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L'AUBERGE NEWCO, LLC HEALTH PLAN 401k Plan overview

Plan NameL'AUBERGE NEWCO, LLC HEALTH PLAN
Plan identification number 501

L'AUBERGE NEWCO, LLC HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

L'AUBERGE NEWCO, LLC has sponsored the creation of one or more 401k plans.

Company Name:L'AUBERGE NEWCO, LLC
Employer identification number (EIN):900966653
NAIC Classification:721110
NAIC Description:Hotels (except Casino Hotels) and Motels

Form 5500 Filing Information

Submission information for form 5500 for 401k plan L'AUBERGE NEWCO, LLC HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012016-06-01TINA LITTLEMAN ALBERTA PRIEST2017-12-28
5012015-06-01TINA LITTLEMAN ALBERTA PRIEST2016-10-21
5012014-06-01TINA LITTLEMAN ALBERTA PRIEST2015-12-02
5012013-06-01TINA LITTLEMAN ALBERTA PRIEST2014-11-20

Plan Statistics for L'AUBERGE NEWCO, LLC HEALTH PLAN

401k plan membership statisitcs for L'AUBERGE NEWCO, LLC HEALTH PLAN

Measure Date Value
2016: L'AUBERGE NEWCO, LLC HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-06-01166
Total number of active participants reported on line 7a of the Form 55002016-06-01162
Number of retired or separated participants receiving benefits2016-06-019
Total of all active and inactive participants2016-06-01171
Total participants2016-06-01171
2015: L'AUBERGE NEWCO, LLC HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-01137
Total number of active participants reported on line 7a of the Form 55002015-06-01160
Number of other retired or separated participants entitled to future benefits2015-06-015
Total of all active and inactive participants2015-06-01165
Total participants2015-06-01165
2014: L'AUBERGE NEWCO, LLC HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-01139
Total number of active participants reported on line 7a of the Form 55002014-06-01137
Total of all active and inactive participants2014-06-01137
Total participants2014-06-01137
2013: L'AUBERGE NEWCO, LLC HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-01103
Total number of active participants reported on line 7a of the Form 55002013-06-01139
Total of all active and inactive participants2013-06-01139
Total participants2013-06-01139

Form 5500 Responses for L'AUBERGE NEWCO, LLC HEALTH PLAN

2016: L'AUBERGE NEWCO, LLC HEALTH PLAN 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01Submission has been amendedNo
2016-06-01This submission is the final filingNo
2016-06-01This return/report is a short plan year return/report (less than 12 months)No
2016-06-01Plan is a collectively bargained planNo
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan benefit arrangement – InsuranceYes
2015: L'AUBERGE NEWCO, LLC HEALTH PLAN 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01Submission has been amendedNo
2015-06-01This submission is the final filingNo
2015-06-01This return/report is a short plan year return/report (less than 12 months)No
2015-06-01Plan is a collectively bargained planNo
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan benefit arrangement – InsuranceYes
2014: L'AUBERGE NEWCO, LLC HEALTH PLAN 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Submission has been amendedNo
2014-06-01This submission is the final filingNo
2014-06-01This return/report is a short plan year return/report (less than 12 months)No
2014-06-01Plan is a collectively bargained planNo
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan benefit arrangement – InsuranceYes
2013: L'AUBERGE NEWCO, LLC HEALTH PLAN 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01Submission has been amendedNo
2013-06-01This submission is the final filingNo
2013-06-01This return/report is a short plan year return/report (less than 12 months)No
2013-06-01Plan is a collectively bargained planNo
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0468146
Policy instance 1
Insurance contract or identification number0468146
Number of Individuals Covered284
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH DISMEMBERMENT
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 CarrierUSD $1,210,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0468146
Policy instance 1
Insurance contract or identification number0468146
Number of Individuals Covered167
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $223
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
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
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 CarrierUSD $768,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $112
Insurance broker organization code?3
Insurance broker nameBENEFIT DESIGN ASSOCIATES, LTD
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number468146
Policy instance 1
Insurance contract or identification number468146
Number of Individuals Covered139
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $3,491
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $677,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $197
Insurance broker organization code?3
Insurance broker nameBENEFIT DESIGN ASSOCIATES LTD

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