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Safety Harbor Resort & Spa 401k Plan


Plan Information

  • Plan Year01/01/2019 — 12/31/2019
  • Date of Plan05/01/2016
  • Net Assets as of 12/31/2019 $238,004
  • Plan Number1
  • Plan Type Single Employer
  • Is the plan collectively bargained? No
  • Did the plan file for an extension of time or the DFVC Program?Yes
  • Plan Funding ArrangementInsurance Trust
  • Plan Benefit ArrangementInsurance Trust

Participant Information as of 12/31/2019

  • Active (Eligible) Participants145
  • Retired or separated participants receiving benefits0
  • Other retired or separated participants entitled to future benefits1
  • Subtotal146
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
  • Total146
  • Total number of participants as of 01/01/2019172
  • Number of participants with account balances14
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested0


  • Total Benefit Payments$0
  • Corrective Distributions$0
  • Administrative Service Providers$0
  • Other Expenses$0
  • Total Expenses$0
  • Total Transfers$0

Sponsor Information

  • Address105 North Bayshore Drive
  • CitySafety Harbor
  • StateFL
  • Zip34695
  • Telephone(888) 237-8772
  • EIN46-5147419
  • Industry Code721110

Audit Information

  • Audit StatusAudited
  • AuditorPdr CPAS & Advisors Inc
  • Auditor EIN59-1687531
  • Audit Opinion Disclaimer
  • Audit TypeLimited Scope Audit

Benefits Provided Under the Plan

Code Benefit Description
2E Profit-sharing A defined contribution plan that allows employer discretionary contributions. These plans often contain a 401(k) feature.
2F ERISA section 404(c) Plan This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
2G Total participant-directed account plan Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
2J Code section 401(k) feature A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
2T Participant-directed Account Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
3D Master plan A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

Questions and Answers

Question Answer Amount
During the plan year did the employer fail to transmit to the plan any participant contributions within the time period described in 29 CFT 2510.3-102? Yes $2,097
Were any loans by the plan or fixed income obligations due the plan in default as of the close of plan year or classified during the year as uncollectible? Disregard participant loans secured by participant's account balance. No
Were any leases to which the plan was a party in default or classified during the year as uncollectible? No
Were there any nonexempt transactions with any party-in-interest? No
Was this plan covered by a fidelity bond? Yes $100,000
Did the plan have a loss, whether or not reimbursed by the plan's fidelity bond, that was caused by fraud or dishonesty? No
Did the plan hold any assets whose current value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan receive any noncash contributions whose value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan have assets held for investment? Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of plan assets? No
Were all the plan assets either distributed to participants or beneficiaries, transferred to another plan, or brought under the control of the PBGC? No
Has the plan failed to provide any benefit when due under the plan? No
If this is an individual account plan, was there a blackout period? No
If there was a blackout period, have you either provided the required notice or one of the exceptions to providing the notice applied under 29 CFR 2520.101-3? No


Income and Expense Statement

Income $50,198
Contributions $17,253
Cash Contributions $17,253
Cash from Employers $0
Cash from Participants $17,253
Others (including rollovers) $0
Noncash Contributions $0
Total Earnings on Investments $32,945
Total Interest $110
Interest-Bearing Cash $0
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $41
Interest from Other Investments $69
Total Dividends $1,436
Preferred Stock $0
Common Stock $0
Rents $0
Net gain (loss) on sale of assets $0
Aggregate Proceeds $0
Aggregate Carrying Amount $0
Total Unrealized Appreciation (depreciation) of assets $0
Real Estate $0
Other $0
Net investment gain (loss) from common/collective trusts $0
Net investment gain (loss) from pooled separate accounts $0
Net investment gain (loss) from master trust investment accounts $0
Net investment gain (loss) from 103-12 investment entities $0
Net investment gain (loss) from registered investment companies $31,399
Other Income $0
Expenses $52,676
Total Benefit Payments $50,559
Directly to participants or beneficiaries, including direct rollovers $50,559
To insurance carriers for the provision of benefits $0
Other Benefit Payment Fees $0
Corrective Distributions $0
Certain deemed distributions of participant loans $0
Interest expense $0
Total Administrative Expenses $2,117
Professional Fees $0
Contract Administrator Fees $2,117
Investment Advisory and management fees $0
Other Administrative Fees $0
Net Income $-2,478
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

