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ROCKY MOUNTAIN WIRELINE SERVICE, INC. MEDICAL AND DENTAL PLAN 401k Plan overview

Plan NameROCKY MOUNTAIN WIRELINE SERVICE, INC. MEDICAL AND DENTAL PLAN
Plan identification number 501

ROCKY MOUNTAIN WIRELINE SERVICE, INC. MEDICAL AND DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • 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

ROCKY MOUNTAIN WIRELINE SERVICE, INC. has sponsored the creation of one or more 401k plans.

Company Name:ROCKY MOUNTAIN WIRELINE SERVICE, INC.
Employer identification number (EIN):841079944
NAIC Classification:211120
NAIC Description:Crude Petroleum Extraction

Additional information about ROCKY MOUNTAIN WIRELINE SERVICE, INC.

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 1988-03-01
Company Identification Number: 19881009445
Legal Registered Office Address: 2144 Highway 6 and 50

Grand Junction
United States of America (USA)
81505-9404

More information about ROCKY MOUNTAIN WIRELINE SERVICE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROCKY MOUNTAIN WIRELINE SERVICE, INC. MEDICAL AND DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012015-01-01KAREN EWALL

Plan Statistics for ROCKY MOUNTAIN WIRELINE SERVICE, INC. MEDICAL AND DENTAL PLAN

401k plan membership statisitcs for ROCKY MOUNTAIN WIRELINE SERVICE, INC. MEDICAL AND DENTAL PLAN

Measure Date Value
2015: ROCKY MOUNTAIN WIRELINE SERVICE, INC. MEDICAL AND DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01109
Total number of active participants reported on line 7a of the Form 55002015-01-0153
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-0153

Form 5500 Responses for ROCKY MOUNTAIN WIRELINE SERVICE, INC. MEDICAL AND DENTAL PLAN

2015: ROCKY MOUNTAIN WIRELINE SERVICE, INC. MEDICAL AND DENTAL 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 amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 )
Policy contract numberGT9035
Policy instance 1
Insurance contract or identification numberGT9035
Number of Individuals Covered53
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,065
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $68,238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,065
Insurance broker organization code?3
Insurance broker nameRANDALL PIFER
ROCKY MOUNTAIN HEALTH CARE OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47004 )
Policy contract number05900000
Policy instance 2
Insurance contract or identification number05900000
Number of Individuals Covered132
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $18,780
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCHIROPRACTIC
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 CarrierUSD $1,064,284
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,780
Insurance broker organization code?3
Insurance broker nameACTIVE INSURANCE SOLUTIONS

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