| Plan Name | PREMIUM OILFIELD SERVICES, LLC HEALTH AND WELFARE PLAN |
| Plan identification number | 504 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | PREMIUM OILFIELD SERVICES, LLC |
| Employer identification number (EIN): | 352437202 |
| NAIC Classification: | 213110 |
| NAIC Description: | Support Activities for Mining |
Additional information about PREMIUM OILFIELD SERVICES, LLC
| Jurisdiction of Incorporation: | Texas Secretary of State |
| Incorporation Date: | 2012-02-13 |
| Company Identification Number: | 0801550309 |
| Legal Registered Office Address: |
4819 HIGHWAY 90 W NEW IBERIA United States of America (USA) 70560 |
More information about PREMIUM OILFIELD SERVICES, LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 504 | 2019-06-01 | KERRY UBRICH | 2020-11-24 | ||
| 504 | 2018-06-01 | KERRY UBRICH | 2019-12-17 | ||
| 504 | 2017-06-01 |
| 2019: PREMIUM OILFIELD SERVICES, LLC HEALTH AND WELFARE PLAN 2019 form 5500 responses | ||
|---|---|---|
| 2019-06-01 | Type of plan entity | Single employer plan |
| 2019-06-01 | Submission has been amended | No |
| 2019-06-01 | This submission is the final filing | No |
| 2019-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-06-01 | Plan is a collectively bargained plan | No |
| 2019-06-01 | Plan funding arrangement – Insurance | Yes |
| 2019-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: PREMIUM OILFIELD SERVICES, LLC HEALTH AND WELFARE PLAN 2018 form 5500 responses | ||
| 2018-06-01 | Type of plan entity | Single employer plan |
| 2018-06-01 | Submission has been amended | No |
| 2018-06-01 | This submission is the final filing | No |
| 2018-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-06-01 | Plan is a collectively bargained plan | No |
| 2018-06-01 | Plan funding arrangement – Insurance | Yes |
| 2018-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: PREMIUM OILFIELD SERVICES, LLC HEALTH AND WELFARE PLAN 2017 form 5500 responses | ||
| 2017-06-01 | Type of plan entity | Single employer plan |
| 2017-06-01 | First time form 5500 has been submitted | Yes |
| 2017-06-01 | Submission has been amended | No |
| 2017-06-01 | This submission is the final filing | No |
| 2017-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-06-01 | Plan is a collectively bargained plan | No |
| 2017-06-01 | Plan funding arrangement – Insurance | Yes |
| 2017-06-01 | Plan benefit arrangement – Insurance | Yes |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 0102741 |
| Policy instance | 1 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 0102741 |
| Policy instance | 1 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 0102741-0102741 |
| Policy instance | 1 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |
| Policy contract number | 0102741-0287556 |
| Policy instance | 2 |