401k Plan data: COASTAL ENERGY CORPORATION GROUP WELFARE PLAN plan

COASTAL ENERGY CORPORATION GROUP WELFARE PLAN 401k Plan overview

Plan Name	COASTAL ENERGY CORPORATION GROUP WELFARE PLAN
Plan identification number	501

COASTAL ENERGY CORPORATION GROUP WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

COASTAL ENERGY CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: COASTAL ENERGY CORPORATION

Employer identification number (EIN): 431243469

NAIC Classification: 424700

Additional information about COASTAL ENERGY CORPORATION

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date: 1978-07-13

Company Identification Number: 0857081

Legal Registered Office Address: Corporation Trust Center
1209 Orange St
Wilmington
United States of America (USA)
19801

More information about COASTAL ENERGY CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COASTAL ENERGY CORPORATION GROUP WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-01-01 PATTY SPITSER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2017-01-01	PATTY SPITSER

Plan Statistics for COASTAL ENERGY CORPORATION GROUP WELFARE PLAN

401k plan membership statisitcs for COASTAL ENERGY CORPORATION GROUP WELFARE PLAN

Measure Date Value
2017: COASTAL ENERGY CORPORATION GROUP WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 103
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 102
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 102

Measure	Date	Value
2017: COASTAL ENERGY CORPORATION GROUP WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	103
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	102
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	102

Form 5500 Responses for COASTAL ENERGY CORPORATION GROUP WELFARE PLAN

2017: COASTAL ENERGY CORPORATION GROUP WELFARE PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 )

Policy contract number

09206B

Policy instance

Insurance contract or identification number	09206B
Number of Individuals Covered	52
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,346
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	OTHER (AD&D)
Welfare Benefit Premiums Paid to Carrier	USD $19,162
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,189
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES

KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 )

Policy contract number

09206

Policy instance

Insurance contract or identification number	09206
Number of Individuals Covered	50
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,590
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	OTHER (AD&D)
Welfare Benefit Premiums Paid to Carrier	USD $16,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,450
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES

KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 )

Policy contract number

09206C

Policy instance

Insurance contract or identification number	09206C
Number of Individuals Covered	49
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,734
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $23,594
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,525
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES

KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 )

Policy contract number

09206A

Policy instance

Insurance contract or identification number	09206A
Number of Individuals Covered	50
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $2,532
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $36,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,219
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES

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Company Name:	COASTAL ENERGY CORPORATION
Employer identification number (EIN):	431243469
NAIC Classification:	424700

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:	1978-07-13
Company Identification Number:	0857081
Legal Registered Office Address:	Corporation Trust Center 1209 Orange St Wilmington United States of America (USA) 19801