401k Plan data: THE HOTELCRAFTERS INC HEALTH & WELFARE PLAN plan

THE HOTELCRAFTERS INC HEALTH & WELFARE PLAN 401k Plan overview

Plan Name	THE HOTELCRAFTERS INC HEALTH & WELFARE PLAN
Plan identification number	501

THE HOTELCRAFTERS INC HEALTH & WELFARE 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) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

THE HOTELCRAFTERS, INC. has sponsored the creation of one or more 401k plans.

Company Name: THE HOTELCRAFTERS, INC.

Employer identification number (EIN): 824582472

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE HOTELCRAFTERS INC HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2019-06-01 ANDREA BARNETT 2021-02-24

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2019-06-01	ANDREA BARNETT	2021-02-24

Plan Statistics for THE HOTELCRAFTERS INC HEALTH & WELFARE PLAN

401k plan membership statisitcs for THE HOTELCRAFTERS INC HEALTH & WELFARE PLAN

Measure Date Value
2019: THE HOTELCRAFTERS INC HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year 2019-06-01 426
Total number of active participants reported on line 7a of the Form 5500 2019-06-01 55
Number of retired or separated participants receiving benefits 2019-06-01 4
Number of other retired or separated participants entitled to future benefits 2019-06-01 0
Total of all active and inactive participants 2019-06-01 59
Number of employers contributing to the scheme 2019-06-01 0

Measure	Date	Value
2019: THE HOTELCRAFTERS INC HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-06-01	426
Total number of active participants reported on line 7a of the Form 5500	2019-06-01	55
Number of retired or separated participants receiving benefits	2019-06-01	4
Number of other retired or separated participants entitled to future benefits	2019-06-01	0
Total of all active and inactive participants	2019-06-01	59
Number of employers contributing to the scheme	2019-06-01	0

Form 5500 Responses for THE HOTELCRAFTERS INC HEALTH & WELFARE PLAN

2019: THE HOTELCRAFTERS INC HEALTH & WELFARE PLAN 2019 form 5500 responses
2019-06-01	Type of plan entity	Single employer plan
2019-06-01	First time form 5500 has been submitted	Yes
2019-06-01	Plan funding arrangement – Insurance	Yes
2019-06-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

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

Policy contract number

911972

Policy instance

Insurance contract or identification number	911972
Number of Individuals Covered	25
Insurance policy start date	2019-06-01
Insurance policy end date	2020-05-31
Total amount of commissions paid to insurance broker	USD $76,039
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,399,716
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $76,039
Insurance broker organization code?	3

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

231630

Policy instance

Insurance contract or identification number	231630
Number of Individuals Covered	39
Insurance policy start date	2019-06-01
Insurance policy end date	2020-05-31
Total amount of commissions paid to insurance broker	USD $51,125
Total amount of fees paid to insurance company	USD $1
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $814,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $51,125
Amount paid for insurance broker fees	1
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

10136971001

Policy instance

Insurance contract or identification number	10136971001
Number of Individuals Covered	40
Insurance policy start date	2019-06-01
Insurance policy end date	2020-05-31
Total amount of commissions paid to insurance broker	USD $1,280
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,662
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,280
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10233711

Policy instance

Insurance contract or identification number	10233711
Number of Individuals Covered	65
Insurance policy start date	2019-06-01
Insurance policy end date	2020-05-31
Total amount of commissions paid to insurance broker	USD $13,948
Total amount of fees paid to insurance company	USD $640
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT,EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $69,741
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,948
Amount paid for insurance broker fees	640
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

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Company Name:	THE HOTELCRAFTERS, INC.
Employer identification number (EIN):	824582472
NAIC Classification:	721110
NAIC Description:	Hotels (except Casino Hotels) and Motels