12/31/2019 12/31/2018 Change YOY
Total Assets $238,004 $240,482 -1.03%
Total noninterest-bearing cash $0 $0 0.0%
Receivables $0 $0 0.0%
Employer Contributions $0 $0 0.0%
Participant Contributions $0 $0 0.0%
Other Contributions $0 $0 0.0%
General Investments $0 $0 0.0%
Interest-bearing cash $0 $0 0.0%
U.S. Government Securities $0 $0 0.0%
Corporate Debt Instruments $0 $0 0.0%
Preferred $0 $0 0.0%
All Other $0 $0 0.0%
Corporate Stocks $0 $0 0.0%
Preferred $0 $0 0.0%
Common $0 $0 0.0%
Partnership/joint venture interests $0 $0 0.0%
Real estate (other than employer real property) $0 $0 0.0%
Loans (other than to participants) $0 $0 0.0%
Participants Loans $0 $3,980 -100.00%
Value of interest in common/collective trusts $189,821 $169,117 12.24%
Value of interest in pooled separate accounts $0 $0 0.0%
Value of interest in master trust investment accounts $0 $0 0.0%
Value of interest in 103-12 investment entities $0 $0 0.0%
Value of interest in registered investment companies $42,375 $60,086 -29.48%
Value of funds held in insurance co. general account $5,808 $7,299 -20.43%
Other Investments $0 $0 0.0%
Employer-related Investments $0 $0 0.0%
Employer Securities $0 $0 0.0%
Employer Real Property $0 $0 0.0%
Buildings and other property used in plan operation $0 $0 0.0%
Total Liabilities $0 $0 0.0%
Benefit Claims Payable (1) $0 $0 0.0%
Operating Payables (1) $0 $0 0.0%
Acquisition Indebtedness (1) $0 $0 0.0%
Other liabilities (1) $0 $0 0.0%
Net Assets $238,004 $240,482 -1.03%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

There is no information on eligible indirect compensation for this plan.

Other Service Providers Receiving Direct or Indirect Compensation

Name Nature of Service Relationship to Plan Sponsor Direct Compensation Paid by Plan Indirect Compensation Paid by Plan Total Compensation
Great-West Life & Annuity Insurance Recordkeeping fees Recordkeeper $1,504 $0 $1,504
Ubs Financial Svcs Ins Agcy Inc Other commissions Broker/Adviser $0 $1,133 $1,133
Retirement Solutions Specialists Contract Administrator Contract Admin $180 $232 $412
Advised Assets Group Investment management Investment Mgmt $378 $0 $378
Total $2,062 $1,365 $3,427

Indirect Compensation

Name Source of Indirect Compensation* Nature of Service Description of Indirect Compensation Indirect Compensation Paid by Plan
Ubs Financial Svcs Ins Agcy Inc Great-West Life & Annuity Insurance Other commissions Other Commissions $1,133
Retirement Solutions Specialists Great-West Life & Annuity Insurance Contract Administrator Tpa Allowance Payment $232
*As outlined by the Form 5500 Instructions for service providers with indirect compensation.

Service Providers Who Fail or Refuse to Provide Information

There are no service providers who failed or refused to provide information.

Termination Information on Accountants and Enrolled Actuaries

There is no termination information for this plan.



Name of Investment Investment Manager Type of Investment Dollar Value
Putnam Retirement Advantage 2025 V Putnam Investments DFE: Common/Collective Trust $109,902
Putnam Retirement Advantage 2030 V Putnam Investments DFE: Common/Collective Trust $49,109
Putnam Retirement Advantage 2020 V Putnam Investments DFE: Common/Collective Trust $30,657
Putnam Retirement Advantage Mat V Putnam Investments DFE: Common/Collective Trust $154
Total $189,822

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Great-West Life & Annuity Insurance Company 14
EIN 84-0467907
Industry Code 68322
Contract Number 500114-01
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $5,808
Value in Separate Accounts at Year End $0
Insurance Fees and Commissions $28
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Ubs Financial Svcs Ins Agcy Inc 15310 Amberly Dr Ste 100 Tampa, FL 33647 Insurance Agent or Broker $28 $0
Allocated Funds
Type of Contract Unspecified
Basis of premium rates
Premiums paid to carrier $0
Premiums due but unpaid at the end of the year $0
If the carrier, service, or other organization incurred any specific costs in connection with the acquisition or retention of the contract or policy, enter amount $0
Specify the nature of the costs
Unallocated Funds
Balance at the end of the previous year $7,299
Additions $2,309
Contributions Deposited during the year $598
Dividends and credits $0
Interest credited during the year $69
Transferred from separate account $1,642
Other $0
Total of Balance and Additions $9,608
Deductions $3,800
Disbursed from fund to pay benefits or purchase annuities during the year $2,971
Administration charge made by carrier $42
Transferred to Separate Account $787
Other $0
Balance at the end of the current year $5,808