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BCBS OF LA 401k Plan overview

Plan NameBCBS OF LA
Plan identification number 501

BCBS OF LA Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

PERFORMANCE ENERGY SERVICES, L.L.C. has sponsored the creation of one or more 401k plans.

Company Name:PERFORMANCE ENERGY SERVICES, L.L.C.
Employer identification number (EIN):721477905
NAIC Classification:237990
NAIC Description:Other Heavy and Civil Engineering Construction

Additional information about PERFORMANCE ENERGY SERVICES, L.L.C.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2015-04-27
Company Identification Number: 0802203614
Legal Registered Office Address: 2727 NORTH LOOP W

HOUSTON
United States of America (USA)
77008

More information about PERFORMANCE ENERGY SERVICES, L.L.C.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BCBS OF LA

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012013-01-01CLAY NUNNALLY
5012012-01-01CHRISSY PREVOST CHRISSY PREVOST2013-07-26
5012011-01-01CHRISSY PREVOST
5012008-11-01CHRISSY PREVOST
5012007-11-01CHRISSY PREVOST
5012006-11-01CHRISSY PREVOST

Plan Statistics for BCBS OF LA

401k plan membership statisitcs for BCBS OF LA

Measure Date Value
2013: BCBS OF LA 2013 401k membership
Total participants, beginning-of-year2013-01-01268
Total number of active participants reported on line 7a of the Form 55002013-01-010
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-010
2012: BCBS OF LA 2012 401k membership
Total participants, beginning-of-year2012-01-01222
Total number of active participants reported on line 7a of the Form 55002012-01-01268
Total of all active and inactive participants2012-01-01268
Total participants2012-01-01268
2011: BCBS OF LA 2011 401k membership
Total participants, beginning-of-year2011-01-01223
Total number of active participants reported on line 7a of the Form 55002011-01-01222
Total of all active and inactive participants2011-01-01222
Total participants2011-01-01222
2008: BCBS OF LA 2008 401k membership
Total participants, beginning-of-year2008-11-01503
Total number of active participants reported on line 7a of the Form 55002008-11-01347
Total of all active and inactive participants2008-11-01347
Total participants2008-11-01347
2007: BCBS OF LA 2007 401k membership
Total participants, beginning-of-year2007-11-01401
Total number of active participants reported on line 7a of the Form 55002007-11-01503
Total of all active and inactive participants2007-11-01503
Total participants2007-11-01503
2006: BCBS OF LA 2006 401k membership
Total number of active participants reported on line 7a of the Form 55002006-11-01401
Total of all active and inactive participants2006-11-01401
Total participants2006-11-01401

Form 5500 Responses for BCBS OF LA

2013: BCBS OF LA 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingYes
2013-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: BCBS OF LA 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01First time form 5500 has been submittedYes
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: BCBS OF LA 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01First time form 5500 has been submittedYes
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2008: BCBS OF LA 2008 form 5500 responses
2008-11-01Type of plan entitySingle employer plan
2008-11-01First time form 5500 has been submittedYes
2008-11-01Submission has been amendedNo
2008-11-01This submission is the final filingNo
2008-11-01This return/report is a short plan year return/report (less than 12 months)No
2008-11-01Plan is a collectively bargained planNo
2008-11-01Plan funding arrangement – InsuranceYes
2008-11-01Plan funding arrangement – General assets of the sponsorYes
2008-11-01Plan benefit arrangement – InsuranceYes
2008-11-01Plan benefit arrangement – General assets of the sponsorYes
2007: BCBS OF LA 2007 form 5500 responses
2007-11-01Type of plan entitySingle employer plan
2007-11-01First time form 5500 has been submittedYes
2007-11-01Submission has been amendedNo
2007-11-01This submission is the final filingNo
2007-11-01This return/report is a short plan year return/report (less than 12 months)No
2007-11-01Plan is a collectively bargained planNo
2007-11-01Plan funding arrangement – InsuranceYes
2007-11-01Plan funding arrangement – General assets of the sponsorYes
2007-11-01Plan benefit arrangement – InsuranceYes
2007-11-01Plan benefit arrangement – General assets of the sponsorYes
2006: BCBS OF LA 2006 form 5500 responses
2006-11-01Type of plan entitySingle employer plan
2006-11-01First time form 5500 has been submittedYes
2006-11-01Submission has been amendedNo
2006-11-01This submission is the final filingNo
2006-11-01This return/report is a short plan year return/report (less than 12 months)No
2006-11-01Plan is a collectively bargained planNo
2006-11-01Plan funding arrangement – InsuranceYes
2006-11-01Plan funding arrangement – General assets of the sponsorYes
2006-11-01Plan benefit arrangement – InsuranceYes
2006-11-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78782ERC
Policy instance 1
Insurance contract or identification number78782ERC
Number of Individuals Covered541
Insurance policy start date2013-01-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $35,475
Total amount of fees paid to insurance companyUSD $41,449
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $4,923
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $21,730
Amount paid for insurance broker fees30770
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78782ERC
Policy instance 1
Insurance contract or identification number78782ERC
Number of Individuals Covered268
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $45,761
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,761
Insurance broker nameINTERGRATED INSURANCE SOLUTIONS
SOUTHERN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60009 )
Policy contract number78782ERC
Policy instance 2
Insurance contract or identification number78782ERC
Number of Individuals Covered254
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $585
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,066
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $585
Insurance broker nameINTEGRATED INSURANCE SOLUTIONS
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78782ERC
Policy instance 1
Insurance contract or identification number78782ERC
Number of Individuals Covered222
Insurance policy start date2011-01-01
Insurance policy end date2012-01-01
Total amount of commissions paid to insurance brokerUSD $44,112
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SOUTHERN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60009 )
Policy contract number78782ERC
Policy instance 2
Insurance contract or identification number78782ERC
Number of Individuals Covered222
Insurance policy start date2011-01-01
Insurance policy end date2012-01-01
Total amount of commissions paid to insurance brokerUSD $473
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $5,306
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78782ERC
Policy instance 1
Insurance contract or identification number78782ERC
Number of Individuals Covered204
Insurance policy start date2010-01-01
Insurance policy end date2011-01-01
Total amount of commissions paid to insurance brokerUSD $44,858
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,794,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SOUTHERN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60009 )
Policy contract number78782ERC
Policy instance 2
Insurance contract or identification number78782ERC
Number of Individuals Covered204
Insurance policy start date2010-01-01
Insurance policy end date2011-01-01
Total amount of commissions paid to insurance brokerUSD $477
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $5,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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