insurance broker fees	5122
Additional information about fees paid to insurance broker	SPECIAL PROGRAMS
Insurance broker organization code?	3

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

83219

Policy instance

Insurance contract or identification number	83219
Number of Individuals Covered	106
Insurance policy start date	2021-04-01
Insurance policy end date	2022-03-31
Total amount of commissions paid to insurance broker	USD $6,538
Total amount of fees paid to insurance company	USD $9,275
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $240,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,538
Amount paid for insurance broker fees	9275
Additional information about fees paid to insurance broker	SPECIAL PROGRAMS
Insurance broker organization code?	3

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

83219

Policy instance

Insurance contract or identification number	83219
Number of Individuals Covered	93
Insurance policy start date	2020-04-01
Insurance policy end date	2021-03-31
Total amount of commissions paid to insurance broker	USD $6,782
Total amount of fees paid to insurance company	USD $1,296
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $232,105
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,782
Amount paid for insurance broker fees	1296
Additional information about fees paid to insurance broker	SPECIAL PROGRAMS
Insurance broker organization code?	3

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

83219

Policy instance

Insurance contract or identification number	83219
Number of Individuals Covered	106
Insurance policy start date	2019-04-01
Insurance policy end date	2020-03-31
Total amount of commissions paid to insurance broker	USD $8,260
Total amount of fees paid to insurance company	USD $963
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $268,995
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,260
Amount paid for insurance broker fees	963
Additional information about fees paid to insurance broker	SPECIAL PROGRAMS
Insurance broker organization code?	3

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

83219

Policy instance

Insurance contract or identification number	83219
Number of Individuals Covered	107
Insurance policy start date	2018-04-01
Insurance policy end date	2019-03-31
Total amount of commissions paid to insurance broker	USD $8,574
Total amount of fees paid to insurance company	USD $400
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $274,553
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,574
Amount paid for insurance broker fees	400
Additional information about fees paid to insurance broker	SPECIAL PROGRAMS
Insurance broker organization code?	3

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

83219

Policy instance

Insurance contract or identification number	83219
Number of Individuals Covered	109
Insurance policy start date	2017-04-01
Insurance policy end date	2018-03-31
Total amount of commissions paid to insurance broker	USD $8,901
Total amount of fees paid to insurance company	USD $594
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $273,597
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,901
Amount paid for insurance broker fees	594
Additional information about fees paid to insurance broker	SPECIAL PROGRAMS
Insurance broker organization code?	3
Insurance broker name	MARSH & MCLENNAN AGENCY LLC

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Company Name:	PALAFOX HOSPITALITY LTD
Employer identification number (EIN):	752531873
NAIC Classification:	721110
NAIC Description:	Hotels (except Casino Hotels) and Motels

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-01-01	LYNDA JAMES	2023-09-28	LYNDA JAMES	2023-09-28
501	2021-01-01
501	2020-01-01
501	2019-01-01
501	2018-01-01
501	2017-01-01	LYNDA JAMES
501	2016-01-01	LYNDA JAMES
501	2015-01-01	LYNDA JAMES
501	2014-01-01	LYNDA JAMES
501	2013-01-01	LYNDA JAMES
501	2012-01-01	LYNDA JAMES
501	2011-01-01	LYNDA JAMES
501	2010-01-01	LYNDA JAMES
501	2009-01-01	LYNDA JAMES