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PACKERS PLUS HEALTH AND WELFARE PLAN 401k Plan overview

Plan NamePACKERS PLUS HEALTH AND WELFARE PLAN
Plan identification number 501

PACKERS PLUS HEALTH AND WELFARE 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
  • Death benefits (include travel accident but not life insurance)
  • 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

PACKERS PLUS ENERGY SERVICES USA INC. has sponsored the creation of one or more 401k plans.

Company Name:PACKERS PLUS ENERGY SERVICES USA INC.
Employer identification number (EIN):980438343
NAIC Classification:324190

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PACKERS PLUS HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-01-01SERENA BEAUREAU2021-08-06
5012019-01-01SAMIE FLORES2020-07-08
5012018-01-01
5012017-01-01
5012016-01-01SAMIE FLORES
5012015-01-01SAMIE FLORES
5012014-01-01SAMIE FLORES
5012013-07-15SAMIE FLORES
5012012-07-15SAMIE FLORES
5012011-07-15SAMIE FLORES
5012009-07-15SAMIE FLORES
5012008-07-15SAMIE FLORES
5012007-07-15SAMIE FLORES

Plan Statistics for PACKERS PLUS HEALTH AND WELFARE PLAN

401k plan membership statisitcs for PACKERS PLUS HEALTH AND WELFARE PLAN

Measure Date Value
2020: PACKERS PLUS HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01133
Total number of active participants reported on line 7a of the Form 55002020-01-0170
Number of retired or separated participants receiving benefits2020-01-015
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0175
Number of employers contributing to the scheme2020-01-010
2019: PACKERS PLUS HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01135
Total number of active participants reported on line 7a of the Form 55002019-01-01130
Number of retired or separated participants receiving benefits2019-01-013
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01133
Number of employers contributing to the scheme2019-01-010
2018: PACKERS PLUS HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01129
Total number of active participants reported on line 7a of the Form 55002018-01-01134
Number of retired or separated participants receiving benefits2018-01-011
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01135
Number of employers contributing to the scheme2018-01-010
2017: PACKERS PLUS HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01133
Total number of active participants reported on line 7a of the Form 55002017-01-01129
Number of retired or separated participants receiving benefits2017-01-011
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01130
2016: PACKERS PLUS HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01265
Total number of active participants reported on line 7a of the Form 55002016-01-01133
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01133
2015: PACKERS PLUS HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01330
Total number of active participants reported on line 7a of the Form 55002015-01-01265
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 participants2015-01-01265
2014: PACKERS PLUS HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01303
Total number of active participants reported on line 7a of the Form 55002014-01-01327
Number of retired or separated participants receiving benefits2014-01-013
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01330
2013: PACKERS PLUS HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-15265
Total number of active participants reported on line 7a of the Form 55002013-07-15303
Number of retired or separated participants receiving benefits2013-07-151
Number of other retired or separated participants entitled to future benefits2013-07-150
Total of all active and inactive participants2013-07-15304
2012: PACKERS PLUS HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-15263
Total number of active participants reported on line 7a of the Form 55002012-07-15257
Number of retired or separated participants receiving benefits2012-07-150
Number of other retired or separated participants entitled to future benefits2012-07-150
Total of all active and inactive participants2012-07-15257
2011: PACKERS PLUS HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-15180
Total number of active participants reported on line 7a of the Form 55002011-07-15263
Number of retired or separated participants receiving benefits2011-07-150
Number of other retired or separated participants entitled to future benefits2011-07-150
Total of all active and inactive participants2011-07-15263
2009: PACKERS PLUS HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-15123
Total number of active participants reported on line 7a of the Form 55002009-07-15140
Number of retired or separated participants receiving benefits2009-07-150
Number of other retired or separated participants entitled to future benefits2009-07-150
Total of all active and inactive participants2009-07-15140
2008: PACKERS PLUS HEALTH AND WELFARE PLAN 2008 401k membership
Total participants, beginning-of-year2008-07-15129
Total number of active participants reported on line 7a of the Form 55002008-07-15123
Number of retired or separated participants receiving benefits2008-07-150
Number of other retired or separated participants entitled to future benefits2008-07-150
Total of all active and inactive participants2008-07-15123
2007: PACKERS PLUS HEALTH AND WELFARE PLAN 2007 401k membership
Total participants, beginning-of-year2007-07-15100
Total number of active participants reported on line 7a of the Form 55002007-07-15129
Number of retired or separated participants receiving benefits2007-07-150
Number of other retired or separated participants entitled to future benefits2007-07-150
Total of all active and inactive participants2007-07-15129

