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BLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 401k Plan overview

Plan NameBLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN
Plan identification number 501

BLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

BLACK BEAR OIL CORP has sponsored the creation of one or more 401k plans.

Company Name:BLACK BEAR OIL CORP
Employer identification number (EIN):061669720
NAIC Classification:221210
NAIC Description:Natural Gas Distribution

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012016-12-01PAUL ADAMS
5012015-12-01PAUL ADAMS
5012014-12-01PAUL ADAMS

Plan Statistics for BLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN

401k plan membership statisitcs for BLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN

Measure Date Value
2016: BLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-12-0112
Total number of active participants reported on line 7a of the Form 55002016-12-0112
Number of retired or separated participants receiving benefits2016-12-010
Number of other retired or separated participants entitled to future benefits2016-12-010
Total of all active and inactive participants2016-12-0112
2015: BLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-12-0112
Total number of active participants reported on line 7a of the Form 55002015-12-0112
Number of retired or separated participants receiving benefits2015-12-010
Number of other retired or separated participants entitled to future benefits2015-12-010
Total of all active and inactive participants2015-12-0112
2014: BLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-12-0112
Total number of active participants reported on line 7a of the Form 55002014-12-0112
Number of retired or separated participants receiving benefits2014-12-010
Number of other retired or separated participants entitled to future benefits2014-12-010
Total of all active and inactive participants2014-12-0112

Financial Data on BLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN

Measure Date Value
2019 : BLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2019 401k financial data
Total plan liabilities at beginning of year2019-11-30$210
Total income from all sources2019-11-30$166,824
Expenses. Total of all expenses incurred2019-11-30$117,154
Benefits paid (including direct rollovers)2019-11-30$107,821
Total plan assets at end of year2019-11-30$61,483
Total plan assets at beginning of year2019-11-30$12,023
Total contributions received or receivable from participants2019-11-30$12,035
Other income received2019-11-30$898
Net income (gross income less expenses)2019-11-30$49,670
Net plan assets at end of year (total assets less liabilities)2019-11-30$61,483
Net plan assets at beginning of year (total assets less liabilities)2019-11-30$11,813
Total contributions received or receivable from employer(s)2019-11-30$153,891
Expenses. Administrative service providers (salaries,fees and commissions)2019-11-30$9,333
2017 : BLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2017 401k financial data
Total income from all sources2017-11-30$37,599
Expenses. Total of all expenses incurred2017-11-30$52,167
Benefits paid (including direct rollovers)2017-11-30$44,799
Total plan assets at end of year2017-11-30$6,116
Total plan assets at beginning of year2017-11-30$20,684
Total contributions received or receivable from participants2017-11-30$7,349
Other income received2017-11-30$128
Net income (gross income less expenses)2017-11-30$-14,568
Net plan assets at end of year (total assets less liabilities)2017-11-30$6,116
Net plan assets at beginning of year (total assets less liabilities)2017-11-30$20,684
Total contributions received or receivable from employer(s)2017-11-30$30,122
Expenses. Administrative service providers (salaries,fees and commissions)2017-11-30$7,368
2016 : BLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2016 401k financial data
Total income from all sources2016-11-30$11,455
Expenses. Total of all expenses incurred2016-11-30$33,003
Benefits paid (including direct rollovers)2016-11-30$26,245
Total plan assets at end of year2016-11-30$20,684
Total plan assets at beginning of year2016-11-30$42,232
Total contributions received or receivable from participants2016-11-30$6,514
Other income received2016-11-30$73
Net income (gross income less expenses)2016-11-30$-21,548
Net plan assets at end of year (total assets less liabilities)2016-11-30$20,684
Net plan assets at beginning of year (total assets less liabilities)2016-11-30$42,232
Total contributions received or receivable from employer(s)2016-11-30$4,868
Expenses. Administrative service providers (salaries,fees and commissions)2016-11-30$6,758
2015 : BLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2015 401k financial data
Total income from all sources2015-11-30$59,651
Expenses. Total of all expenses incurred2015-11-30$17,419
Benefits paid (including direct rollovers)2015-11-30$10,320
Total plan assets at end of year2015-11-30$42,232
Total plan assets at beginning of year2015-11-30$0
Total contributions received or receivable from participants2015-11-30$5,922
Other income received2015-11-30$14
Net income (gross income less expenses)2015-11-30$42,232
Net plan assets at end of year (total assets less liabilities)2015-11-30$42,232
Net plan assets at beginning of year (total assets less liabilities)2015-11-30$0
Total contributions received or receivable from employer(s)2015-11-30$53,715
Expenses. Administrative service providers (salaries,fees and commissions)2015-11-30$7,099

Form 5500 Responses for BLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN

2016: BLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2016 form 5500 responses
2016-12-01Type of plan entitySingle employer plan
2016-12-01Plan funding arrangement – TrustYes
2016-12-01Plan benefit arrangement - TrustYes
2015: BLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2015 form 5500 responses
2015-12-01Type of plan entitySingle employer plan
2015-12-01Plan funding arrangement – TrustYes
2015-12-01Plan benefit arrangement - TrustYes
2014: BLACK BEAR OIL CORP. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2014 form 5500 responses
2014-12-01Type of plan entitySingle employer plan
2014-12-01First time form 5500 has been submittedYes
2014-12-01Plan funding arrangement – TrustYes
2014-12-01Plan benefit arrangement - TrustYes

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