401k Plan data: THE RESTAURANT GROUPS HEALTH AND WELFARE BENEFITS PLAN plan

THE RESTAURANT GROUPS HEALTH AND WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	THE RESTAURANT GROUPS HEALTH AND WELFARE BENEFITS PLAN
Plan identification number	501

THE RESTAURANT GROUPS HEALTH AND WELFARE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Other welfare benefit cover

401k Sponsoring company profile

EMERGE! INC. has sponsored the creation of one or more 401k plans.

Company Name: EMERGE! INC.

Employer identification number (EIN): 800748365

NAIC Classification: 722511
NAIC Description: Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE RESTAURANT GROUPS HEALTH AND WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-03-01 SONYA GIBBS 2023-08-02 SONYA GIBBS 2023-08-02
501 2022-03-01 SONYA GIBBS 2023-07-25 SONYA GIBBS 2023-07-25
501 2021-03-01 SONYA GIBBS 2023-04-26

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-03-01	SONYA GIBBS	2023-08-02	SONYA GIBBS	2023-08-02
501	2022-03-01	SONYA GIBBS	2023-07-25	SONYA GIBBS	2023-07-25
501	2021-03-01	SONYA GIBBS	2023-04-26

Plan Statistics for THE RESTAURANT GROUPS HEALTH AND WELFARE BENEFITS PLAN

401k plan membership statisitcs for THE RESTAURANT GROUPS HEALTH AND WELFARE BENEFITS PLAN

Measure Date Value
2023: THE RESTAURANT GROUPS HEALTH AND WELFARE BENEFITS PLAN 2023 401k membership
Total participants, beginning-of-year 2023-03-01 307
Total number of active participants reported on line 7a of the Form 5500 2023-03-01 491
Total of all active and inactive participants 2023-03-01 491
2022: THE RESTAURANT GROUPS HEALTH AND WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-03-01 192
Total number of active participants reported on line 7a of the Form 5500 2022-03-01 307
Total of all active and inactive participants 2022-03-01 307
2021: THE RESTAURANT GROUPS HEALTH AND WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-03-01 104
Total number of active participants reported on line 7a of the Form 5500 2021-03-01 192
Number of retired or separated participants receiving benefits 2021-03-01 0
Number of other retired or separated participants entitled to future benefits 2021-03-01 0
Total of all active and inactive participants 2021-03-01 192

Measure	Date	Value
2023: THE RESTAURANT GROUPS HEALTH AND WELFARE BENEFITS PLAN 2023 401k membership
Total participants, beginning-of-year	2023-03-01	307
Total number of active participants reported on line 7a of the Form 5500	2023-03-01	491
Total of all active and inactive participants	2023-03-01	491
2022: THE RESTAURANT GROUPS HEALTH AND WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-03-01	192
Total number of active participants reported on line 7a of the Form 5500	2022-03-01	307
Total of all active and inactive participants	2022-03-01	307
2021: THE RESTAURANT GROUPS HEALTH AND WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-03-01	104
Total number of active participants reported on line 7a of the Form 5500	2021-03-01	192
Number of retired or separated participants receiving benefits	2021-03-01	0
Number of other retired or separated participants entitled to future benefits	2021-03-01	0
Total of all active and inactive participants	2021-03-01	192

Form 5500 Responses for THE RESTAURANT GROUPS HEALTH AND WELFARE BENEFITS PLAN

2023: THE RESTAURANT GROUPS HEALTH AND WELFARE BENEFITS PLAN 2023 form 5500 responses
2023-03-01	Type of plan entity	Single employer plan
2023-03-01	Submission has been amended	No
2023-03-01	This submission is the final filing	No
2023-03-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2023-03-01	Plan is a collectively bargained plan	No
2023-03-01	Plan funding arrangement – Insurance	Yes
2023-03-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-03-01	Plan benefit arrangement – Insurance	Yes
2023-03-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: THE RESTAURANT GROUPS HEALTH AND WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-03-01	Type of plan entity	Single employer plan
2022-03-01	Submission has been amended	No
2022-03-01	This submission is the final filing	No
2022-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-03-01	Plan is a collectively bargained plan	No
2022-03-01	Plan funding arrangement – Insurance	Yes
2022-03-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-03-01	Plan benefit arrangement – Insurance	Yes
2022-03-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: THE RESTAURANT GROUPS HEALTH AND WELFARE BENEFITS PLAN 2021 form 5500 responses
2021-03-01	Type of plan entity	Single employer plan
2021-03-01	First time form 5500 has been submitted	Yes
2021-03-01	Submission has been amended	No
2021-03-01	This submission is the final filing	No
2021-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-03-01	Plan is a collectively bargained plan	No
2021-03-01	Plan funding arrangement – Insurance	Yes
2021-03-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E5460811

Policy instance

Insurance contract or identification number	E5460811
Number of Individuals Covered	149
Insurance policy start date	2023-03-01
Insurance policy end date	2023-04-30
Total amount of commissions paid to insurance broker	USD $4,263
Total amount of fees paid to insurance company	USD $95
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	CRITICAL ILLNESS, ACCIDENT, VOLUNTARY LIFE
Welfare Benefit Premiums Paid to Carrier	USD $29,723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,211
Insurance broker organization code?	3
Amount paid for insurance broker fees	22
Additional information about fees paid to insurance broker	FEES

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

927487

Policy instance

Insurance contract or identification number	927487
Number of Individuals Covered	491
Insurance policy start date	2023-03-01
Insurance policy end date	2023-04-30
Total amount of commissions paid to insurance broker	USD $1,712
Total amount of fees paid to insurance company	USD $11,391
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $259,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,712
Amount paid for insurance broker fees	11391
Additional information about fees paid to insurance broker	SERVICE FEE AGREEMENT
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

927487

Policy instance

Insurance contract or identification number	927487
Number of Individuals Covered	307
Insurance policy start date	2022-03-01
Insurance policy end date	2023-02-28
Total amount of commissions paid to insurance broker	USD $6,658
Total amount of fees paid to insurance company	USD $54,680
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,304,266
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,391
Amount paid for insurance broker fees	38142
Additional information about fees paid to insurance broker	SERVICE FEE AGREEMENT
Insurance broker organization code?	3

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E5460811

Policy instance

Insurance contract or identification number	E5460811
Number of Individuals Covered	153
Insurance policy start date	2022-03-01
Insurance policy end date	2023-02-28
Total amount of commissions paid to insurance broker	USD $68,801
Total amount of fees paid to insurance company	USD $16,091
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	CRITICAL ILLNESS, ACCIDENT, VOLUNTARY LIFE
Welfare Benefit Premiums Paid to Carrier	USD $206,349
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $911
Amount paid for insurance broker fees	138
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

04F6985

Policy instance

Insurance contract or identification number	04F6985
Number of Individuals Covered	327
Insurance policy start date	2021-03-01
Insurance policy end date	2022-02-28
Total amount of commissions paid to insurance broker	USD $42,516
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $897,005
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $42,516
Insurance broker organization code?	3

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Company Name:	EMERGE! INC.
Employer identification number (EIN):	800748365
NAIC Classification:	722511
NAIC Description:	Full-Service Restaurants