401k Plan data: LYNCH OIL WELFARE BENEFIT PLAN WRAP DOCUMENT plan

LYNCH OIL WELFARE BENEFIT PLAN WRAP DOCUMENT 401k Plan overview

Plan Name	LYNCH OIL WELFARE BENEFIT PLAN WRAP DOCUMENT
Plan identification number	501

LYNCH OIL WELFARE BENEFIT PLAN WRAP DOCUMENT Benefits

401k Plan Type

Welfare Benefit

Plan Features/Benefits

Health (other than dental or vision)
Life insurance
Dental
Vision
Death benefits (include travel accident but not life insurance)
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

LYNCH OIL COMPANY INC. has sponsored the creation of one or more 401k plans.

Company Name: LYNCH OIL COMPANY INC.

Employer identification number (EIN): 591840858

NAIC Classification: 424700

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LYNCH OIL WELFARE BENEFIT PLAN WRAP DOCUMENT

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-05-01 BRYAN LOZANO 2023-11-01
501 2021-05-01 BRYAN LOZANO 2022-11-21
501 2020-05-01 JUDY A CABAN 2021-10-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2022-05-01	BRYAN LOZANO	2023-11-01
501	2021-05-01	BRYAN LOZANO	2022-11-21
501	2020-05-01	JUDY A CABAN	2021-10-15

Plan Statistics for LYNCH OIL WELFARE BENEFIT PLAN WRAP DOCUMENT

401k plan membership statisitcs for LYNCH OIL WELFARE BENEFIT PLAN WRAP DOCUMENT

Measure Date Value
2022: LYNCH OIL WELFARE BENEFIT PLAN WRAP DOCUMENT 2022 401k membership
Total participants, beginning-of-year 2022-05-01 112
Total number of active participants reported on line 7a of the Form 5500 2022-05-01 91
Number of retired or separated participants receiving benefits 2022-05-01 1
Number of other retired or separated participants entitled to future benefits 2022-05-01 6
Total of all active and inactive participants 2022-05-01 98
Number of employers contributing to the scheme 2022-05-01 0
2021: LYNCH OIL WELFARE BENEFIT PLAN WRAP DOCUMENT 2021 401k membership
Total participants, beginning-of-year 2021-05-01 114
Total number of active participants reported on line 7a of the Form 5500 2021-05-01 93
Number of retired or separated participants receiving benefits 2021-05-01 0
Number of other retired or separated participants entitled to future benefits 2021-05-01 0
Total of all active and inactive participants 2021-05-01 93
Number of employers contributing to the scheme 2021-05-01 0
2020: LYNCH OIL WELFARE BENEFIT PLAN WRAP DOCUMENT 2020 401k membership
Total participants, beginning-of-year 2020-05-01 110
Total number of active participants reported on line 7a of the Form 5500 2020-05-01 213
Number of retired or separated participants receiving benefits 2020-05-01 0
Number of other retired or separated participants entitled to future benefits 2020-05-01 0
Total of all active and inactive participants 2020-05-01 213
Number of employers contributing to the scheme 2020-05-01 0

Measure	Date	Value
2022: LYNCH OIL WELFARE BENEFIT PLAN WRAP DOCUMENT 2022 401k membership
Total participants, beginning-of-year	2022-05-01	112
Total number of active participants reported on line 7a of the Form 5500	2022-05-01	91
Number of retired or separated participants receiving benefits	2022-05-01	1
Number of other retired or separated participants entitled to future benefits	2022-05-01	6
Total of all active and inactive participants	2022-05-01	98
Number of employers contributing to the scheme	2022-05-01	0
2021: LYNCH OIL WELFARE BENEFIT PLAN WRAP DOCUMENT 2021 401k membership
Total participants, beginning-of-year	2021-05-01	114
Total number of active participants reported on line 7a of the Form 5500	2021-05-01	93
Number of retired or separated participants receiving benefits	2021-05-01	0
Number of other retired or separated participants entitled to future benefits	2021-05-01	0
Total of all active and inactive participants	2021-05-01	93
Number of employers contributing to the scheme	2021-05-01	0
2020: LYNCH OIL WELFARE BENEFIT PLAN WRAP DOCUMENT 2020 401k membership
Total participants, beginning-of-year	2020-05-01	110
Total number of active participants reported on line 7a of the Form 5500	2020-05-01	213
Number of retired or separated participants receiving benefits	2020-05-01	0
Number of other retired or separated participants entitled to future benefits	2020-05-01	0
Total of all active and inactive participants	2020-05-01	213
Number of employers contributing to the scheme	2020-05-01	0

Form 5500 Responses for LYNCH OIL WELFARE BENEFIT PLAN WRAP DOCUMENT

2022: LYNCH OIL WELFARE BENEFIT PLAN WRAP DOCUMENT 2022 form 5500 responses
2022-05-01	Type of plan entity	Single employer plan
2022-05-01	Plan funding arrangement – Insurance	Yes
2022-05-01	Plan benefit arrangement – Insurance	Yes
2021: LYNCH OIL WELFARE BENEFIT PLAN WRAP DOCUMENT 2021 form 5500 responses
2021-05-01	Type of plan entity	Single employer plan
2021-05-01	Plan funding arrangement – Insurance	Yes
2021-05-01	Plan benefit arrangement – Insurance	Yes
2020: LYNCH OIL WELFARE BENEFIT PLAN WRAP DOCUMENT 2020 form 5500 responses
2020-05-01	Type of plan entity	Single employer plan
2020-05-01	First time form 5500 has been submitted	Yes
2020-05-01	Plan funding arrangement – Insurance	Yes
2020-05-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

921327

Policy instance

Insurance contract or identification number	921327
Number of Individuals Covered	162
Insurance policy start date	2022-05-01
Insurance policy end date	2023-04-30
Total amount of commissions paid to insurance broker	USD $5,921
Total amount of fees paid to insurance company	USD $26,577
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $18,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,360
Amount paid for insurance broker fees	16063
Additional information about fees paid to insurance broker	SERVICE FEE AGREEMENT, BONUS
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

921327

Policy instance

Insurance contract or identification number	921327
Number of Individuals Covered	228
Insurance policy start date	2021-05-01
Insurance policy end date	2022-04-30
Total amount of commissions paid to insurance broker	USD $4,641
Total amount of fees paid to insurance company	USD $21,912
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $664,170
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,641
Amount paid for insurance broker fees	21912
Additional information about fees paid to insurance broker	SERVICE FEE AGREEMENT
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

921327

Policy instance

Insurance contract or identification number	921327
Number of Individuals Covered	213
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Total amount of commissions paid to insurance broker	USD $4,117
Total amount of fees paid to insurance company	USD $14,241
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $480,299
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,117
Amount paid for insurance broker fees	14241
Additional information about fees paid to insurance broker	SERVICE FEE AGREEMENT
Insurance broker organization code?	3

Potentially related plans

LYNCH OIL COMPANY, INC. 401(K) PLAN [EIN = 820322621]

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Company Name:	LYNCH OIL COMPANY INC.
Employer identification number (EIN):	591840858
NAIC Classification:	424700