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CLEOPATRA RESOURCES, LLC GROUP MEDICAL PLAN 401k Plan overview

Plan NameCLEOPATRA RESOURCES, LLC GROUP MEDICAL PLAN
Plan identification number 501

CLEOPATRA RESOURCES, LLC GROUP MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

CLEOPATRA RESOURCES, LLC has sponsored the creation of one or more 401k plans.

Company Name:CLEOPATRA RESOURCES, LLC
Employer identification number (EIN):454645722
NAIC Classification:221210
NAIC Description:Natural Gas Distribution

Additional information about CLEOPATRA RESOURCES, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 4966814

More information about CLEOPATRA RESOURCES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLEOPATRA RESOURCES, LLC GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-01-01
5012019-01-01
5012018-01-01

Plan Statistics for CLEOPATRA RESOURCES, LLC GROUP MEDICAL PLAN

401k plan membership statisitcs for CLEOPATRA RESOURCES, LLC GROUP MEDICAL PLAN

Measure Date Value
2020: CLEOPATRA RESOURCES, LLC GROUP MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-010
Total number of active participants reported on line 7a of the Form 55002020-01-010
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-010
2019: CLEOPATRA RESOURCES, LLC GROUP MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01149
Total number of active participants reported on line 7a of the Form 55002019-01-01129
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01130
2018: CLEOPATRA RESOURCES, LLC GROUP MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0147
Total number of active participants reported on line 7a of the Form 55002018-01-01147
Number of retired or separated participants receiving benefits2018-01-012
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01149

Financial Data on CLEOPATRA RESOURCES, LLC GROUP MEDICAL PLAN

Measure Date Value
2020 : CLEOPATRA RESOURCES, LLC GROUP MEDICAL PLAN 2020 401k financial data
Total plan liabilities at end of year2020-12-31$0
Total plan liabilities at beginning of year2020-12-31$138,923
Total income from all sources2020-12-31$301,979
Expenses. Total of all expenses incurred2020-12-31$321,603
Benefits paid (including direct rollovers)2020-12-31$-36,862
Total plan assets at end of year2020-12-31$0
Total plan assets at beginning of year2020-12-31$158,547
Value of fidelity bond covering the plan2020-12-31$1,000,000
Expenses. Other expenses not covered elsewhere2020-12-31$178,177
Other income received2020-12-31$62
Net income (gross income less expenses)2020-12-31$-19,624
Net plan assets at end of year (total assets less liabilities)2020-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$19,624
Total contributions received or receivable from employer(s)2020-12-31$301,917
Value of corrective distributions2020-12-31$160,349
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$19,939
2019 : CLEOPATRA RESOURCES, LLC GROUP MEDICAL PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$138,923
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$183,989
Total income from all sources (including contributions)2019-12-31$1,774,555
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$1,592,295
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,080,753
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,774,285
Value of total assets at end of year2019-12-31$158,547
Value of total assets at beginning of year2019-12-31$21,353
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$511,542
Total interest from all sources2019-12-31$270
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$600,928
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$87,303
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$131,127
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$148,777
Administrative expenses (other) incurred2019-12-31$373,373
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$182,260
Value of net assets at end of year (total assets less liabilities)2019-12-31$19,624
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$-162,636
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$34,274
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$71,244
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$21,353
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$21,353
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$270
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$1,080,753
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Assets. Invements in employer securities at end of year2019-12-31$0
Assets. Invements in employer securities at beginning of year2019-12-31$0
Contributions received in cash from employer2019-12-31$1,173,357
Contract administrator fees2019-12-31$103,895
Liabilities. Value of benefit claims payable at end of year2019-12-31$7,796
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$35,212
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2019-12-31251589048
2018 : CLEOPATRA RESOURCES, LLC GROUP MEDICAL PLAN 2018 401k financial data
Total plan liabilities at end of year2018-12-31$183,989
Total income from all sources2018-12-31$1,827,100
Expenses. Total of all expenses incurred2018-12-31$1,989,736
Benefits paid (including direct rollovers)2018-12-31$1,423,582
Total plan assets at end of year2018-12-31$21,353
Value of fidelity bond covering the plan2018-12-31$1,000,000
Total contributions received or receivable from participants2018-12-31$197,421
Expenses. Other expenses not covered elsewhere2018-12-31$500,329
Contributions received from other sources (not participants or employers)2018-12-31$969
Other income received2018-12-31$263
Net income (gross income less expenses)2018-12-31$-162,636
Net plan assets at end of year (total assets less liabilities)2018-12-31$-162,636
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$0
Total contributions received or receivable from employer(s)2018-12-31$1,628,447
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$65,825

Form 5500 Responses for CLEOPATRA RESOURCES, LLC GROUP MEDICAL PLAN

2020: CLEOPATRA RESOURCES, LLC GROUP MEDICAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingYes
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: CLEOPATRA RESOURCES, LLC GROUP MEDICAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: CLEOPATRA RESOURCES, LLC GROUP MEDICAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01First time form 5500 has been submittedYes
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500351
Policy instance 1
Insurance contract or identification number30500351
Number of Individuals Covered130
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $373,373
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered150
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $431,860
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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