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| Plan Name | THE EMPLOYEE MEDICAL PLAN OF DUBOSE NATIONAL ENERGY SERVICES, INC. |
| Plan identification number | 505 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | DUBOSE NATIONAL ENERGY SERVICES INC |
| Employer identification number (EIN): | 561715568 |
| NAIC Classification: | 423990 |
| NAIC Description: | Other Miscellaneous Durable Goods Merchant Wholesalers |
Additional information about DUBOSE NATIONAL ENERGY SERVICES INC
| Jurisdiction of Incorporation: | North Carolina Secretary of State |
| Incorporation Date: | |
| Company Identification Number: | 0276985 |
More information about DUBOSE NATIONAL ENERGY SERVICES INC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 505 | 2015-02-01 | CARL M. ROGERS |
| Measure | Date | Value |
|---|---|---|
| 2015: THE EMPLOYEE MEDICAL PLAN OF DUBOSE NATIONAL ENERGY SERVICES, INC. 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-02-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-02-01 | 120 |
| Number of retired or separated participants receiving benefits | 2015-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-02-01 | 0 |
| Total of all active and inactive participants | 2015-02-01 | 120 |
| 2015: THE EMPLOYEE MEDICAL PLAN OF DUBOSE NATIONAL ENERGY SERVICES, INC. 2015 form 5500 responses | ||
|---|---|---|
| 2015-02-01 | Type of plan entity | Single employer plan |
| 2015-02-01 | First time form 5500 has been submitted | Yes |
| 2015-02-01 | Submission has been amended | No |
| 2015-02-01 | This submission is the final filing | No |
| 2015-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-02-01 | Plan is a collectively bargained plan | No |
| 2015-02-01 | Plan funding arrangement – Insurance | Yes |
| 2015-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00507846 |
| Policy instance | 1 |
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) | |
| Policy contract number | IISI 3296 |
| Policy instance | 2 |