401k Plan data: NAILL SERVICES, INC. AND WELLSITE SERVICES, INC. WELFARE BENEFIT PLAN plan

NAILL SERVICES, INC. AND WELLSITE SERVICES, INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	NAILL SERVICES, INC. AND WELLSITE SERVICES, INC. WELFARE BENEFIT PLAN
Plan identification number	501

NAILL SERVICES, INC. AND WELLSITE SERVICES, INC. WELFARE 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 Death benefits (include travel accident but not life insurance) 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

NAILL SERVICES, INC. AND WELLSITE SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: NAILL SERVICES, INC. AND WELLSITE SERVICES, INC.

Employer identification number (EIN): 450510224

NAIC Classification: 211120
NAIC Description: Crude Petroleum Extraction

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NAILL SERVICES, INC. AND WELLSITE SERVICES, INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-03-01 LINDA KAMMERZELL 2021-07-07
501 2019-03-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2020-03-01	LINDA KAMMERZELL	2021-07-07
501	2019-03-01

Plan Statistics for NAILL SERVICES, INC. AND WELLSITE SERVICES, INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for NAILL SERVICES, INC. AND WELLSITE SERVICES, INC. WELFARE BENEFIT PLAN

Measure Date Value
2020: NAILL SERVICES, INC. AND WELLSITE SERVICES, INC. WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-03-01 127
Total number of active participants reported on line 7a of the Form 5500 2020-03-01 59
Number of retired or separated participants receiving benefits 2020-03-01 0
Number of other retired or separated participants entitled to future benefits 2020-03-01 0
Total of all active and inactive participants 2020-03-01 59
Number of employers contributing to the scheme 2020-03-01 0
2019: NAILL SERVICES, INC. AND WELLSITE SERVICES, INC. WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-03-01 129
Total number of active participants reported on line 7a of the Form 5500 2019-03-01 125
Number of retired or separated participants receiving benefits 2019-03-01 2
Number of other retired or separated participants entitled to future benefits 2019-03-01 0
Total of all active and inactive participants 2019-03-01 127

Measure	Date	Value
2020: NAILL SERVICES, INC. AND WELLSITE SERVICES, INC. WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-03-01	127
Total number of active participants reported on line 7a of the Form 5500	2020-03-01	59
Number of retired or separated participants receiving benefits	2020-03-01	0
Number of other retired or separated participants entitled to future benefits	2020-03-01	0
Total of all active and inactive participants	2020-03-01	59
Number of employers contributing to the scheme	2020-03-01	0
2019: NAILL SERVICES, INC. AND WELLSITE SERVICES, INC. WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-03-01	129
Total number of active participants reported on line 7a of the Form 5500	2019-03-01	125
Number of retired or separated participants receiving benefits	2019-03-01	2
Number of other retired or separated participants entitled to future benefits	2019-03-01	0
Total of all active and inactive participants	2019-03-01	127

Form 5500 Responses for NAILL SERVICES, INC. AND WELLSITE SERVICES, INC. WELFARE BENEFIT PLAN

2020: NAILL SERVICES, INC. AND WELLSITE SERVICES, INC. WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-03-01	Type of plan entity	Single employer plan
2020-03-01	Plan funding arrangement – Insurance	Yes
2020-03-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-03-01	Plan benefit arrangement – Insurance	Yes
2020-03-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: NAILL SERVICES, INC. AND WELLSITE SERVICES, INC. WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-03-01	Type of plan entity	Single employer plan
2019-03-01	Submission has been amended	No
2019-03-01	This submission is the final filing	No
2019-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-03-01	Plan is a collectively bargained plan	No
2019-03-01	Plan funding arrangement – Insurance	Yes
2019-03-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-03-01	Plan benefit arrangement – Insurance	Yes
2019-03-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

166261

Policy instance

Insurance contract or identification number	166261
Number of Individuals Covered	59
Insurance policy start date	2020-03-01
Insurance policy end date	2021-02-28
Total amount of commissions paid to insurance broker	USD $4,433
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $38,193
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,433
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

VDT601982

Policy instance

Insurance contract or identification number	VDT601982
Number of Individuals Covered	17
Insurance policy start date	2019-03-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $417
Total amount of fees paid to insurance company	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,394
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $417
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

VDT601981

Policy instance

Insurance contract or identification number	VDT601981
Number of Individuals Covered	21
Insurance policy start date	2019-03-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $328
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,279
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $328
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SOK605960

Policy instance

Insurance contract or identification number	SOK605960
Number of Individuals Covered	122
Insurance policy start date	2019-03-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $234
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $2,343
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $234
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM608157

Policy instance

Insurance contract or identification number	SGM608157
Number of Individuals Covered	122
Insurance policy start date	2019-03-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $739
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,387
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $739
Insurance broker organization code?	3

Potentially related plans

NAILL SERVICES, INC. AND WELLSITE SERVICES, INC. WELFARE BENEFIT PLAN [EIN = 462375864]

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Company Name:	NAILL SERVICES, INC. AND WELLSITE SERVICES, INC.
Employer identification number (EIN):	450510224
NAIC Classification:	211120
NAIC Description:	Crude Petroleum Extraction