401k Plan data: FORELAND REFINING CORPORATION DENTAL PLAN plan

FORELAND REFINING CORPORATION DENTAL PLAN 401k Plan overview

Plan Name	FORELAND REFINING CORPORATION DENTAL PLAN
Plan identification number	501

FORELAND REFINING CORPORATION DENTAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Dental

401k Sponsoring company profile

FORELAND REFINING CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: FORELAND REFINING CORPORATION

Employer identification number (EIN): 742881250

NAIC Classification: 324110
NAIC Description: Petroleum Refineries

Additional information about FORELAND REFINING CORPORATION

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1998-05-29

Company Identification Number: 0149243300

Legal Registered Office Address: 707 W 700 S STE 101

WOODS CROSS
United States of America (USA)
84087

More information about FORELAND REFINING CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FORELAND REFINING CORPORATION DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-11-01 FIONA JACKSON 2019-08-08
501 2016-11-01
501 2015-11-01 FIONA JACKSON
501 2014-11-01 FIONA JACKSON
501 2013-11-01 FIONA JACKSON
501 2012-11-01 FIONA JACKSON

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2017-11-01	FIONA JACKSON	2019-08-08
501	2016-11-01
501	2015-11-01	FIONA JACKSON
501	2014-11-01	FIONA JACKSON
501	2013-11-01	FIONA JACKSON
501	2012-11-01	FIONA JACKSON

Plan Statistics for FORELAND REFINING CORPORATION DENTAL PLAN

401k plan membership statisitcs for FORELAND REFINING CORPORATION DENTAL PLAN

Measure Date Value
2017: FORELAND REFINING CORPORATION DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year 2017-11-01 104
Total number of active participants reported on line 7a of the Form 5500 2017-11-01 113
Number of retired or separated participants receiving benefits 2017-11-01 0
Number of other retired or separated participants entitled to future benefits 2017-11-01 0
Total of all active and inactive participants 2017-11-01 113
Number of employers contributing to the scheme 2017-11-01 0
2016: FORELAND REFINING CORPORATION DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year 2016-11-01 117
Total number of active participants reported on line 7a of the Form 5500 2016-11-01 113
Number of retired or separated participants receiving benefits 2016-11-01 0
Number of other retired or separated participants entitled to future benefits 2016-11-01 0
Total of all active and inactive participants 2016-11-01 113
2015: FORELAND REFINING CORPORATION DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year 2015-11-01 124
Total number of active participants reported on line 7a of the Form 5500 2015-11-01 117
Number of retired or separated participants receiving benefits 2015-11-01 0
Number of other retired or separated participants entitled to future benefits 2015-11-01 0
Total of all active and inactive participants 2015-11-01 117
2014: FORELAND REFINING CORPORATION DENTAL PLAN 2014 401k membership
Total participants, beginning-of-year 2014-11-01 137
Total number of active participants reported on line 7a of the Form 5500 2014-11-01 123
Number of retired or separated participants receiving benefits 2014-11-01 1
Number of other retired or separated participants entitled to future benefits 2014-11-01 0
Total of all active and inactive participants 2014-11-01 124
2013: FORELAND REFINING CORPORATION DENTAL PLAN 2013 401k membership
Total participants, beginning-of-year 2013-11-01 129
Total number of active participants reported on line 7a of the Form 5500 2013-11-01 133
Number of retired or separated participants receiving benefits 2013-11-01 0
Number of other retired or separated participants entitled to future benefits 2013-11-01 0
Total of all active and inactive participants 2013-11-01 133
2012: FORELAND REFINING CORPORATION DENTAL PLAN 2012 401k membership
Total participants, beginning-of-year 2012-11-01 100
Total number of active participants reported on line 7a of the Form 5500 2012-11-01 128
Number of retired or separated participants receiving benefits 2012-11-01 1
Number of other retired or separated participants entitled to future benefits 2012-11-01 0
Total of all active and inactive participants 2012-11-01 129