Form 5500 Responses for PACKERS PLUS HEALTH AND WELFARE PLAN

2020: PACKERS PLUS HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: PACKERS PLUS HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: PACKERS PLUS HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: PACKERS PLUS HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: PACKERS PLUS HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: PACKERS PLUS HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
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 funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: PACKERS PLUS HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: PACKERS PLUS HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-07-15Type of plan entitySingle employer plan
2013-07-15Submission has been amendedNo
2013-07-15This submission is the final filingNo
2013-07-15This return/report is a short plan year return/report (less than 12 months)Yes
2013-07-15Plan is a collectively bargained planNo
2013-07-15Plan funding arrangement – InsuranceYes
2013-07-15Plan funding arrangement – General assets of the sponsorYes
2013-07-15Plan benefit arrangement – InsuranceYes
2013-07-15Plan benefit arrangement – General assets of the sponsorYes
2012: PACKERS PLUS HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-07-15Type of plan entitySingle employer plan
2012-07-15Submission has been amendedNo
2012-07-15This submission is the final filingNo
2012-07-15This return/report is a short plan year return/report (less than 12 months)No
2012-07-15Plan is a collectively bargained planNo
2012-07-15Plan funding arrangement – InsuranceYes
2012-07-15Plan funding arrangement – General assets of the sponsorYes
2012-07-15Plan benefit arrangement – InsuranceYes
2012-07-15Plan benefit arrangement – General assets of the sponsorYes
2011: PACKERS PLUS HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-07-15Type of plan entitySingle employer plan
2011-07-15Submission has been amendedNo
2011-07-15This submission is the final filingNo
2011-07-15This return/report is a short plan year return/report (less than 12 months)No
2011-07-15Plan is a collectively bargained planNo
2011-07-15Plan funding arrangement – InsuranceYes
2011-07-15Plan funding arrangement – General assets of the sponsorYes
2011-07-15Plan benefit arrangement – InsuranceYes
2011-07-15Plan benefit arrangement – General assets of the sponsorYes
2009: PACKERS PLUS HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-07-15Type of plan entitySingle employer plan
2009-07-15Submission has been amendedNo
2009-07-15This submission is the final filingNo
2009-07-15This return/report is a short plan year return/report (less than 12 months)No
2009-07-15Plan is a collectively bargained planNo
2009-07-15Plan funding arrangement – InsuranceYes
2009-07-15Plan funding arrangement – General assets of the sponsorYes
2009-07-15Plan benefit arrangement – InsuranceYes
2009-07-15Plan benefit arrangement – General assets of the sponsorYes
2008: PACKERS PLUS HEALTH AND WELFARE PLAN 2008 form 5500 responses
2008-07-15Type of plan entitySingle employer plan
2008-07-15Submission has been amendedNo
2008-07-15This submission is the final filingNo
2008-07-15This return/report is a short plan year return/report (less than 12 months)No
2008-07-15Plan is a collectively bargained planNo
2008-07-15Plan funding arrangement – InsuranceYes
2008-07-15Plan funding arrangement – General assets of the sponsorYes
2008-07-15Plan benefit arrangement – InsuranceYes
2008-07-15Plan benefit arrangement – General assets of the sponsorYes
2007: PACKERS PLUS HEALTH AND WELFARE PLAN 2007 form 5500 responses
2007-07-15Type of plan entitySingle employer plan
2007-07-15First time form 5500 has been submittedYes
2007-07-15Submission has been amendedNo
2007-07-15This submission is the final filingNo
2007-07-15This return/report is a short plan year return/report (less than 12 months)No
2007-07-15Plan is a collectively bargained planNo
2007-07-15Plan funding arrangement – InsuranceYes
2007-07-15Plan funding arrangement – General assets of the sponsorYes
2007-07-15Plan benefit arrangement – InsuranceYes
2007-07-15Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract number912288
Policy instance 1
Insurance contract or identification number912288
Number of Individuals Covered70
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $11,230
Total amount of fees paid to insurance companyUSD $1,374
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $109,956
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,230
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number402690
Policy instance 2
Insurance contract or identification number402690
Number of Individuals Covered57
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $18,100
Total amount of fees paid to insurance companyUSD $1,508
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 $106,913
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,100
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract number912288
Policy instance 1
Insurance contract or identification number912288
Number of Individuals Covered136
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $16,309
Total amount of fees paid to insurance companyUSD $3,993
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $159,755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,309
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number402692
Policy instance 2
Insurance contract or identification number402692
Number of Individuals Covered130
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $22,365
Total amount of fees paid to insurance companyUSD $1,864
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 $162,854
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,365
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number489376
Policy instance 1
Insurance contract or identification number489376
Number of Individuals Covered134
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $14,567
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $145,668
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,567
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number402690
Policy instance 2
Insurance contract or identification number402690
Number of Individuals Covered135
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $24,885
Total amount of fees paid to insurance companyUSD $2,074
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 $165,902
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,885
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number489376
Policy instance 1
Insurance contract or identification number489376
Number of Individuals Covered128
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $15,128
Total amount of fees paid to insurance companyUSD $6,625
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $151,279
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,869
Amount paid for insurance broker fees6625
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number402690
Policy instance 2
Insurance contract or identification number402690
Number of Individuals Covered129
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $22,940
Total amount of fees paid to insurance companyUSD $1,912
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 $152,933
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,940
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.

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