401k Plan data: EVANSVILLE MARINE SERVICE, INC. HEALTH AND VISION PLAN plan

EVANSVILLE MARINE SERVICE, INC. HEALTH AND VISION PLAN 401k Plan overview

Plan Name	EVANSVILLE MARINE SERVICE, INC. HEALTH AND VISION PLAN
Plan identification number	501

EVANSVILLE MARINE SERVICE, INC. HEALTH AND VISION PLAN Benefits

401k Plan Type

Welfare Benefit

Plan Features/Benefits

Health (other than dental or vision)
Life insurance
Dental
Vision
Temporary disability (accident and sickness)
Long-term disability cover
Death benefits (include travel accident but not life insurance)
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.
Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

EVANSVILLE MARINE SERVICE, INC. has sponsored the creation of one or more 401k plans.

Company Name: EVANSVILLE MARINE SERVICE, INC.

Employer identification number (EIN): 351930685

NAIC Classification: 483000
NAIC Description: Water Transportation

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EVANSVILLE MARINE SERVICE, INC. HEALTH AND VISION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-08-01 KRISTI FRANK 2024-12-17
501 2022-08-01 KRISTI FRANK 2024-02-28
501 2021-08-01 KRISTI FRANK 2022-11-18
501 2020-08-01 KRISTI FRANK 2021-11-15
501 2019-08-01 KRISTI FRANK 2021-02-19
501 2018-08-01 KRISTI FRANK 2019-12-17
501 2017-08-01
501 2016-08-01
501 2015-08-01 ROBERT ALDRICH
501 2013-08-01 ROBERT ALDRICH

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2023-08-01	KRISTI FRANK	2024-12-17
501	2022-08-01	KRISTI FRANK	2024-02-28
501	2021-08-01	KRISTI FRANK	2022-11-18
501	2020-08-01	KRISTI FRANK	2021-11-15
501	2019-08-01	KRISTI FRANK	2021-02-19
501	2018-08-01	KRISTI FRANK	2019-12-17
501	2017-08-01
501	2016-08-01
501	2015-08-01	ROBERT ALDRICH
501	2013-08-01	ROBERT ALDRICH

Form 5500 Responses for EVANSVILLE MARINE SERVICE, INC. HEALTH AND VISION PLAN

2023: EVANSVILLE MARINE SERVICE, INC. HEALTH AND VISION PLAN 2023 form 5500 responses
2023-08-01	Type of plan entity	Single employer plan
2023-08-01	Plan funding arrangement – Insurance	Yes
2023-08-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-08-01	Plan benefit arrangement – Insurance	Yes
2023-08-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: EVANSVILLE MARINE SERVICE, INC. HEALTH AND VISION PLAN 2022 form 5500 responses
2022-08-01	Type of plan entity	Single employer plan
2022-08-01	Plan funding arrangement – Insurance	Yes
2022-08-01	Plan benefit arrangement – Insurance	Yes
2021: EVANSVILLE MARINE SERVICE, INC. HEALTH AND VISION PLAN 2021 form 5500 responses
2021-08-01	Type of plan entity	Single employer plan
2021-08-01	Plan funding arrangement – Insurance	Yes
2021-08-01	Plan benefit arrangement – Insurance	Yes
2020: EVANSVILLE MARINE SERVICE, INC. HEALTH AND VISION PLAN 2020 form 5500 responses
2020-08-01	Type of plan entity	Single employer plan
2020-08-01	Plan funding arrangement – Insurance	Yes
2020-08-01	Plan benefit arrangement – Insurance	Yes
2019: EVANSVILLE MARINE SERVICE, INC. HEALTH AND VISION PLAN 2019 form 5500 responses
2019-08-01	Type of plan entity	Single employer plan
2019-08-01	Plan funding arrangement – Insurance	Yes
2019-08-01	Plan benefit arrangement – Insurance	Yes
2018: EVANSVILLE MARINE SERVICE, INC. HEALTH AND VISION PLAN 2018 form 5500 responses
2018-08-01	Type of plan entity	Single employer plan
2018-08-01	Plan funding arrangement – Insurance	Yes
2018-08-01	Plan benefit arrangement – Insurance	Yes
2017: EVANSVILLE MARINE SERVICE, INC. HEALTH AND VISION PLAN 2017 form 5500 responses
2017-08-01	Type of plan entity	Single employer plan
2017-08-01	Plan funding arrangement – Insurance	Yes
2017-08-01	Plan benefit arrangement – Insurance	Yes
2016: EVANSVILLE MARINE SERVICE, INC. HEALTH AND VISION PLAN 2016 form 5500 responses
2016-08-01	Type of plan entity	Single employer plan
2016-08-01	Submission has been amended	No
2016-08-01	This submission is the final filing	No
2016-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-08-01	Plan is a collectively bargained plan	No
2016-08-01	Plan funding arrangement – Insurance	Yes
2016-08-01	Plan benefit arrangement – Insurance	Yes
2015: EVANSVILLE MARINE SERVICE, INC. HEALTH AND VISION 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)	No
2015-08-01	Plan is a collectively bargained plan	No
2015-08-01	Plan funding arrangement – Insurance	Yes
2015-08-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-08-01	Plan benefit arrangement – Insurance	Yes
2013: EVANSVILLE MARINE SERVICE, INC. HEALTH AND VISION PLAN 2013 form 5500 responses
2013-08-01	Type of plan entity	Single employer plan
2013-08-01	First time form 5500 has been submitted	Yes
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 funding arrangement – General assets of the sponsor	Yes
2013-08-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BANKERS FIDELITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61239 )