Measure	Date	Value
2017: FORELAND REFINING CORPORATION DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year	2017-11-01	104
Total number of active participants reported on line 7a of the Form 5500	2017-11-01	113
Number of retired or separated participants receiving benefits	2017-11-01	0
Number of other retired or separated participants entitled to future benefits	2017-11-01	0
Total of all active and inactive participants	2017-11-01	113
Number of employers contributing to the scheme	2017-11-01	0
2016: FORELAND REFINING CORPORATION DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year	2016-11-01	117
Total number of active participants reported on line 7a of the Form 5500	2016-11-01	113
Number of retired or separated participants receiving benefits	2016-11-01	0
Number of other retired or separated participants entitled to future benefits	2016-11-01	0
Total of all active and inactive participants	2016-11-01	113
2015: FORELAND REFINING CORPORATION DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year	2015-11-01	124
Total number of active participants reported on line 7a of the Form 5500	2015-11-01	117
Number of retired or separated participants receiving benefits	2015-11-01	0
Number of other retired or separated participants entitled to future benefits	2015-11-01	0
Total of all active and inactive participants	2015-11-01	117
2014: FORELAND REFINING CORPORATION DENTAL PLAN 2014 401k membership
Total participants, beginning-of-year	2014-11-01	137
Total number of active participants reported on line 7a of the Form 5500	2014-11-01	123
Number of retired or separated participants receiving benefits	2014-11-01	1
Number of other retired or separated participants entitled to future benefits	2014-11-01	0
Total of all active and inactive participants	2014-11-01	124
2013: FORELAND REFINING CORPORATION DENTAL PLAN 2013 401k membership
Total participants, beginning-of-year	2013-11-01	129
Total number of active participants reported on line 7a of the Form 5500	2013-11-01	133
Number of retired or separated participants receiving benefits	2013-11-01	0
Number of other retired or separated participants entitled to future benefits	2013-11-01	0
Total of all active and inactive participants	2013-11-01	133
2012: FORELAND REFINING CORPORATION DENTAL PLAN 2012 401k membership
Total participants, beginning-of-year	2012-11-01	100
Total number of active participants reported on line 7a of the Form 5500	2012-11-01	128
Number of retired or separated participants receiving benefits	2012-11-01	1
Number of other retired or separated participants entitled to future benefits	2012-11-01	0
Total of all active and inactive participants	2012-11-01	129

Form 5500 Responses for FORELAND REFINING CORPORATION DENTAL PLAN

2017: FORELAND REFINING CORPORATION DENTAL PLAN 2017 form 5500 responses
2017-11-01	Type of plan entity	Single employer plan
2017-11-01	Plan funding arrangement – Insurance	Yes
2017-11-01	Plan benefit arrangement – Insurance	Yes
2016: FORELAND REFINING CORPORATION DENTAL PLAN 2016 form 5500 responses
2016-11-01	Type of plan entity	Single employer plan
2016-11-01	Plan funding arrangement – Insurance	Yes
2016-11-01	Plan benefit arrangement – Insurance	Yes
2015: FORELAND REFINING CORPORATION DENTAL PLAN 2015 form 5500 responses
2015-11-01	Type of plan entity	Single employer plan
2015-11-01	Submission has been amended	No
2015-11-01	This submission is the final filing	No
2015-11-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-11-01	Plan is a collectively bargained plan	No
2015-11-01	Plan funding arrangement – Insurance	Yes
2015-11-01	Plan benefit arrangement – Insurance	Yes
2014: FORELAND REFINING CORPORATION DENTAL PLAN 2014 form 5500 responses
2014-11-01	Type of plan entity	Single employer plan
2014-11-01	Submission has been amended	No
2014-11-01	This submission is the final filing	No
2014-11-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-11-01	Plan is a collectively bargained plan	No
2014-11-01	Plan funding arrangement – Insurance	Yes
2014-11-01	Plan benefit arrangement – Insurance	Yes
2013: FORELAND REFINING CORPORATION DENTAL PLAN 2013 form 5500 responses
2013-11-01	Type of plan entity	Single employer plan
2013-11-01	Submission has been amended	No
2013-11-01	This submission is the final filing	No
2013-11-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-11-01	Plan is a collectively bargained plan	No
2013-11-01	Plan funding arrangement – Insurance	Yes
2013-11-01	Plan benefit arrangement – Insurance	Yes
2012: FORELAND REFINING CORPORATION DENTAL PLAN 2012 form 5500 responses
2012-11-01	Type of plan entity	Single employer plan
2012-11-01	First time form 5500 has been submitted	Yes
2012-11-01	Submission has been amended	No
2012-11-01	This submission is the final filing	No
2012-11-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-11-01	Plan is a collectively bargained plan	No
2012-11-01	Plan funding arrangement – Insurance	Yes
2012-11-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

BKP UTP42390

Policy instance

Insurance contract or identification number	BKP UTP42390
Number of Individuals Covered	338
Insurance policy start date	2017-11-01
Insurance policy end date	2018-10-31
Total amount of commissions paid to insurance broker	USD $2,196
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $112,291
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

FORELAND REFINING HEALTH & WELFARE BENEFIT PLAN [EIN = 742281250]

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Company Name:	FORELAND REFINING CORPORATION
Employer identification number (EIN):	742881250
NAIC Classification:	324110
NAIC Description:	Petroleum Refineries

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1998-05-29
Company Identification Number:	0149243300
Legal Registered Office Address:	707 W 700 S STE 101 WOODS CROSS United States of America (USA) 84087