401k Plan data: FINLEY RESOURCES INC. MEDICAL plan

FINLEY RESOURCES INC. MEDICAL 401k Plan overview

Plan Name	FINLEY RESOURCES INC. MEDICAL
Plan identification number	501

FINLEY RESOURCES INC. MEDICAL Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

FINLEY RESOURCES INC. has sponsored the creation of one or more 401k plans.

Company Name: FINLEY RESOURCES INC.

Employer identification number (EIN): 752510032

NAIC Classification: 211130
NAIC Description: Natural Gas Extraction

Additional information about FINLEY RESOURCES INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1993-09-20

Company Identification Number: 0128506900

Legal Registered Office Address: 1308 LAKE ST STE 200

FORT WORTH
United States of America (USA)
76102

More information about FINLEY RESOURCES INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FINLEY RESOURCES INC. MEDICAL

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2015-09-01
501 2014-09-01

Plan Statistics for FINLEY RESOURCES INC. MEDICAL

401k plan membership statisitcs for FINLEY RESOURCES INC. MEDICAL

Measure Date Value
2015: FINLEY RESOURCES INC. MEDICAL 2015 401k membership
Total participants, beginning-of-year 2015-09-01 0
Total number of active participants reported on line 7a of the Form 5500 2015-09-01 0
Number of retired or separated participants receiving benefits 2015-09-01 0
Number of other retired or separated participants entitled to future benefits 2015-09-01 0
Total of all active and inactive participants 2015-09-01 0
2014: FINLEY RESOURCES INC. MEDICAL 2014 401k membership
Total participants, beginning-of-year 2014-09-01 101
Total number of active participants reported on line 7a of the Form 5500 2014-09-01 84
Number of retired or separated participants receiving benefits 2014-09-01 1
Number of other retired or separated participants entitled to future benefits 2014-09-01 0
Total of all active and inactive participants 2014-09-01 85

Measure	Date	Value
2015: FINLEY RESOURCES INC. MEDICAL 2015 401k membership
Total participants, beginning-of-year	2015-09-01	0
Total number of active participants reported on line 7a of the Form 5500	2015-09-01	0
Number of retired or separated participants receiving benefits	2015-09-01	0
Number of other retired or separated participants entitled to future benefits	2015-09-01	0
Total of all active and inactive participants	2015-09-01	0
2014: FINLEY RESOURCES INC. MEDICAL 2014 401k membership
Total participants, beginning-of-year	2014-09-01	101
Total number of active participants reported on line 7a of the Form 5500	2014-09-01	84
Number of retired or separated participants receiving benefits	2014-09-01	1
Number of other retired or separated participants entitled to future benefits	2014-09-01	0
Total of all active and inactive participants	2014-09-01	85

Form 5500 Responses for FINLEY RESOURCES INC. MEDICAL

2015: FINLEY RESOURCES INC. MEDICAL 2015 form 5500 responses
2015-09-01	Type of plan entity	Single employer plan
2015-09-01	Submission has been amended	No
2015-09-01	This submission is the final filing	Yes
2015-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-09-01	Plan is a collectively bargained plan	No
2015-09-01	Plan funding arrangement – Insurance	Yes
2015-09-01	Plan benefit arrangement – Insurance	Yes
2014: FINLEY RESOURCES INC. MEDICAL 2014 form 5500 responses
2014-09-01	Type of plan entity	Single employer plan
2014-09-01	First time form 5500 has been submitted	Yes
2014-09-01	Submission has been amended	No
2014-09-01	This submission is the final filing	No
2014-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-09-01	Plan is a collectively bargained plan	No
2014-09-01	Plan funding arrangement – Insurance	Yes
2014-09-01	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

110442

Policy instance

Insurance contract or identification number	110442
Number of Individuals Covered	199
Insurance policy start date	2014-09-01
Insurance policy end date	2015-08-31
Total amount of commissions paid to insurance broker	USD $74,939
Total amount of fees paid to insurance company	USD $828
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	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 $1,208,949
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $59,567
Amount paid for insurance broker fees	828
Additional information about fees paid to insurance broker	SPECIAL PROGRAMS
Insurance broker organization code?	3
Insurance broker name	CENTERSTONE INS & FINANCIAL SRVS

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Company Name:	FINLEY RESOURCES INC.
Employer identification number (EIN):	752510032
NAIC Classification:	211130
NAIC Description:	Natural Gas Extraction

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1993-09-20
Company Identification Number:	0128506900
Legal Registered Office Address:	1308 LAKE ST STE 200 FORT WORTH United States of America (USA) 76102