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AGAVE ENERGY LIFE INSURANCE 401k Plan overview

Plan NameAGAVE ENERGY LIFE INSURANCE
Plan identification number 503

AGAVE ENERGY LIFE INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

HEALTHCARE SERVICE CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:HEALTHCARE SERVICE CORPORATION
Employer identification number (EIN):361236610
NAIC Classification:524140

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AGAVE ENERGY LIFE INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032015-01-01BILL THALMAN
5032012-01-01GENE GEORGE GENE GEORGE2013-10-07
5032011-01-01GENE GEORGE
5032009-01-01GENE GEORGE,EXECUTIVE DIR,TREASURY GENE GEORGE,EXECUTIVE DIR.TREASURY2010-10-13

Plan Statistics for AGAVE ENERGY LIFE INSURANCE

401k plan membership statisitcs for AGAVE ENERGY LIFE INSURANCE

Measure Date Value
2015: AGAVE ENERGY LIFE INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-01-01172
Total number of active participants reported on line 7a of the Form 55002015-01-01180
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01180
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01180
2012: AGAVE ENERGY LIFE INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-01-0116,748
Total number of active participants reported on line 7a of the Form 55002012-01-0117,114
Total of all active and inactive participants2012-01-0117,114
Total participants2012-01-0117,114
2011: AGAVE ENERGY LIFE INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-01-0116,242
Total number of active participants reported on line 7a of the Form 55002011-01-0116,748
Total of all active and inactive participants2011-01-0116,748
Total participants2011-01-0116,748
2009: AGAVE ENERGY LIFE INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-01-0117,608
Total number of active participants reported on line 7a of the Form 55002009-01-0117,597
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-0117,597
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010

Form 5500 Responses for AGAVE ENERGY LIFE INSURANCE

2015: AGAVE ENERGY LIFE INSURANCE 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01First time form 5500 has been submittedYes
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2012: AGAVE ENERGY LIFE INSURANCE 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingYes
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 funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: AGAVE ENERGY LIFE INSURANCE 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: AGAVE ENERGY LIFE INSURANCE 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number4056
Policy instance 1
Insurance contract or identification number4056
Number of Individuals Covered17114
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number4056
Policy instance 1
Insurance contract or identification number4056
Number of Individuals Covered16748
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number4056
Policy instance 1
Insurance contract or identification number4056
Number of Individuals Covered16242
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D ACCIDENTAL DEATH & DISMEMBERMENT

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