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GROVER GUNDRILLING GROUP HEALTH PLAN 401k Plan overview

Plan NameGROVER GUNDRILLING GROUP HEALTH PLAN
Plan identification number 501

GROVER GUNDRILLING GROUP HEALTH PLAN Benefits

401k Plan TypeWelfare 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
  • 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

GROVER GUNDRILLING, LLC has sponsored the creation of one or more 401k plans.

Company Name:GROVER GUNDRILLING, LLC
Employer identification number (EIN):800800225
NAIC Classification:332700

Additional information about GROVER GUNDRILLING, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 5129562

More information about GROVER GUNDRILLING, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROVER GUNDRILLING GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-01-01KIMBERLY VEILLEUX2019-07-30
5012017-01-01
5012016-01-01
5012015-01-01
5012015-01-01P. CHRISTIAN HESTER2016-07-27

Plan Statistics for GROVER GUNDRILLING GROUP HEALTH PLAN

401k plan membership statisitcs for GROVER GUNDRILLING GROUP HEALTH PLAN

Measure Date Value
2018: GROVER GUNDRILLING GROUP HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01117
Total number of active participants reported on line 7a of the Form 55002018-01-0139
Number of retired or separated participants receiving benefits2018-01-012
Number of other retired or separated participants entitled to future benefits2018-01-016
Total of all active and inactive participants2018-01-0147
2017: GROVER GUNDRILLING GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0189
Total number of active participants reported on line 7a of the Form 55002017-01-0166
Number of retired or separated participants receiving benefits2017-01-016
Number of other retired or separated participants entitled to future benefits2017-01-0145
Total of all active and inactive participants2017-01-01117
2016: GROVER GUNDRILLING GROUP HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01189
Total number of active participants reported on line 7a of the Form 55002016-01-01148
Total of all active and inactive participants2016-01-01148
2015: GROVER GUNDRILLING GROUP HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01271
Total number of active participants reported on line 7a of the Form 55002015-01-01189
Total of all active and inactive participants2015-01-01189

Form 5500 Responses for GROVER GUNDRILLING GROUP HEALTH PLAN

2018: GROVER GUNDRILLING GROUP HEALTH PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: GROVER GUNDRILLING GROUP HEALTH PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: GROVER GUNDRILLING GROUP HEALTH PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: GROVER GUNDRILLING GROUP HEALTH PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01First time form 5500 has been submittedYes
2015-01-01Submission has been amendedYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

ANTHEM HEALTH PLANS OF MAINE, INC. (National Association of Insurance Commissioners NAIC id number: 52618 )
Policy contract number00B967
Policy instance 1
Insurance contract or identification number00B967
Number of Individuals Covered88
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $11,275
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $619,632
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,400
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00547287
Policy instance 2
Insurance contract or identification number00547287
Number of Individuals Covered59
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,083
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,696
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,277
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number909878
Policy instance 3
Insurance contract or identification number909878
Number of Individuals Covered63
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,533
Total amount of fees paid to insurance companyUSD $308
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $20,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,515
Amount paid for insurance broker fees246
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number909879
Policy instance 4
Insurance contract or identification number909879
Number of Individuals Covered15
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $990
Total amount of fees paid to insurance companyUSD $76
Other welfare benefits providedLIFESTYLE AD&D, LIFESTYLE LIFE
Welfare Benefit Premiums Paid to CarrierUSD $4,600
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $495
Amount paid for insurance broker fees66
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number17484
Policy instance 1
Insurance contract or identification number17484
Number of Individuals Covered162
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,333
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,667
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,333
Insurance broker organization code?3
Insurance broker nameWOODROW W CROSS AGENCY
ANTHEM HEALTH PLANS OF MAINE, INC. (National Association of Insurance Commissioners NAIC id number: 52618 )
Policy contract number00B967
Policy instance 2
Insurance contract or identification number00B967
Number of Individuals Covered133
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $18,975
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $845,635
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,975
Insurance broker organization code?3
Insurance broker nameWOODROW W CROSS AGENCY
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30073851
Policy instance 3
Insurance contract or identification number30073851
Number of Individuals Covered66
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,147
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,147
Insurance broker organization code?3
Insurance broker nameCROSS FINANCIAL CORP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number909878
Policy instance 4
Insurance contract or identification number909878
Number of Individuals Covered96
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,140
Total amount of fees paid to insurance companyUSD $819
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $40,980
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,140
Amount paid for insurance broker fees819
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameCROSS INSURANCE

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