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| Plan Name | MIDTEX OIL, LP CRITICAL ILLNESS BENEFIT PLAN |
| Plan identification number | 506 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | MIDTEX OIL, LP |
| Employer identification number (EIN): | 741864941 |
| NAIC Classification: | 424720 |
| NAIC Description: | Petroleum and Petroleum Products Merchant Wholesalers (except Bulk Stations and Terminals) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 506 | 2022-05-01 | ||||
| 506 | 2022-05-01 | TAMARA BLACK |
| 2022: MIDTEX OIL, LP CRITICAL ILLNESS BENEFIT PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-05-01 | Type of plan entity | Single employer plan |
| 2022-05-01 | Submission has been amended | No |
| 2022-05-01 | This submission is the final filing | Yes |
| 2022-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-05-01 | Plan is a collectively bargained plan | No |
| 2022-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-05-01 | Plan benefit arrangement – Insurance | Yes |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F025599 |
| Policy instance | 1 |
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