401k Plan data: ASPEN EARTHWORKS AND COMPANY EMPLOYEE BENEFITS PLAN plan

ASPEN EARTHWORKS AND COMPANY EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan Name	ASPEN EARTHWORKS AND COMPANY EMPLOYEE BENEFITS PLAN
Plan identification number	501

ASPEN EARTHWORKS AND COMPANY EMPLOYEE BENEFITS PLAN 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)

401k Sponsoring company profile

ASPEN EARTHWORKS, INC. has sponsored the creation of one or more 401k plans.

Company Name: ASPEN EARTHWORKS, INC.

Employer identification number (EIN): 465044355

NAIC Classification: 238900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASPEN EARTHWORKS AND COMPANY EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-07-01 BRANDON MUSICANT 2024-12-12

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-07-01	BRANDON MUSICANT	2024-12-12

Plan Statistics for ASPEN EARTHWORKS AND COMPANY EMPLOYEE BENEFITS PLAN

401k plan membership statisitcs for ASPEN EARTHWORKS AND COMPANY EMPLOYEE BENEFITS PLAN

Measure Date Value
2023: ASPEN EARTHWORKS AND COMPANY EMPLOYEE BENEFITS PLAN 2023 401k membership
Total participants, beginning-of-year 2023-07-01 161
Total number of active participants reported on line 7a of the Form 5500 2023-07-01 174
Number of retired or separated participants receiving benefits 2023-07-01 0
Number of other retired or separated participants entitled to future benefits 2023-07-01 0
Total of all active and inactive participants 2023-07-01 174
Number of employers contributing to the scheme 2023-07-01 0

Measure	Date	Value
2023: ASPEN EARTHWORKS AND COMPANY EMPLOYEE BENEFITS PLAN 2023 401k membership
Total participants, beginning-of-year	2023-07-01	161
Total number of active participants reported on line 7a of the Form 5500	2023-07-01	174
Number of retired or separated participants receiving benefits	2023-07-01	0
Number of other retired or separated participants entitled to future benefits	2023-07-01	0
Total of all active and inactive participants	2023-07-01	174
Number of employers contributing to the scheme	2023-07-01	0

Form 5500 Responses for ASPEN EARTHWORKS AND COMPANY EMPLOYEE BENEFITS PLAN

2023: ASPEN EARTHWORKS AND COMPANY EMPLOYEE BENEFITS PLAN 2023 form 5500 responses
2023-07-01	Type of plan entity	Single employer plan
2023-07-01	First time form 5500 has been submitted	Yes
2023-07-01	Plan funding arrangement – Insurance	Yes
2023-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )

Policy contract number

L08528

Policy instance

Insurance contract or identification number	L08528
Number of Individuals Covered	143
Insurance policy start date	2023-07-01
Insurance policy end date	2024-06-30
Total amount of commissions paid to insurance broker	USD $24,226
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $536,063
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )

Policy contract number

CM10002589

Policy instance

Insurance contract or identification number	CM10002589
Number of Individuals Covered	174
Insurance policy start date	2024-04-01
Insurance policy end date	2024-06-30
Total amount of commissions paid to insurance broker	USD $179
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $1,847
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )

Policy contract number

CM10002589

Policy instance

Insurance contract or identification number	CM10002589
Number of Individuals Covered	161
Insurance policy start date	2023-07-01
Insurance policy end date	2024-03-31
Total amount of commissions paid to insurance broker	USD $520
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $5,797
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	ASPEN EARTHWORKS, INC.
Employer identification number (EIN):	465044355
NAIC Classification:	238900