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| Plan Name | LEGACY OFFSHORE- LONG TERM DISABILITY PLAN |
| Plan identification number | 507 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | LEGACY OFFSHORE, LLC |
| Employer identification number (EIN): | 300450130 |
| NAIC Classification: | 238900 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 507 | 2014-03-15 | CHARLES ZAMORA |
| Measure | Date | Value |
|---|---|---|
| 2014: LEGACY OFFSHORE- LONG TERM DISABILITY PLAN 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-03-15 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-03-15 | 98 |
| Number of retired or separated participants receiving benefits | 2014-03-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-03-15 | 0 |
| Total of all active and inactive participants | 2014-03-15 | 98 |
| 2014: LEGACY OFFSHORE- LONG TERM DISABILITY PLAN 2014 form 5500 responses | ||
|---|---|---|
| 2014-03-15 | Type of plan entity | Single employer plan |
| 2014-03-15 | First time form 5500 has been submitted | Yes |
| 2014-03-15 | Submission has been amended | No |
| 2014-03-15 | This submission is the final filing | No |
| 2014-03-15 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-03-15 | Plan is a collectively bargained plan | No |
| 2014-03-15 | Plan funding arrangement – Insurance | Yes |
| 2014-03-15 | Plan benefit arrangement – Insurance | Yes |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 399579 |
| Policy instance | 1 |
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