401k Plan data: SOUTHWEST GEORGIA OIL COMPANY WELFARE BENEFIT PLAN plan

SOUTHWEST GEORGIA OIL COMPANY WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	SOUTHWEST GEORGIA OIL COMPANY WELFARE BENEFIT PLAN
Plan identification number	501

SOUTHWEST GEORGIA OIL COMPANY 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 Other welfare benefit cover

401k Sponsoring company profile

SOUTHWEST GEORGIA OIL COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name: SOUTHWEST GEORGIA OIL COMPANY, INC.

Employer identification number (EIN): 580976116

NAIC Classification: 447100
NAIC Description: Gasoline Stations, Gas

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOUTHWEST GEORGIA OIL COMPANY WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-05-01 GLENNIE BENCH 2025-01-09 GLENNIE BENCH 2025-01-09
501 2022-05-01 GLENNIE BENCH 2024-02-06 GLENNIE BENCH 2024-02-06
501 2021-05-01 GLENNIE BENCH 2023-02-01 GLENNIE BENCH 2023-02-01
501 2020-05-01 GLENNIE BENCH 2022-02-08 GLENNIE BENCH 2022-02-08
501 2019-05-01 GLENNIE BENCH 2021-02-01 GLENNIE BENCH 2021-02-01
501 2018-05-01
501 2017-05-01 CANITA GUNTER PETERSON
501 2016-05-01
501 2015-05-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-05-01	GLENNIE BENCH	2025-01-09	GLENNIE BENCH	2025-01-09
501	2022-05-01	GLENNIE BENCH	2024-02-06	GLENNIE BENCH	2024-02-06
501	2021-05-01	GLENNIE BENCH	2023-02-01	GLENNIE BENCH	2023-02-01
501	2020-05-01	GLENNIE BENCH	2022-02-08	GLENNIE BENCH	2022-02-08
501	2019-05-01	GLENNIE BENCH	2021-02-01	GLENNIE BENCH	2021-02-01
501	2018-05-01
501	2017-05-01	CANITA GUNTER PETERSON
501	2016-05-01
501	2015-05-01

Form 5500 Responses for SOUTHWEST GEORGIA OIL COMPANY WELFARE BENEFIT PLAN

2023: SOUTHWEST GEORGIA OIL COMPANY WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-05-01	Type of plan entity	Single employer plan
2023-05-01	Plan funding arrangement – Insurance	Yes
2023-05-01	Plan benefit arrangement – Insurance	Yes
2022: SOUTHWEST GEORGIA OIL COMPANY WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-05-01	Type of plan entity	Single employer plan
2022-05-01	Plan funding arrangement – Insurance	Yes
2022-05-01	Plan benefit arrangement – Insurance	Yes
2021: SOUTHWEST GEORGIA OIL COMPANY WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-05-01	Type of plan entity	Single employer plan
2021-05-01	Plan funding arrangement – Insurance	Yes
2021-05-01	Plan benefit arrangement – Insurance	Yes
2020: SOUTHWEST GEORGIA OIL COMPANY WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-05-01	Type of plan entity	Single employer plan
2020-05-01	Plan funding arrangement – Insurance	Yes
2020-05-01	Plan benefit arrangement – Insurance	Yes
2019: SOUTHWEST GEORGIA OIL COMPANY WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-05-01	Type of plan entity	Single employer plan
2019-05-01	Plan funding arrangement – Insurance	Yes
2019-05-01	Plan benefit arrangement – Insurance	Yes
2018: SOUTHWEST GEORGIA OIL COMPANY WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-05-01	Type of plan entity	Single employer plan
2018-05-01	Plan funding arrangement – Insurance	Yes
2018-05-01	Plan benefit arrangement – Insurance	Yes
2017: SOUTHWEST GEORGIA OIL COMPANY WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-05-01	Type of plan entity	Single employer plan
2017-05-01	Plan funding arrangement – Insurance	Yes
2017-05-01	Plan benefit arrangement – Insurance	Yes
2016: SOUTHWEST GEORGIA OIL COMPANY WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-05-01	Type of plan entity	Single employer plan
2016-05-01	Plan funding arrangement – Insurance	Yes
2016-05-01	Plan benefit arrangement – Insurance	Yes
2015: SOUTHWEST GEORGIA OIL COMPANY WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-05-01	Type of plan entity	Single employer plan
2015-05-01	Plan funding arrangement – Insurance	Yes
2015-05-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

306251

Policy instance

Insurance contract or identification number	306251
Number of Individuals Covered	234
Insurance policy start date	2023-05-01
Insurance policy end date	2024-04-30
Total amount of commissions paid to insurance broker	USD $18,940
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $177,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

417009413956

Policy instance

Insurance contract or identification number	417009413956
Number of Individuals Covered	231
Insurance policy start date	2023-05-01
Insurance policy end date	2024-04-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $310,981
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

00549530

Policy instance

Insurance contract or identification number	00549530
Number of Individuals Covered	274
Insurance policy start date	2023-05-01
Insurance policy end date	2024-04-30
Total amount of commissions paid to insurance broker	USD $28,281
Total amount of fees paid to insurance company	USD $1,967
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENT, VOL CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $202,138
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

306251

Policy instance

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

417009413956

Policy instance

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

Policy contract number

00549530

Policy instance

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

Policy contract number

00549530

Policy instance

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

417009413956

Policy instance

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

306251

Policy instance

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

306251

Policy instance

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

HCL34756

Policy instance

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

Policy contract number

00549530

Policy instance

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

306251

Policy instance

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

417002413956

Policy instance

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

Policy contract number

00549530

Policy instance

BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )

Policy contract number

GA7890

Policy instance

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

Policy contract number

00549530

Policy instance

GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )

Policy contract number

GA3006

Policy instance

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )

Policy contract number

GA7890

Policy instance

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

24187

Policy instance

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

24177

Policy instance

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )

Policy contract number

GA3006

Policy instance

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )

Policy contract number

GA7890

Policy instance

BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )

Policy contract number

GA 7890

Policy instance

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

24181

Policy instance

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Company Name:	SOUTHWEST GEORGIA OIL COMPANY, INC.
Employer identification number (EIN):	580976116
NAIC Classification:	447100
NAIC Description:	Gasoline Stations, Gas