401k Plan data: DOUBLE EAGLE ENERGY OPERATING III LLC WRAP PLAN plan

DOUBLE EAGLE ENERGY OPERATING III LLC WRAP PLAN 401k Plan overview

Plan Name	DOUBLE EAGLE ENERGY OPERATING III LLC WRAP PLAN
Plan identification number	501

DOUBLE EAGLE ENERGY OPERATING III LLC WRAP PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Other welfare benefit cover 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.

401k Sponsoring company profile

DOUBLE EAGLE ENERGY OPERATING III LLC has sponsored the creation of one or more 401k plans.

Company Name: DOUBLE EAGLE ENERGY OPERATING III LLC

Employer identification number (EIN): 821109123

NAIC Classification: 211120
NAIC Description: Crude Petroleum Extraction

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DOUBLE EAGLE ENERGY OPERATING III LLC WRAP PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-07-01

Plan Statistics for DOUBLE EAGLE ENERGY OPERATING III LLC WRAP PLAN

401k plan membership statisitcs for DOUBLE EAGLE ENERGY OPERATING III LLC WRAP PLAN

Measure Date Value
2020: DOUBLE EAGLE ENERGY OPERATING III LLC WRAP PLAN 2020 401k membership
Total participants, beginning-of-year 2020-07-01 110
Total number of active participants reported on line 7a of the Form 5500 2020-07-01 72
Number of retired or separated participants receiving benefits 2020-07-01 8
Total of all active and inactive participants 2020-07-01 80
Total participants 2020-07-01 80

Measure	Date	Value
2020: DOUBLE EAGLE ENERGY OPERATING III LLC WRAP PLAN 2020 401k membership
Total participants, beginning-of-year	2020-07-01	110
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	72
Number of retired or separated participants receiving benefits	2020-07-01	8
Total of all active and inactive participants	2020-07-01	80
Total participants	2020-07-01	80

Form 5500 Responses for DOUBLE EAGLE ENERGY OPERATING III LLC WRAP PLAN

2020: DOUBLE EAGLE ENERGY OPERATING III LLC WRAP PLAN 2020 form 5500 responses
2020-07-01	Type of plan entity	Single employer plan
2020-07-01	First time form 5500 has been submitted	Yes
2020-07-01	Submission has been amended	No
2020-07-01	This submission is the final filing	No
2020-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-07-01	Plan is a collectively bargained plan	No
2020-07-01	Plan funding arrangement – Insurance	Yes
2020-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-07-01	Plan benefit arrangement – Insurance	Yes
2020-07-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1094924

Policy instance

Insurance contract or identification number	1094924
Number of Individuals Covered	358
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $24,399
Total amount of fees paid to insurance company	USD $1,612
Are there contracts with allocated funds for individual policies?	0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
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
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 Carrier	USD $157,922
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $17,529
Amount paid for insurance broker fees	-48
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

KUT77

Policy instance

Insurance contract or identification number	KUT77
Number of Individuals Covered	39
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $18,472
Total amount of fees paid to insurance company	USD $199
Are there contracts with allocated funds for individual policies?	0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	WORKSITE BENEFITS
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 Carrier	USD $45,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,597
Amount paid for insurance broker fees	117
Additional information about fees paid to insurance broker	FEES PAID
Insurance broker organization code?	3

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Company Name:	DOUBLE EAGLE ENERGY OPERATING III LLC
Employer identification number (EIN):	821109123
NAIC Classification:	211120
NAIC Description:	Crude Petroleum Extraction