401k Plan data: TITAN OILFIELD SERVICE, LLC GROUP BENEFIT PLAN plan

TITAN OILFIELD SERVICE, LLC GROUP BENEFIT PLAN 401k Plan overview

Plan Name	TITAN OILFIELD SERVICE, LLC GROUP BENEFIT PLAN
Plan identification number	501

TITAN OILFIELD SERVICE, LLC GROUP BENEFIT PLAN Benefits

401k Plan Type

Welfare Benefit

Plan Features/Benefits

Health (other than dental or vision)
Life insurance
Dental
Vision
Temporary disability (accident and sickness)
Long-term disability 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.
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

TITAN ENERGY SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name: TITAN ENERGY SERVICES, LLC

Employer identification number (EIN): 274832465

NAIC Classification: 211120
NAIC Description: Crude Petroleum Extraction

Additional information about TITAN ENERGY SERVICES, LLC

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division

Incorporation Date: 2011-02-08

Company Identification Number: 603084590

Legal Registered Office Address: 901 5TH AVE STE 3500

SEATTLE
United States of America (USA)
981642059

More information about TITAN ENERGY SERVICES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TITAN OILFIELD SERVICE, LLC GROUP BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-01-01 REBECCA HOWE 2021-06-23 REBECCA HOWE 2021-06-23
501 2019-01-01 PATTY HAUKENBERRY 2020-07-21 PATTY HAUKENBERRY 2020-07-21
501 2017-05-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2020-01-01	REBECCA HOWE	2021-06-23	REBECCA HOWE	2021-06-23
501	2019-01-01	PATTY HAUKENBERRY	2020-07-21	PATTY HAUKENBERRY	2020-07-21
501	2017-05-01

Plan Statistics for TITAN OILFIELD SERVICE, LLC GROUP BENEFIT PLAN

401k plan membership statisitcs for TITAN OILFIELD SERVICE, LLC GROUP BENEFIT PLAN

Measure Date Value
2020: TITAN OILFIELD SERVICE, LLC GROUP BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 286
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 113
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 113
2019: TITAN OILFIELD SERVICE, LLC GROUP BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 286
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 286
2017: TITAN OILFIELD SERVICE, LLC GROUP BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-05-01 100
Total number of active participants reported on line 7a of the Form 5500 2017-05-01 228
Number of retired or separated participants receiving benefits 2017-05-01 0
Number of other retired or separated participants entitled to future benefits 2017-05-01 0
Total of all active and inactive participants 2017-05-01 228

Measure	Date	Value
2020: TITAN OILFIELD SERVICE, LLC GROUP BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	286
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	113
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	113
2019: TITAN OILFIELD SERVICE, LLC GROUP BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	286
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	286
2017: TITAN OILFIELD SERVICE, LLC GROUP BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-05-01	100
Total number of active participants reported on line 7a of the Form 5500	2017-05-01	228
Number of retired or separated participants receiving benefits	2017-05-01	0
Number of other retired or separated participants entitled to future benefits	2017-05-01	0
Total of all active and inactive participants	2017-05-01	228

Form 5500 Responses for TITAN OILFIELD SERVICE, LLC GROUP BENEFIT PLAN

2020: TITAN OILFIELD SERVICE, LLC GROUP BENEFIT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: TITAN OILFIELD SERVICE, LLC GROUP BENEFIT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2017: TITAN OILFIELD SERVICE, LLC GROUP BENEFIT PLAN 2017 form 5500 responses
2017-05-01	Type of plan entity	Single employer plan
2017-05-01	First time form 5500 has been submitted	Yes
2017-05-01	Plan funding arrangement – Insurance	Yes
2017-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-05-01	Plan benefit arrangement – Insurance	Yes
2017-05-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

471764

Policy instance

Insurance contract or identification number	471764
Number of Individuals Covered	40
Insurance policy start date	2020-01-01
Insurance policy end date	2021-01-01
Total amount of commissions paid to insurance broker	USD $2,363
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,363
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

211568

Policy instance

Insurance contract or identification number	211568
Number of Individuals Covered	45
Insurance policy start date	2020-01-01
Insurance policy end date	2021-01-01
Total amount of commissions paid to insurance broker	USD $1,061
Total amount of fees paid to insurance company	USD $1,959
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ADD
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1959
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $1,061

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

252998

Policy instance

Insurance contract or identification number	252998
Number of Individuals Covered	113
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $694
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	694
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

252998

Policy instance

Insurance contract or identification number	252998
Number of Individuals Covered	113
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,388
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1388
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

252998

Policy instance

Insurance contract or identification number	252998
Number of Individuals Covered	113
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $6,930
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	6930
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

471764

Policy instance

Insurance contract or identification number	471764
Number of Individuals Covered	100
Insurance policy start date	2019-01-01
Insurance policy end date	2020-01-01
Total amount of commissions paid to insurance broker	USD $3,159
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,371
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

211568

Policy instance

Insurance contract or identification number	211568
Number of Individuals Covered	119
Insurance policy start date	2019-01-01
Insurance policy end date	2020-01-01
Total amount of commissions paid to insurance broker	USD $2,218
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ADD
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,554
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

252998

Policy instance

Insurance contract or identification number	252998
Number of Individuals Covered	286
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,317
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1317
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

252998

Policy instance

Insurance contract or identification number	252998
Number of Individuals Covered	286
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,634
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	2634
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

252998

Policy instance

Insurance contract or identification number	252998
Number of Individuals Covered	286
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $13,170
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	13170
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

76658

Policy instance

Insurance contract or identification number	76658
Number of Individuals Covered	227
Insurance policy start date	2017-05-01
Insurance policy end date	2018-04-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

76658

Policy instance

Insurance contract or identification number	76658
Number of Individuals Covered	228
Insurance policy start date	2017-05-01
Insurance policy end date	2018-04-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

76658

Policy instance

Insurance contract or identification number	76658
Number of Individuals Covered	225
Insurance policy start date	2017-05-01
Insurance policy end date	2018-04-30
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

TITAN OILFIELD SERVICES, INC. 401(K) PLAN [EIN = 452857521]

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Company Name:	TITAN ENERGY SERVICES, LLC
Employer identification number (EIN):	274832465
NAIC Classification:	211120
NAIC Description:	Crude Petroleum Extraction

Jurisdiction of Incorporation:	Washington Secretary of State Corporations Division
Incorporation Date:	2011-02-08
Company Identification Number:	603084590
Legal Registered Office Address:	901 5TH AVE STE 3500 SEATTLE United States of America (USA) 981642059