401k Plan data: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT plan

MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 401k Plan overview

Plan Name	MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT
Plan identification number	504

MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Temporary disability (accident and sickness) Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

MEWBOURNE OIL COMPANY has sponsored the creation of one or more 401k plans.

Company Name: MEWBOURNE OIL COMPANY

Employer identification number (EIN): 751254872

NAIC Classification: 211120
NAIC Description: Crude Petroleum Extraction

Additional information about MEWBOURNE OIL COMPANY

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1991-05-13

Company Identification Number: 0008758306

Legal Registered Office Address: PO BOX 7698

TYLER
United States of America (USA)
75711

More information about MEWBOURNE OIL COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2015-07-01 DREW GREENE
504 2014-07-01 DREW GREENE
504 2013-07-01 DREW GREENE
504 2012-07-01 JOSEPH ODOM JOSEPH ODOM 2014-01-17
504 2011-07-01 JOSEPH ODOM JOSEPH ODOM 2012-11-21
504 2011-03-26 JOSEPH ODOM JOSEPH ODOM 2012-02-17
504 2009-03-26 JOSEPH ODOM JOSEPH ODOM 2010-09-01

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
504	2015-07-01	DREW GREENE
504	2014-07-01	DREW GREENE
504	2013-07-01	DREW GREENE
504	2012-07-01	JOSEPH ODOM	JOSEPH ODOM	2014-01-17
504	2011-07-01	JOSEPH ODOM	JOSEPH ODOM	2012-11-21
504	2011-03-26	JOSEPH ODOM	JOSEPH ODOM	2012-02-17
504	2009-03-26	JOSEPH ODOM	JOSEPH ODOM	2010-09-01

Plan Statistics for MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT

401k plan membership statisitcs for MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT

Measure Date Value
2015: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2015 401k membership
Total participants, beginning-of-year 2015-07-01 393
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 0
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 0
2014: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2014 401k membership
Total participants, beginning-of-year 2014-07-01 358
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 405
Total of all active and inactive participants 2014-07-01 405
Total participants 2014-07-01 405
2013: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2013 401k membership
Total participants, beginning-of-year 2013-07-01 323
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 358
Total of all active and inactive participants 2013-07-01 358
Total participants 2013-07-01 358
2012: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2012 401k membership
Total participants, beginning-of-year 2012-07-01 281
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 323
Total of all active and inactive participants 2012-07-01 323
Total participants 2012-07-01 323
2011: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2011 401k membership
Total participants, beginning-of-year 2011-07-01 247
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 281
Total of all active and inactive participants 2011-07-01 281
Total participants 2011-07-01 281
Total participants, beginning-of-year 2011-03-26 247
Total number of active participants reported on line 7a of the Form 5500 2011-03-26 250
Total of all active and inactive participants 2011-03-26 250
Total participants 2011-03-26 250
2009: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2009 401k membership
Total participants, beginning-of-year 2009-03-26 173
Total number of active participants reported on line 7a of the Form 5500 2009-03-26 240
Total of all active and inactive participants 2009-03-26 240
Total participants 2009-03-26 240

Measure	Date	Value
2015: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2015 401k membership
Total participants, beginning-of-year	2015-07-01	393
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	0
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	0
2014: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2014 401k membership
Total participants, beginning-of-year	2014-07-01	358
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	405
Total of all active and inactive participants	2014-07-01	405
Total participants	2014-07-01	405
2013: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2013 401k membership
Total participants, beginning-of-year	2013-07-01	323
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	358
Total of all active and inactive participants	2013-07-01	358
Total participants	2013-07-01	358
2012: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2012 401k membership
Total participants, beginning-of-year	2012-07-01	281
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	323
Total of all active and inactive participants	2012-07-01	323
Total participants	2012-07-01	323
2011: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2011 401k membership
Total participants, beginning-of-year	2011-07-01	247
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	281
Total of all active and inactive participants	2011-07-01	281
Total participants	2011-07-01	281
Total participants, beginning-of-year	2011-03-26	247
Total number of active participants reported on line 7a of the Form 5500	2011-03-26	250
Total of all active and inactive participants	2011-03-26	250
Total participants	2011-03-26	250
2009: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2009 401k membership
Total participants, beginning-of-year	2009-03-26	173
Total number of active participants reported on line 7a of the Form 5500	2009-03-26	240
Total of all active and inactive participants	2009-03-26	240
Total participants	2009-03-26	240

Form 5500 Responses for MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT

2015: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	Yes
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2014: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2013: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2012: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2011: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2011-03-26	Type of plan entity	Single employer plan
2011-03-26	This return/report is a short plan year return/report (less than 12 months)	Yes
2011-03-26	Plan funding arrangement – Insurance	Yes
2011-03-26	Plan benefit arrangement – Insurance	Yes
2009: MEWBOURNE OIL COMPANY BUSINESS TRAVEL ACCIDENT 2009 form 5500 responses
2009-03-26	Type of plan entity	Single employer plan
2009-03-26	Plan funding arrangement – Insurance	Yes
2009-03-26	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

ETB012675

Policy instance

Insurance contract or identification number	ETB012675
Number of Individuals Covered	408
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $717
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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	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
Other welfare benefits provided	BUSINESS TRAVEL ACCIDENT
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 $4,778
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $717
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES, LLC

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

ETB012675

Policy instance

Insurance contract or identification number	ETB012675
Number of Individuals Covered	405
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $717
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,778
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $717
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES LLC

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

ETB012675

Policy instance

Insurance contract or identification number	ETB012675
Number of Individuals Covered	358
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $717
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,778
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

ETB012675

Policy instance

Insurance contract or identification number	ETB012675
Number of Individuals Covered	323
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $717
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,778
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $717
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES LLC

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

ETB-012675

Policy instance

Insurance contract or identification number	ETB-012675
Number of Individuals Covered	281
Insurance policy start date	2011-07-01
Insurance policy end date	3012-06-30
Total amount of commissions paid to insurance broker	USD $566
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,775

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

ETB-012675

Policy instance

Insurance contract or identification number	ETB-012675
Insurance policy start date	2011-03-26
Insurance policy end date	2011-06-30
Life Insurance Welfare Benefit	Yes

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

ETB-012675

Policy instance

Insurance contract or identification number	ETB-012675
Insurance policy start date	2010-03-26
Insurance policy end date	2011-03-25
Life Insurance Welfare Benefit	Yes

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Company Name:	MEWBOURNE OIL COMPANY
Employer identification number (EIN):	751254872
NAIC Classification:	211120
NAIC Description:	Crude Petroleum Extraction

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1991-05-13
Company Identification Number:	0008758306
Legal Registered Office Address:	PO BOX 7698 TYLER United States of America (USA) 75711