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SANTMYER OIL COMPANY, INC. WRAP WELFARE BENEFITS PLAN 401k Plan overview

Plan NameSANTMYER OIL COMPANY, INC. WRAP WELFARE BENEFITS PLAN
Plan identification number 501

SANTMYER OIL COMPANY, INC. WRAP WELFARE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

SANTMYER COMPANIES, INC. has sponsored the creation of one or more 401k plans.

Company Name:SANTMYER COMPANIES, INC.
Employer identification number (EIN):832686509
NAIC Classification:424700

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SANTMYER OIL COMPANY, INC. WRAP WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-06-01LISA HORNE2023-10-26
5012021-06-01LISA HORNE2023-02-09
5012020-06-01LISA HORNE2021-11-03
5012019-06-01LISA HORNE2020-11-18
5012018-06-01DAVID FIRST2019-08-29

Plan Statistics for SANTMYER OIL COMPANY, INC. WRAP WELFARE BENEFITS PLAN

401k plan membership statisitcs for SANTMYER OIL COMPANY, INC. WRAP WELFARE BENEFITS PLAN

Measure Date Value
2022: SANTMYER OIL COMPANY, INC. WRAP WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-01124
Total number of active participants reported on line 7a of the Form 55002022-06-01102
Number of retired or separated participants receiving benefits2022-06-010
Number of other retired or separated participants entitled to future benefits2022-06-010
Total of all active and inactive participants2022-06-01102
Number of employers contributing to the scheme2022-06-010
2021: SANTMYER OIL COMPANY, INC. WRAP WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-01133
Total number of active participants reported on line 7a of the Form 55002021-06-01124
Number of retired or separated participants receiving benefits2021-06-010
Number of other retired or separated participants entitled to future benefits2021-06-010
Total of all active and inactive participants2021-06-01124
Number of employers contributing to the scheme2021-06-010
2020: SANTMYER OIL COMPANY, INC. WRAP WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01178
Total number of active participants reported on line 7a of the Form 55002020-06-01133
Number of retired or separated participants receiving benefits2020-06-010
Number of other retired or separated participants entitled to future benefits2020-06-010
Total of all active and inactive participants2020-06-01133
Number of employers contributing to the scheme2020-06-010
2019: SANTMYER OIL COMPANY, INC. WRAP WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-01134
Total number of active participants reported on line 7a of the Form 55002019-06-01178
Number of retired or separated participants receiving benefits2019-06-010
Number of other retired or separated participants entitled to future benefits2019-06-010
Total of all active and inactive participants2019-06-01178
Number of employers contributing to the scheme2019-06-010
2018: SANTMYER OIL COMPANY, INC. WRAP WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-01100
Total number of active participants reported on line 7a of the Form 55002018-06-01131
Number of retired or separated participants receiving benefits2018-06-010
Number of other retired or separated participants entitled to future benefits2018-06-010
Total of all active and inactive participants2018-06-01131
Number of employers contributing to the scheme2018-06-010

Form 5500 Responses for SANTMYER OIL COMPANY, INC. WRAP WELFARE BENEFITS PLAN

2022: SANTMYER OIL COMPANY, INC. WRAP WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-06-01Type of plan entitySingle employer plan
2022-06-01Plan funding arrangement – InsuranceYes
2022-06-01Plan funding arrangement – General assets of the sponsorYes
2022-06-01Plan benefit arrangement – InsuranceYes
2022-06-01Plan benefit arrangement – General assets of the sponsorYes
2021: SANTMYER OIL COMPANY, INC. WRAP WELFARE BENEFITS PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan funding arrangement – General assets of the sponsorYes
2021-06-01Plan benefit arrangement – InsuranceYes
2021-06-01Plan benefit arrangement – General assets of the sponsorYes
2020: SANTMYER OIL COMPANY, INC. WRAP WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan funding arrangement – General assets of the sponsorYes
2020-06-01Plan benefit arrangement – InsuranceYes
2020-06-01Plan benefit arrangement – General assets of the sponsorYes
2019: SANTMYER OIL COMPANY, INC. WRAP WELFARE BENEFITS PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan benefit arrangement – InsuranceYes
2018: SANTMYER OIL COMPANY, INC. WRAP WELFARE BENEFITS PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10268517
Policy instance 2
Insurance contract or identification number10268517
Number of Individuals Covered102
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $9,596
Total amount of fees paid to insurance companyUSD $4,211
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $97,629
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,596
Amount paid for insurance broker fees4211
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30000903
Policy instance 1
Insurance contract or identification number30000903
Number of Individuals Covered70
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $944
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,740
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $944
Amount paid for insurance broker fees0
Insurance broker organization code?3
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract numberDD1048
Policy instance 3
Insurance contract or identification numberDD1048
Number of Individuals Covered169
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $5,213
Total amount of fees paid to insurance companyUSD $389
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $52,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,213
Amount paid for insurance broker fees389
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30000903
Policy instance 2
Insurance contract or identification number30000903
Number of Individuals Covered68
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $900
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,284
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $900
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number249746
Policy instance 1
Insurance contract or identification number249746
Number of Individuals Covered124
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $10,769
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $75,019
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,769
Amount paid for insurance broker fees0
Insurance broker organization code?3
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number501595
Policy instance 4
Insurance contract or identification number501595
Number of Individuals Covered97
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $28,903
Total amount of fees paid to insurance companyUSD $18,335
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,236,180
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,903
Amount paid for insurance broker fees18335
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract numberDD1048
Policy instance 3
Insurance contract or identification numberDD1048
Number of Individuals Covered167
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $4,864
Total amount of fees paid to insurance companyUSD $362
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,525
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,864
Amount paid for insurance broker fees362
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30000903
Policy instance 2
Insurance contract or identification number30000903
Number of Individuals Covered75
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $852
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,718
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $852
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number249746
Policy instance 1
Insurance contract or identification number249746
Number of Individuals Covered133
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $13,260
Total amount of fees paid to insurance companyUSD $944
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $93,421
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,260
Amount paid for insurance broker fees944
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number583122
Policy instance 4
Insurance contract or identification number583122
Number of Individuals Covered90
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,376
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,178
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30000903
Policy instance 3
Insurance contract or identification number30000903
Number of Individuals Covered82
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $917
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,392
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $917
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number249746
Policy instance 2
Insurance contract or identification number249746
Number of Individuals Covered175
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $12,594
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $93,671
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,966
Amount paid for insurance broker fees0
Insurance broker organization code?3
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number501595
Policy instance 1
Insurance contract or identification number501595
Number of Individuals Covered96
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $28,656
Total amount of fees paid to insurance companyUSD $3,909
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,184,917
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,415
Amount paid for insurance broker fees3907
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number583122
Policy instance 4
Insurance contract or identification number583122
Number of Individuals Covered87
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,379
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,571
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,379
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30000903
Policy instance 3
Insurance contract or identification number30000903
Number of Individuals Covered77
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $655
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,193
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $655
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number249746
Policy instance 2
Insurance contract or identification number249746
Number of Individuals Covered131
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $10,238
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $80,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,238
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number249746
Policy instance 1
Insurance contract or identification number249746
Number of Individuals Covered185
Insurance policy start date2018-01-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $25,440
Total amount of fees paid to insurance companyUSD $1,908
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $494,872
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,264
Amount paid for insurance broker fees1908
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3

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