| Plan Name | POWER SERVICE EMPLOYEE BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | POWER SERVICE, INC. |
| Employer identification number (EIN): | 830176022 |
| NAIC Classification: | 423800 |
Additional information about POWER SERVICE, INC.
| Jurisdiction of Incorporation: | Wyoming Corporations Division |
| Incorporation Date: | 1954-07-30 |
| Company Identification Number: | 000065118 |
| Legal Registered Office Address: |
5625 Chapman Pl Casper United States of America (USA) 82604 |
More information about POWER SERVICE, INC.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2016-01-01 | JEFF TULLOS | |||
| 501 | 2015-01-01 | TONY CERCY | TONY CERCY | 2016-04-05 | |
| 501 | 2015-01-01 | TONY CERCY | TONY CERCY | 2016-04-28 | |
| 501 | 2014-01-01 | TONY CERCY | TONY CERCY | 2016-04-28 | |
| 501 | 2014-01-01 | TONY CERCY | TONY CERCY | 2016-04-05 | |
| 501 | 2013-01-01 | TONY CERCY | TONY CERCY | 2016-04-28 |
| 2016: POWER SERVICE EMPLOYEE BENEFIT PLAN 2016 form 5500 responses | ||
|---|---|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | Yes |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: POWER SERVICE EMPLOYEE BENEFIT PLAN 2015 form 5500 responses | ||
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | Yes |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: POWER SERVICE EMPLOYEE BENEFIT PLAN 2014 form 5500 responses | ||
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | Yes |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: POWER SERVICE EMPLOYEE BENEFIT PLAN 2013 form 5500 responses | ||
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | First time form 5500 has been submitted | Yes |
| 2013-01-01 | Submission has been amended | Yes |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |
| Policy contract number | 00607353 |
| Policy instance | 1 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00421650 |
| Policy instance | 2 |
| DELTA DENTAL OF WYOMING (National Association of Insurance Commissioners NAIC id number: 15200 ) | |
| Policy contract number | 548 |
| Policy instance | 3 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00421650 |
| Policy instance | 2 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |
| Policy contract number | 00607353 |
| Policy instance | 1 |
| DELTA DENTAL OF WYOMING (National Association of Insurance Commissioners NAIC id number: 15200 ) | |
| Policy contract number | 548 |
| Policy instance | 3 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00421650 |
| Policy instance | 2 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |
| Policy contract number | 00607353 |
| Policy instance | 1 |
| DELTA DENTAL OF WYOMING (National Association of Insurance Commissioners NAIC id number: 15200 ) | |
| Policy contract number | 548 |
| Policy instance | 3 |