401k Plan data: EAGLE COMPLETIONS USA, LTD. plan

EAGLE COMPLETIONS USA, LTD. 401k Plan overview

Plan Name	EAGLE COMPLETIONS USA, LTD.
Plan identification number	501

EAGLE COMPLETIONS USA, LTD. 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) Other welfare benefit cover

401k Sponsoring company profile

EAGLE COMPLETIONS USA, LTD has sponsored the creation of one or more 401k plans.

Company Name: EAGLE COMPLETIONS USA, LTD

Employer identification number (EIN): 474320288

NAIC Classification: 332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EAGLE COMPLETIONS USA, LTD.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2019-03-01
501 2018-03-01 TRACEE DILLARD 2019-11-26
501 2018-03-01 MARTHA BERZOZA 2019-11-25

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2019-03-01
501	2018-03-01	TRACEE DILLARD	2019-11-26
501	2018-03-01	MARTHA BERZOZA	2019-11-25

Plan Statistics for EAGLE COMPLETIONS USA, LTD.

401k plan membership statisitcs for EAGLE COMPLETIONS USA, LTD.

Measure Date Value
2019: EAGLE COMPLETIONS USA, LTD. 2019 401k membership
Total participants, beginning-of-year 2019-03-01 74
Total number of active participants reported on line 7a of the Form 5500 2019-03-01 133
Number of retired or separated participants receiving benefits 2019-03-01 1
Number of other retired or separated participants entitled to future benefits 2019-03-01 13
Total of all active and inactive participants 2019-03-01 147
2018: EAGLE COMPLETIONS USA, LTD. 2018 401k membership
Total participants, beginning-of-year 2018-03-01 100
Total number of active participants reported on line 7a of the Form 5500 2018-03-01 118
Number of retired or separated participants receiving benefits 2018-03-01 0
Number of other retired or separated participants entitled to future benefits 2018-03-01 0
Total of all active and inactive participants 2018-03-01 118
Number of employers contributing to the scheme 2018-03-01 0

Measure	Date	Value
2019: EAGLE COMPLETIONS USA, LTD. 2019 401k membership
Total participants, beginning-of-year	2019-03-01	74
Total number of active participants reported on line 7a of the Form 5500	2019-03-01	133
Number of retired or separated participants receiving benefits	2019-03-01	1
Number of other retired or separated participants entitled to future benefits	2019-03-01	13
Total of all active and inactive participants	2019-03-01	147
2018: EAGLE COMPLETIONS USA, LTD. 2018 401k membership
Total participants, beginning-of-year	2018-03-01	100
Total number of active participants reported on line 7a of the Form 5500	2018-03-01	118
Number of retired or separated participants receiving benefits	2018-03-01	0
Number of other retired or separated participants entitled to future benefits	2018-03-01	0
Total of all active and inactive participants	2018-03-01	118
Number of employers contributing to the scheme	2018-03-01	0

Form 5500 Responses for EAGLE COMPLETIONS USA, LTD.

2019: EAGLE COMPLETIONS USA, LTD. 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 benefit arrangement – Insurance	Yes
2018: EAGLE COMPLETIONS USA, LTD. 2018 form 5500 responses
2018-03-01	Type of plan entity	Single employer plan
2018-03-01	First time form 5500 has been submitted	Yes
2018-03-01	Submission has been amended	Yes
2018-03-01	Plan funding arrangement – Insurance	Yes
2018-03-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

002676 292154

Policy instance

Insurance contract or identification number	002676 292154
Number of Individuals Covered	133
Insurance policy start date	2019-03-01
Insurance policy end date	2020-02-29
Total amount of commissions paid to insurance broker	USD $45,825
Total amount of fees paid to insurance company	USD $1,770
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	Yes
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
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 $959,251
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $43,803
Amount paid for insurance broker fees	1770
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00548483

Policy instance

Insurance contract or identification number	00548483
Number of Individuals Covered	45
Insurance policy start date	2019-03-01
Insurance policy end date	2020-02-29
Total amount of commissions paid to insurance broker	USD $10,680
Total amount of fees paid to insurance company	USD $4,390
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
Other welfare benefits provided	AD&D, SUPPLEMENTAL LIFE, DEPENDENT LIFE, SUPPLEMENTAL AD&D, DEPENDENT AD&D
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 $90,915
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,680
Amount paid for insurance broker fees	4390
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

2676

Policy instance

Insurance contract or identification number	2676
Number of Individuals Covered	109
Insurance policy start date	2018-03-01
Insurance policy end date	2019-02-28
Total amount of commissions paid to insurance broker	USD $56,638
Total amount of fees paid to insurance company	USD $1,410
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,143,462
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $56,638
Amount paid for insurance broker fees	1410
Additional information about fees paid to insurance broker	SPECIAL PROGRAMS
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

548483

Policy instance

Insurance contract or identification number	548483
Number of Individuals Covered	118
Insurance policy start date	2018-03-01
Insurance policy end date	2019-02-28
Total amount of commissions paid to insurance broker	USD $12,426
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $104,213
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,426
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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Company Name:	EAGLE COMPLETIONS USA, LTD
Employer identification number (EIN):	474320288
NAIC Classification:	332900