401k Plan data: PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN plan

PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN 401k Plan overview

Plan Name	PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN
Plan identification number	502

PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

PATTISON SAND COMPANY, LLC has sponsored the creation of one or more 401k plans.

Company Name: PATTISON SAND COMPANY, LLC

Employer identification number (EIN): 260130847

NAIC Classification: 212322
NAIC Description: Industrial Sand Mining

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2015-05-01
502 2014-05-01
502 2013-05-01
502 2012-05-01 MATTHEW CANNOVA
502 2011-05-01

Plan Statistics for PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN

401k plan membership statisitcs for PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN

Measure Date Value
2015: PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-05-01 221
Total number of active participants reported on line 7a of the Form 5500 2015-05-01 0
Total of all active and inactive participants 2015-05-01 0
Total participants 2015-05-01 0
2014: PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-05-01 167
Total number of active participants reported on line 7a of the Form 5500 2014-05-01 229
Total of all active and inactive participants 2014-05-01 229
Total participants 2014-05-01 229
2013: PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-05-01 147
Total number of active participants reported on line 7a of the Form 5500 2013-05-01 167
Total of all active and inactive participants 2013-05-01 167
Total participants 2013-05-01 167
2012: PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-05-01 171
Total number of active participants reported on line 7a of the Form 5500 2012-05-01 145
Total of all active and inactive participants 2012-05-01 145
Total participants 2012-05-01 145
2011: PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-05-01 113
Total number of active participants reported on line 7a of the Form 5500 2011-05-01 172
Total of all active and inactive participants 2011-05-01 172
Total participants 2011-05-01 172

Measure	Date	Value
2015: PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-05-01	221
Total number of active participants reported on line 7a of the Form 5500	2015-05-01	0
Total of all active and inactive participants	2015-05-01	0
Total participants	2015-05-01	0
2014: PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-05-01	167
Total number of active participants reported on line 7a of the Form 5500	2014-05-01	229
Total of all active and inactive participants	2014-05-01	229
Total participants	2014-05-01	229
2013: PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-05-01	147
Total number of active participants reported on line 7a of the Form 5500	2013-05-01	167
Total of all active and inactive participants	2013-05-01	167
Total participants	2013-05-01	167
2012: PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-05-01	171
Total number of active participants reported on line 7a of the Form 5500	2012-05-01	145
Total of all active and inactive participants	2012-05-01	145
Total participants	2012-05-01	145
2011: PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-05-01	113
Total number of active participants reported on line 7a of the Form 5500	2011-05-01	172
Total of all active and inactive participants	2011-05-01	172
Total participants	2011-05-01	172

Form 5500 Responses for PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN

2015: PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN 2015 form 5500 responses
2015-05-01	Type of plan entity	Single employer plan
2015-05-01	Submission has been amended	No
2015-05-01	This submission is the final filing	Yes
2015-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-05-01	Plan is a collectively bargained plan	No
2015-05-01	Plan funding arrangement – Insurance	Yes
2015-05-01	Plan benefit arrangement – Insurance	Yes
2014: PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN 2014 form 5500 responses
2014-05-01	Type of plan entity	Single employer plan
2014-05-01	Submission has been amended	No
2014-05-01	This submission is the final filing	No
2014-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-05-01	Plan is a collectively bargained plan	No
2014-05-01	Plan funding arrangement – Insurance	Yes
2014-05-01	Plan benefit arrangement – Insurance	Yes
2013: PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN 2013 form 5500 responses
2013-05-01	Type of plan entity	Single employer plan
2013-05-01	Submission has been amended	Yes
2013-05-01	This submission is the final filing	No
2013-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-05-01	Plan is a collectively bargained plan	No
2013-05-01	Plan funding arrangement – Insurance	Yes
2013-05-01	Plan benefit arrangement – Insurance	Yes
2012: PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN 2012 form 5500 responses
2012-05-01	Type of plan entity	Single employer plan
2012-05-01	Submission has been amended	No
2012-05-01	This submission is the final filing	No
2012-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-05-01	Plan is a collectively bargained plan	No
2012-05-01	Plan funding arrangement – Insurance	Yes
2012-05-01	Plan benefit arrangement – Insurance	Yes
2011: PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN 2011 form 5500 responses
2011-05-01	Type of plan entity	Single employer plan
2011-05-01	First time form 5500 has been submitted	Yes
2011-05-01	Submission has been amended	No
2011-05-01	This submission is the final filing	No
2011-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-05-01	Plan is a collectively bargained plan	No
2011-05-01	Plan funding arrangement – Insurance	Yes
2011-05-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

KM05738034

Policy instance

Insurance contract or identification number	KM05738034
Number of Individuals Covered	463
Insurance policy start date	2015-05-01
Insurance policy end date	2016-04-30
Total amount of commissions paid to insurance broker	USD $6,453
Total amount of fees paid to insurance company	USD $614
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
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 Carrier	USD $45,473
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,099
Amount paid for insurance broker fees	194
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENATION
Insurance broker organization code?	3
Insurance broker name	HOLMES MURPHY & ASSOCIATION INC.

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

KM05738034

Policy instance

Insurance contract or identification number	KM05738034
Number of Individuals Covered	717
Insurance policy start date	2014-05-01
Insurance policy end date	2015-04-30
Total amount of commissions paid to insurance broker	USD $6,748
Total amount of fees paid to insurance company	USD $838
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
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 Carrier	USD $48,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,748
Amount paid for insurance broker fees	838
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	HOLMES MURPHY & ASSOCIATION INC.

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

KM05738034

Policy instance

Insurance contract or identification number	KM05738034
Number of Individuals Covered	553
Insurance policy start date	2012-05-01
Insurance policy end date	2013-04-30
Total amount of commissions paid to insurance broker	USD $5,406
Total amount of fees paid to insurance company	USD $42
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
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 Carrier	USD $36,288
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,406
Amount paid for insurance broker fees	42
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	HOLMES MURPHY & ASSOCIATION INC.

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

KM05738034

Policy instance

Insurance contract or identification number	KM05738034
Number of Individuals Covered	666
Insurance policy start date	2011-05-01
Insurance policy end date	2012-04-30
Total amount of commissions paid to insurance broker	USD $4,984
Total amount of fees paid to insurance company	USD $483
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
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 Carrier	USD $34,032
Commission paid to Insurance Broker	USD $4,984
Amount paid for insurance broker fees	483
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	HOLMES MURPHY & ASSOCIATION INC.

Potentially related plans

PATTISON SAND COMPANY, LLC LIFE AND DISABILITY BENEFITS PLAN [EIN = 260310847]

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Company Name:	PATTISON SAND COMPANY, LLC
Employer identification number (EIN):	260130847
NAIC Classification:	212322
NAIC Description:	Industrial Sand Mining