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HOLIDAY OIL LIFE AND DISABILITY BENEFIT PLAN 401k Plan overview

Plan NameHOLIDAY OIL LIFE AND DISABILITY BENEFIT PLAN
Plan identification number 502

HOLIDAY OIL LIFE AND DISABILITY BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

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

Company Name:HOLIDAY OIL COMPANY
Employer identification number (EIN):870295888
NAIC Classification:447100
NAIC Description: Gasoline Stations, Gas

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOLIDAY OIL LIFE AND DISABILITY BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-11-01KIM FACER2024-02-23 KIM FACER2024-02-23
5022021-11-01JAMES PETERSON2023-05-31
5022020-11-01JAMES PETERSON2022-02-17
5022019-11-01JAMES PETERSON2021-04-16

Plan Statistics for HOLIDAY OIL LIFE AND DISABILITY BENEFIT PLAN

401k plan membership statisitcs for HOLIDAY OIL LIFE AND DISABILITY BENEFIT PLAN

Measure Date Value
2022: HOLIDAY OIL LIFE AND DISABILITY BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-11-01394
Total number of active participants reported on line 7a of the Form 55002022-11-010
Number of retired or separated participants receiving benefits2022-11-010
Number of other retired or separated participants entitled to future benefits2022-11-010
Total of all active and inactive participants2022-11-010
2021: HOLIDAY OIL LIFE AND DISABILITY BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-11-01322
Total number of active participants reported on line 7a of the Form 55002021-11-01394
Number of retired or separated participants receiving benefits2021-11-010
Number of other retired or separated participants entitled to future benefits2021-11-010
Total of all active and inactive participants2021-11-01394
Number of employers contributing to the scheme2021-11-010
2020: HOLIDAY OIL LIFE AND DISABILITY BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-11-01322
Total number of active participants reported on line 7a of the Form 55002020-11-01322
Number of retired or separated participants receiving benefits2020-11-010
Number of other retired or separated participants entitled to future benefits2020-11-010
Total of all active and inactive participants2020-11-01322
Number of employers contributing to the scheme2020-11-010
2019: HOLIDAY OIL LIFE AND DISABILITY BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-11-01100
Total number of active participants reported on line 7a of the Form 55002019-11-01322
Number of retired or separated participants receiving benefits2019-11-010
Number of other retired or separated participants entitled to future benefits2019-11-010
Total of all active and inactive participants2019-11-01322
Number of employers contributing to the scheme2019-11-010

Form 5500 Responses for HOLIDAY OIL LIFE AND DISABILITY BENEFIT PLAN

2022: HOLIDAY OIL LIFE AND DISABILITY BENEFIT PLAN 2022 form 5500 responses
2022-11-01Type of plan entitySingle employer plan
2022-11-01Submission has been amendedNo
2022-11-01This submission is the final filingYes
2022-11-01This return/report is a short plan year return/report (less than 12 months)No
2022-11-01Plan is a collectively bargained planNo
2022-11-01Plan funding arrangement – InsuranceYes
2022-11-01Plan benefit arrangement – InsuranceYes
2021: HOLIDAY OIL LIFE AND DISABILITY BENEFIT PLAN 2021 form 5500 responses
2021-11-01Type of plan entitySingle employer plan
2021-11-01Plan funding arrangement – InsuranceYes
2021-11-01Plan benefit arrangement – InsuranceYes
2020: HOLIDAY OIL LIFE AND DISABILITY BENEFIT PLAN 2020 form 5500 responses
2020-11-01Type of plan entitySingle employer plan
2020-11-01Plan funding arrangement – InsuranceYes
2020-11-01Plan benefit arrangement – InsuranceYes
2019: HOLIDAY OIL LIFE AND DISABILITY BENEFIT PLAN 2019 form 5500 responses
2019-11-01Type of plan entitySingle employer plan
2019-11-01First time form 5500 has been submittedYes
2019-11-01Plan funding arrangement – InsuranceYes
2019-11-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number10267946
Policy instance 1
Insurance contract or identification number10267946
Number of Individuals Covered394
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Total amount of commissions paid to insurance brokerUSD $23,817
Total amount of fees paid to insurance companyUSD $5,667
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $173,244
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,817
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBROKER BONUS
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number221091G
Policy instance 1
Insurance contract or identification number221091G
Number of Individuals Covered322
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $5,746
Total amount of fees paid to insurance companyUSD $647
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $52,438
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,590
Amount paid for insurance broker fees647
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
BLOMQUIST HALE CONSULTING INC (National Association of Insurance Commissioners NAIC id number: 10310 )
Policy contract number00
Policy instance 2
Insurance contract or identification number00
Number of Individuals Covered245
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $9,689
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 number221091G
Policy instance 1
Insurance contract or identification number221091G
Number of Individuals Covered322
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $8,854
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $68,557
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,616
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLOMQUIST HALE CONSULTING INC (National Association of Insurance Commissioners NAIC id number: 10310 )
Policy contract number00
Policy instance 2
Insurance contract or identification number00
Number of Individuals Covered244
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $7,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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