Policy contract number

W5357-001

Policy instance

Insurance contract or identification number	W5357-001
Number of Individuals Covered	83
Insurance policy start date	2023-08-01
Insurance policy end date	2024-07-31
Total amount of commissions paid to insurance broker	USD $4,461
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT, CRITICAL ILLNESS, CANCER
Welfare Benefit Premiums Paid to Carrier	USD $20,880
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G615932

Policy instance

Insurance contract or identification number	G615932
Number of Individuals Covered	136
Insurance policy start date	2023-08-01
Insurance policy end date	2024-07-31
Total amount of commissions paid to insurance broker	USD $11,409
Total amount of fees paid to insurance company	USD $5,148
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $105,057
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )

Policy contract number

W10505

Policy instance

Insurance contract or identification number	W10505
Number of Individuals Covered	208
Insurance policy start date	2023-08-01
Insurance policy end date	2024-07-31
Total amount of commissions paid to insurance broker	USD $546
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,063
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

554111821010

Policy instance

Insurance contract or identification number	554111821010
Number of Individuals Covered	204
Insurance policy start date	2023-08-01
Insurance policy end date	2024-07-31
Total amount of commissions paid to insurance broker	USD $5,107
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $51,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

554111821010

Policy instance

ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )

Policy contract number

W10505

Policy instance

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

81334

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G615932

Policy instance

ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )

Policy contract number

8E0000

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G00615932

Policy instance

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

81334

Policy instance

ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )

Policy contract number

W10505

Policy instance

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

554111821010

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G00615932

Policy instance

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

81334

Policy instance

ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )

Policy contract number

W10505

Policy instance

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

554111821010

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G00615932

Policy instance

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

81334

Policy instance

ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )

Policy contract number

W10505

Policy instance

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

554111821010

Policy instance

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

554111821010

Policy instance

ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )

Policy contract number

W10505

Policy instance

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

81334

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G00615932

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G615932

Policy instance

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

81334

Policy instance

ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )

Policy contract number

235368

Policy instance

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

554111821010

Policy instance

ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )

Policy contract number

00235368

Policy instance

ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )

Policy contract number

00235368

Policy instance

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Company Name:	EVANSVILLE MARINE SERVICE, INC.
Employer identification number (EIN):	351930685
NAIC Classification:	483000
NAIC Description:	Water Transportation