401k Plan data: GROUP INSURANCE PLAN plan

GROUP INSURANCE PLAN 401k Plan overview

Plan Name	GROUP INSURANCE PLAN
Plan identification number	501

GROUP INSURANCE PLAN Benefits

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

401k Sponsoring company profile

PANHANDLE OILFIELD SERVICE, INC. has sponsored the creation of one or more 401k plans.

Company Name: PANHANDLE OILFIELD SERVICE, INC.

Employer identification number (EIN): 481109486

NAIC Classification: 424700

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2016-08-01 ASHLEY MCGINLEY
501 2016-01-01 ASHLEY MCGINLEY
501 2016-01-01 ASHLEY MCGINLEY 2021-12-21
501 2015-08-01 ASHLEY MCGINLEY ASHLEY MCGINLEY 2016-12-20
501 2014-08-01 ASHLEY MCGINLEY ASHLEY MCGINLEY 2016-12-20
501 2013-08-01 ASHLEY MCGINLEY ASHLEY MCGINLEY 2016-12-20
501 2012-08-01 ASHLEY MCGINLEY
501 2012-01-01 ASHLEY MCGINLEY ASHLEY MCGINLEY 2016-12-19
501 2011-08-01 ASHLEY MCGINLEY
501 2010-08-01 ASHLEY MCGINLEY
501 2010-08-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2016-08-01	ASHLEY MCGINLEY
501	2016-01-01	ASHLEY MCGINLEY
501	2016-01-01	ASHLEY MCGINLEY	2021-12-21
501	2015-08-01	ASHLEY MCGINLEY		ASHLEY MCGINLEY	2016-12-20
501	2014-08-01	ASHLEY MCGINLEY		ASHLEY MCGINLEY	2016-12-20
501	2013-08-01	ASHLEY MCGINLEY		ASHLEY MCGINLEY	2016-12-20
501	2012-08-01	ASHLEY MCGINLEY
501	2012-01-01	ASHLEY MCGINLEY		ASHLEY MCGINLEY	2016-12-19
501	2011-08-01	ASHLEY MCGINLEY
501	2010-08-01	ASHLEY MCGINLEY
501	2010-08-01

Plan Statistics for GROUP INSURANCE PLAN

401k plan membership statisitcs for GROUP INSURANCE PLAN

Measure Date Value
2016: GROUP INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-08-01 180
Total number of active participants reported on line 7a of the Form 5500 2016-08-01 0
Number of retired or separated participants receiving benefits 2016-08-01 0
Number of other retired or separated participants entitled to future benefits 2016-08-01 0
Total of all active and inactive participants 2016-08-01 0
Total participants, beginning-of-year 2016-01-01 169
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 149
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 149
Total participants 2016-01-01 149
Number of employers contributing to the scheme 2016-01-01 0
2015: GROUP INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-08-01 133
Total number of active participants reported on line 7a of the Form 5500 2015-08-01 180
Number of retired or separated participants receiving benefits 2015-08-01 0
Number of other retired or separated participants entitled to future benefits 2015-08-01 0
Total of all active and inactive participants 2015-08-01 180
Total participants 2015-08-01 180
2014: GROUP INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-08-01 147
Total number of active participants reported on line 7a of the Form 5500 2014-08-01 133
Number of retired or separated participants receiving benefits 2014-08-01 0
Number of other retired or separated participants entitled to future benefits 2014-08-01 0
Total of all active and inactive participants 2014-08-01 133
Total participants 2014-08-01 133
2013: GROUP INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-08-01 142
Total number of active participants reported on line 7a of the Form 5500 2013-08-01 147
Number of retired or separated participants receiving benefits 2013-08-01 0
Number of other retired or separated participants entitled to future benefits 2013-08-01 0
Total of all active and inactive participants 2013-08-01 147
Total participants 2013-08-01 147
2012: GROUP INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-08-01 149
Total number of active participants reported on line 7a of the Form 5500 2012-08-01 142
Number of retired or separated participants receiving benefits 2012-08-01 0
Number of other retired or separated participants entitled to future benefits 2012-08-01 0
Total of all active and inactive participants 2012-08-01 142
Total participants, beginning-of-year 2012-01-01 149
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 142
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 142
Total participants 2012-01-01 142
2011: GROUP INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-08-01 169
Total number of active participants reported on line 7a of the Form 5500 2011-08-01 149
Number of retired or separated participants receiving benefits 2011-08-01 0
Number of other retired or separated participants entitled to future benefits 2011-08-01 0
Total of all active and inactive participants 2011-08-01 149
2010: GROUP INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-08-01 169
Total number of active participants reported on line 7a of the Form 5500 2010-08-01 169
Number of retired or separated participants receiving benefits 2010-08-01 0
Number of other retired or separated participants entitled to future benefits 2010-08-01 0
Total of all active and inactive participants 2010-08-01 169
Total participants 2010-08-01 169

