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PA IOS, LLC MEDICAL PLAN 401k Plan overview

Plan NamePA IOS, LLC MEDICAL PLAN
Plan identification number 501

PA IOS, LLC MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

PA IOS, LLC has sponsored the creation of one or more 401k plans.

Company Name:PA IOS, LLC
Employer identification number (EIN):271231674
NAIC Classification:211110
NAIC Description: Oil and Gas Extraction, Oil

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PA IOS, LLC MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012015-08-01JOSEPH CASCHERA
5012014-08-01ARLIE THRUSH
5012013-08-01ARLIE THRUSH
5012012-08-01LINDA MCCAULEY

Plan Statistics for PA IOS, LLC MEDICAL PLAN

401k plan membership statisitcs for PA IOS, LLC MEDICAL PLAN

Measure Date Value
2015: PA IOS, LLC MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-01124
Total number of active participants reported on line 7a of the Form 55002015-08-0187
Number of retired or separated participants receiving benefits2015-08-014
Number of other retired or separated participants entitled to future benefits2015-08-010
Total of all active and inactive participants2015-08-0191
2014: PA IOS, LLC MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-01160
Total number of active participants reported on line 7a of the Form 55002014-08-01120
Number of retired or separated participants receiving benefits2014-08-014
Number of other retired or separated participants entitled to future benefits2014-08-010
Total of all active and inactive participants2014-08-01124
2013: PA IOS, LLC MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-01239
Total number of active participants reported on line 7a of the Form 55002013-08-01160
Number of retired or separated participants receiving benefits2013-08-010
Number of other retired or separated participants entitled to future benefits2013-08-010
Total of all active and inactive participants2013-08-01160
2012: PA IOS, LLC MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-01130
Total number of active participants reported on line 7a of the Form 55002012-08-01239
Number of retired or separated participants receiving benefits2012-08-010
Number of other retired or separated participants entitled to future benefits2012-08-010
Total of all active and inactive participants2012-08-01239

Form 5500 Responses for PA IOS, LLC MEDICAL PLAN

2015: PA IOS, LLC MEDICAL PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Submission has been amendedNo
2015-08-01This submission is the final filingNo
2015-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-08-01Plan is a collectively bargained planNo
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan benefit arrangement – InsuranceYes
2014: PA IOS, LLC MEDICAL PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Submission has been amendedNo
2014-08-01This submission is the final filingNo
2014-08-01This return/report is a short plan year return/report (less than 12 months)No
2014-08-01Plan is a collectively bargained planNo
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan benefit arrangement – InsuranceYes
2013: PA IOS, LLC MEDICAL PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Submission has been amendedNo
2013-08-01This submission is the final filingNo
2013-08-01This return/report is a short plan year return/report (less than 12 months)No
2013-08-01Plan is a collectively bargained planNo
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – InsuranceYes
2012: PA IOS, LLC MEDICAL PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01First time form 5500 has been submittedYes
2012-08-01Submission has been amendedNo
2012-08-01This submission is the final filingNo
2012-08-01This return/report is a short plan year return/report (less than 12 months)No
2012-08-01Plan is a collectively bargained planNo
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUE CROSS OF NORTHEASTERN PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 60147 )
Policy contract number204379
Policy instance 1
BLUE CROSS OF NORTHEASTERN PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 60147 )
Policy contract number501000, 501001
Policy instance 2
BLUE CROSS OF NORTHEASTERN PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 60147 )
Policy contract number204379, 204380
Policy instance 1
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number2273060000
Policy instance 1
HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number2273060000
Policy instance 1
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number2273060000
Policy instance 2

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