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| Plan Name | CHAMPION ENERGY LIFE & DISABILITY |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | CHAMPION ENERGY CORP. |
| Employer identification number (EIN): | 061156651 |
| NAIC Classification: | 424700 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2012-01-01 | JOSEPH MELFI | JOSEPH MELFI | 2013-10-15 | |
| 502 | 2011-01-01 | JOSEPH MELFI | JOSEPH MELFI | 2012-10-15 | |
| 502 | 2010-01-01 | JOSEPH MELFI | JOSEPH MELFI | 2011-10-11 | |
| 502 | 2009-01-01 | JOSEPH MELFI | JOSEPH MELFI | 2010-10-14 |
| Measure | Date | Value |
|---|---|---|
| 2012: CHAMPION ENERGY LIFE & DISABILITY 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-01-01 | 152 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 0 |
| Total of all active and inactive participants | 2012-01-01 | 0 |
| 2011: CHAMPION ENERGY LIFE & DISABILITY 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-01-01 | 240 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 152 |
| Total of all active and inactive participants | 2011-01-01 | 152 |
| 2010: CHAMPION ENERGY LIFE & DISABILITY 2010 401k membership | ||
| Total participants, beginning-of-year | 2010-01-01 | 283 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 240 |
| Total of all active and inactive participants | 2010-01-01 | 240 |
| 2009: CHAMPION ENERGY LIFE & DISABILITY 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-01-01 | 230 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 283 |
| Total of all active and inactive participants | 2009-01-01 | 283 |
| 2012: CHAMPION ENERGY LIFE & DISABILITY 2012 form 5500 responses | ||
|---|---|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | This submission is the final filing | Yes |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: CHAMPION ENERGY LIFE & DISABILITY 2011 form 5500 responses | ||
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: CHAMPION ENERGY LIFE & DISABILITY 2010 form 5500 responses | ||
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: CHAMPION ENERGY LIFE & DISABILITY 2009 form 5500 responses | ||
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
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