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INTERNATIONAL OFFSHORE SERVICES, LLC LIFE AND AD&D PLAN 401k Plan overview

Plan NameINTERNATIONAL OFFSHORE SERVICES, LLC LIFE AND AD&D PLAN
Plan identification number 505

INTERNATIONAL OFFSHORE SERVICES, LLC LIFE AND AD&D PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Other welfare benefit cover

401k Sponsoring company profile

INTERNATIONAL OFFSHORE SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name:INTERNATIONAL OFFSHORE SERVICES, LLC
Employer identification number (EIN):205039136
NAIC Classification:483000
NAIC Description: Water Transportation

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INTERNATIONAL OFFSHORE SERVICES, LLC LIFE AND AD&D PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052012-01-01RICHARD M. CURRENCE, JR.

Plan Statistics for INTERNATIONAL OFFSHORE SERVICES, LLC LIFE AND AD&D PLAN

401k plan membership statisitcs for INTERNATIONAL OFFSHORE SERVICES, LLC LIFE AND AD&D PLAN

Measure Date Value
2012: INTERNATIONAL OFFSHORE SERVICES, LLC LIFE AND AD&D PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01386
Total number of active participants reported on line 7a of the Form 55002012-01-01265
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01265

Form 5500 Responses for INTERNATIONAL OFFSHORE SERVICES, LLC LIFE AND AD&D PLAN

2012: INTERNATIONAL OFFSHORE SERVICES, LLC LIFE AND AD&D PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01First time form 5500 has been submittedYes
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGAE10246
Policy instance 1
Insurance contract or identification numberGAE10246
Number of Individuals Covered338
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $17,786
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $88,930
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,786
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameHUB INTERNATIONAL MIDWEST LTD

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