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| Plan Name | COVEY PARK EMPLOYMENT MANAGEMENT SERVICES LLC LIFE & DISABILITY PLAN |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | COVEY PARK EMPLOYMENT SERVICES LLC |
| Employer identification number (EIN): | 473867212 |
| NAIC Classification: | 211130 |
| NAIC Description: | Natural Gas Extraction |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2019-01-01 | ||||
| 503 | 2018-01-01 | ||||
| 503 | 2017-01-01 |
| Measure | Date | Value |
|---|---|---|
| 2019: COVEY PARK EMPLOYMENT MANAGEMENT SERVICES LLC LIFE & DISABILITY PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-01-01 | 183 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 0 |
| 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 | 0 |
| 2018: COVEY PARK EMPLOYMENT MANAGEMENT SERVICES LLC LIFE & DISABILITY PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-01-01 | 177 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 183 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 183 |
| Number of employers contributing to the scheme | 2018-01-01 | 0 |
| 2017: COVEY PARK EMPLOYMENT MANAGEMENT SERVICES LLC LIFE & DISABILITY PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-01-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 177 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 177 |
| 2019: COVEY PARK EMPLOYMENT MANAGEMENT SERVICES LLC LIFE & DISABILITY PLAN 2019 form 5500 responses | ||
|---|---|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | This submission is the final filing | Yes |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: COVEY PARK EMPLOYMENT MANAGEMENT SERVICES LLC LIFE & DISABILITY PLAN 2018 form 5500 responses | ||
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: COVEY PARK EMPLOYMENT MANAGEMENT SERVICES LLC LIFE & DISABILITY PLAN 2017 form 5500 responses | ||
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | First time form 5500 has been submitted | Yes |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 61796 | ||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||
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| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | GLUG0B4WW | ||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||
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| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | GUG0B4WW | ||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||
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