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| Plan Name | PREMIUM OILFIELD SERVICES, LLC BCBS MEDICAL |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | PREMIUM OILFIELD SERVICES, LLC |
| Employer identification number (EIN): | 352437202 |
| NAIC Classification: | 213110 |
| NAIC Description: | Support Activities for Mining |
Additional information about PREMIUM OILFIELD SERVICES, LLC
| Jurisdiction of Incorporation: | Texas Secretary of State |
| Incorporation Date: | 2012-02-13 |
| Company Identification Number: | 0801550309 |
| Legal Registered Office Address: |
4819 HIGHWAY 90 W NEW IBERIA United States of America (USA) 70560 |
More information about PREMIUM OILFIELD SERVICES, LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2017-06-01 | ||||
| 502 | 2016-06-01 | ||||
| 502 | 2015-06-01 | ||||
| 502 | 2014-06-01 | KERRY UBRICH |
| Measure | Date | Value |
|---|---|---|
| 2017: PREMIUM OILFIELD SERVICES, LLC BCBS MEDICAL 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-06-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-06-01 | 0 |
| Number of retired or separated participants receiving benefits | 2017-06-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-06-01 | 0 |
| Total of all active and inactive participants | 2017-06-01 | 0 |
| 2016: PREMIUM OILFIELD SERVICES, LLC BCBS MEDICAL 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-06-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 99 |
| Number of retired or separated participants receiving benefits | 2016-06-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-06-01 | 0 |
| Total of all active and inactive participants | 2016-06-01 | 99 |
| 2015: PREMIUM OILFIELD SERVICES, LLC BCBS MEDICAL 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-06-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 104 |
| Number of retired or separated participants receiving benefits | 2015-06-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-06-01 | 0 |
| Total of all active and inactive participants | 2015-06-01 | 104 |
| 2014: PREMIUM OILFIELD SERVICES, LLC BCBS MEDICAL 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-06-01 | 139 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-06-01 | 139 |
| Number of retired or separated participants receiving benefits | 2014-06-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-06-01 | 0 |
| Total of all active and inactive participants | 2014-06-01 | 139 |
| 2017: PREMIUM OILFIELD SERVICES, LLC BCBS MEDICAL 2017 form 5500 responses | ||
|---|---|---|
| 2017-06-01 | Type of plan entity | Single employer plan |
| 2017-06-01 | Submission has been amended | No |
| 2017-06-01 | This submission is the final filing | Yes |
| 2017-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-06-01 | Plan is a collectively bargained plan | No |
| 2017-06-01 | Plan funding arrangement – Insurance | Yes |
| 2017-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: PREMIUM OILFIELD SERVICES, LLC BCBS MEDICAL 2016 form 5500 responses | ||
| 2016-06-01 | Type of plan entity | Single employer plan |
| 2016-06-01 | Submission has been amended | No |
| 2016-06-01 | This submission is the final filing | No |
| 2016-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-06-01 | Plan is a collectively bargained plan | No |
| 2016-06-01 | Plan funding arrangement – Insurance | Yes |
| 2016-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: PREMIUM OILFIELD SERVICES, LLC BCBS MEDICAL 2015 form 5500 responses | ||
| 2015-06-01 | Type of plan entity | Single employer plan |
| 2015-06-01 | Submission has been amended | No |
| 2015-06-01 | This submission is the final filing | No |
| 2015-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-06-01 | Plan is a collectively bargained plan | No |
| 2015-06-01 | Plan funding arrangement – Insurance | Yes |
| 2015-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: PREMIUM OILFIELD SERVICES, LLC BCBS MEDICAL 2014 form 5500 responses | ||
| 2014-06-01 | Type of plan entity | Single employer plan |
| 2014-06-01 | First time form 5500 has been submitted | Yes |
| 2014-06-01 | Submission has been amended | No |
| 2014-06-01 | This submission is the final filing | No |
| 2014-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-06-01 | Plan is a collectively bargained plan | No |
| 2014-06-01 | Plan funding arrangement – Insurance | Yes |
| 2014-06-01 | Plan benefit arrangement – Insurance | Yes |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 145867 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 145867 145938 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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