401k Plan data: PA IOS, LLC EMPLOYEE BENEFIT PLAN plan

PA IOS, LLC EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan Name	PA IOS, LLC EMPLOYEE BENEFIT PLAN
Plan identification number	502

PA IOS, LLC EMPLOYEE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Dental Vision Temporary disability (accident and sickness) 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 EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2015-08-01 JOSEPH CASCHERA
502 2014-08-01 ARLIE THRUSH
502 2013-08-01 ARLIE THRUSH
502 2012-08-01 LINDA MCCAULEY

Plan id#	Filing Submission Date	Name of Administrator
502	2015-08-01	JOSEPH CASCHERA
502	2014-08-01	ARLIE THRUSH
502	2013-08-01	ARLIE THRUSH
502	2012-08-01	LINDA MCCAULEY

Plan Statistics for PA IOS, LLC EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for PA IOS, LLC EMPLOYEE BENEFIT PLAN

Measure Date Value
2015: PA IOS, LLC EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-08-01 128
Total number of active participants reported on line 7a of the Form 5500 2015-08-01 26
Number of retired or separated participants receiving benefits 2015-08-01 4
Number of other retired or separated participants entitled to future benefits 2015-08-01 0
Total of all active and inactive participants 2015-08-01 30
2014: PA IOS, LLC EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-08-01 165
Total number of active participants reported on line 7a of the Form 5500 2014-08-01 124
Number of retired or separated participants receiving benefits 2014-08-01 4
Number of other retired or separated participants entitled to future benefits 2014-08-01 0
Total of all active and inactive participants 2014-08-01 128
2013: PA IOS, LLC EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-08-01 143
Total number of active participants reported on line 7a of the Form 5500 2013-08-01 165
Number of retired or separated participants receiving benefits 2013-08-01 0
Number of other retired or separated participants entitled to future benefits 2013-08-01 0
Total of all active and inactive participants 2013-08-01 165
2012: PA IOS, LLC EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-08-01 119
Total number of active participants reported on line 7a of the Form 5500 2012-08-01 143
Number of retired or separated participants receiving benefits 2012-08-01 0
Number of other retired or separated participants entitled to future benefits 2012-08-01 0
Total of all active and inactive participants 2012-08-01 143

Measure	Date	Value
2015: PA IOS, LLC EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-08-01	128
Total number of active participants reported on line 7a of the Form 5500	2015-08-01	26
Number of retired or separated participants receiving benefits	2015-08-01	4
Number of other retired or separated participants entitled to future benefits	2015-08-01	0
Total of all active and inactive participants	2015-08-01	30
2014: PA IOS, LLC EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-08-01	165
Total number of active participants reported on line 7a of the Form 5500	2014-08-01	124
Number of retired or separated participants receiving benefits	2014-08-01	4
Number of other retired or separated participants entitled to future benefits	2014-08-01	0
Total of all active and inactive participants	2014-08-01	128
2013: PA IOS, LLC EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-08-01	143
Total number of active participants reported on line 7a of the Form 5500	2013-08-01	165
Number of retired or separated participants receiving benefits	2013-08-01	0
Number of other retired or separated participants entitled to future benefits	2013-08-01	0
Total of all active and inactive participants	2013-08-01	165
2012: PA IOS, LLC EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-08-01	119
Total number of active participants reported on line 7a of the Form 5500	2012-08-01	143
Number of retired or separated participants receiving benefits	2012-08-01	0
Number of other retired or separated participants entitled to future benefits	2012-08-01	0
Total of all active and inactive participants	2012-08-01	143

Form 5500 Responses for PA IOS, LLC EMPLOYEE BENEFIT PLAN

2015: PA IOS, LLC EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-08-01	Type of plan entity	Single employer plan
2015-08-01	Submission has been amended	No
2015-08-01	This submission is the final filing	No
2015-08-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-08-01	Plan is a collectively bargained plan	No
2015-08-01	Plan funding arrangement – Insurance	Yes
2015-08-01	Plan benefit arrangement – Insurance	Yes
2014: PA IOS, LLC EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-08-01	Type of plan entity	Single employer plan
2014-08-01	Submission has been amended	No
2014-08-01	This submission is the final filing	No
2014-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-08-01	Plan is a collectively bargained plan	No
2014-08-01	Plan funding arrangement – Insurance	Yes
2014-08-01	Plan benefit arrangement – Insurance	Yes
2013: PA IOS, LLC EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-08-01	Type of plan entity	Single employer plan
2013-08-01	Submission has been amended	No
2013-08-01	This submission is the final filing	No
2013-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-08-01	Plan is a collectively bargained plan	No
2013-08-01	Plan funding arrangement – Insurance	Yes
2013-08-01	Plan benefit arrangement – Insurance	Yes
2012: PA IOS, LLC EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-08-01	Type of plan entity	Single employer plan
2012-08-01	First time form 5500 has been submitted	Yes
2012-08-01	Submission has been amended	No
2012-08-01	This submission is the final filing	No
2012-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-08-01	Plan is a collectively bargained plan	No
2012-08-01	Plan funding arrangement – Insurance	Yes
2012-08-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00466167
Policy instance	1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00466167
Policy instance	1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00466167
Policy instance	1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00466167
Policy instance	1

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