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PIZZICATO, INC. DENTAL PLAN 401k Plan overview

Plan NamePIZZICATO, INC. DENTAL PLAN
Plan identification number 502

PIZZICATO, INC. DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental
  • 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.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

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

Company Name:PIZZICATO, INC.
Employer identification number (EIN):911241822
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Additional information about PIZZICATO, INC.

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division
Incorporation Date: 1998-03-30
Company Identification Number: 62560280
Legal Registered Office Address: 0121 SW BANCROFT

PORTLAND
United States of America (USA)
97239

More information about PIZZICATO, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PIZZICATO, INC. DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022019-10-01CHRISTINE BUI2021-02-25
5022018-10-01CHRISTIE BUI2019-12-23
5022017-10-01CHRISTIE BUI2019-03-28
5022016-10-01CHRISTIE BUI CHRISTIE BUI2018-02-22

Plan Statistics for PIZZICATO, INC. DENTAL PLAN

401k plan membership statisitcs for PIZZICATO, INC. DENTAL PLAN

Measure Date Value
2019: PIZZICATO, INC. DENTAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-0191
Total number of active participants reported on line 7a of the Form 55002019-10-0183
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-0183
Number of employers contributing to the scheme2019-10-010
2018: PIZZICATO, INC. DENTAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01105
Total number of active participants reported on line 7a of the Form 55002018-10-01105
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-01105
Number of employers contributing to the scheme2018-10-010
2017: PIZZICATO, INC. DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01104
Total number of active participants reported on line 7a of the Form 55002017-10-01106
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01106
Number of employers contributing to the scheme2017-10-010
2016: PIZZICATO, INC. DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01100
Total number of active participants reported on line 7a of the Form 55002016-10-01104
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01104

Form 5500 Responses for PIZZICATO, INC. DENTAL PLAN

2019: PIZZICATO, INC. DENTAL PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – InsuranceYes
2018: PIZZICATO, INC. DENTAL PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – InsuranceYes
2017: PIZZICATO, INC. DENTAL PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – InsuranceYes
2016: PIZZICATO, INC. DENTAL PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number16579
Policy instance 1
Insurance contract or identification number16579
Number of Individuals Covered77
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $681
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,454
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $681
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number16579
Policy instance 1
Insurance contract or identification number16579
Number of Individuals Covered123
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $1,058
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $52,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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