Measure	Date	Value
2016: GROUP INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-08-01	180
Total number of active participants reported on line 7a of the Form 5500	2016-08-01	0
Number of retired or separated participants receiving benefits	2016-08-01	0
Number of other retired or separated participants entitled to future benefits	2016-08-01	0
Total of all active and inactive participants	2016-08-01	0
Total participants, beginning-of-year	2016-01-01	169
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	149
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	149
Total participants	2016-01-01	149
Number of employers contributing to the scheme	2016-01-01	0
2015: GROUP INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-08-01	133
Total number of active participants reported on line 7a of the Form 5500	2015-08-01	180
Number of retired or separated participants receiving benefits	2015-08-01	0
Number of other retired or separated participants entitled to future benefits	2015-08-01	0
Total of all active and inactive participants	2015-08-01	180
Total participants	2015-08-01	180
2014: GROUP INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-08-01	147
Total number of active participants reported on line 7a of the Form 5500	2014-08-01	133
Number of retired or separated participants receiving benefits	2014-08-01	0
Number of other retired or separated participants entitled to future benefits	2014-08-01	0
Total of all active and inactive participants	2014-08-01	133
Total participants	2014-08-01	133
2013: GROUP INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-08-01	142
Total number of active participants reported on line 7a of the Form 5500	2013-08-01	147
Number of retired or separated participants receiving benefits	2013-08-01	0
Number of other retired or separated participants entitled to future benefits	2013-08-01	0
Total of all active and inactive participants	2013-08-01	147
Total participants	2013-08-01	147
2012: GROUP INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-08-01	149
Total number of active participants reported on line 7a of the Form 5500	2012-08-01	142
Number of retired or separated participants receiving benefits	2012-08-01	0
Number of other retired or separated participants entitled to future benefits	2012-08-01	0
Total of all active and inactive participants	2012-08-01	142
Total participants, beginning-of-year	2012-01-01	149
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	142
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	142
Total participants	2012-01-01	142
2011: GROUP INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-08-01	169
Total number of active participants reported on line 7a of the Form 5500	2011-08-01	149
Number of retired or separated participants receiving benefits	2011-08-01	0
Number of other retired or separated participants entitled to future benefits	2011-08-01	0
Total of all active and inactive participants	2011-08-01	149
2010: GROUP INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-08-01	169
Total number of active participants reported on line 7a of the Form 5500	2010-08-01	169
Number of retired or separated participants receiving benefits	2010-08-01	0
Number of other retired or separated participants entitled to future benefits	2010-08-01	0
Total of all active and inactive participants	2010-08-01	169
Total participants	2010-08-01	169

Form 5500 Responses for GROUP INSURANCE PLAN

2016: GROUP INSURANCE PLAN 2016 form 5500 responses
2016-08-01	Type of plan entity	Single employer plan
2016-08-01	Submission has been amended	No
2016-08-01	This submission is the final filing	Yes
2016-08-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2016-08-01	Plan is a collectively bargained plan	No
2016-08-01	Plan funding arrangement – Insurance	Yes
2016-08-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-08-01	Plan benefit arrangement – Insurance	Yes
2016-08-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: GROUP INSURANCE PLAN 2015 form 5500 responses
2015-08-01	Type of plan entity	Single employer plan
2015-08-01	Submission has been amended	No
2015-08-01	This submission is the final filing	No
2015-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-08-01	Plan is a collectively bargained plan	No
2015-08-01	Plan funding arrangement – Insurance	Yes
2015-08-01	Plan benefit arrangement – Insurance	Yes
2014: GROUP INSURANCE PLAN 2014 form 5500 responses
2014-08-01	Type of plan entity	Single employer plan
2014-08-01	Submission has been amended	No
2014-08-01	This submission is the final filing	No
2014-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-08-01	Plan is a collectively bargained plan	No
2014-08-01	Plan funding arrangement – Insurance	Yes
2014-08-01	Plan benefit arrangement – Insurance	Yes
2013: GROUP INSURANCE PLAN 2013 form 5500 responses
2013-08-01	Type of plan entity	Single employer plan
2013-08-01	Submission has been amended	No
2013-08-01	This submission is the final filing	No
2013-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-08-01	Plan is a collectively bargained plan	No
2013-08-01	Plan funding arrangement – Insurance	Yes
2013-08-01	Plan benefit arrangement – Insurance	Yes
2012: GROUP INSURANCE PLAN 2012 form 5500 responses
2012-08-01	Type of plan entity	Single employer plan
2012-08-01	Submission has been amended	Yes
2012-08-01	This submission is the final filing	No
2012-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-08-01	Plan is a collectively bargained plan	No
2012-08-01	Plan funding arrangement – Insurance	Yes
2012-08-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	First time form 5500 has been submitted	Yes
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: GROUP INSURANCE PLAN 2011 form 5500 responses
2011-08-01	Type of plan entity	Single employer plan
2011-08-01	Submission has been amended	Yes
2011-08-01	This submission is the final filing	No
2011-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-08-01	Plan is a collectively bargained plan	No
2011-08-01	Plan funding arrangement – Insurance	Yes
2011-08-01	Plan benefit arrangement – Insurance	Yes
2010: GROUP INSURANCE PLAN 2010 form 5500 responses
2010-08-01	Type of plan entity	Single employer plan
2010-08-01	Submission has been amended	Yes
2010-08-01	This submission is the final filing	No
2010-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-08-01	Plan is a collectively bargained plan	No
2010-08-01	Plan funding arrangement – Insurance	Yes
2010-08-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )

Policy contract number

25620

Policy instance

Insurance contract or identification number	25620
Number of Individuals Covered	180
Insurance policy start date	2015-11-01
Insurance policy end date	2016-10-31
Total amount of commissions paid to insurance broker	USD $0
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 $241,480
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	PANHANDLE OILFIELD SERVICE, INC.
Employer identification number (EIN):	481109486
NAIC Classification:	424700