401k Plan data: NATRON ENERGY INC HEALTH & WELFARE BENEFIT PLAN plan

NATRON ENERGY INC HEALTH & WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	NATRON ENERGY INC HEALTH & WELFARE BENEFIT PLAN
Plan identification number	502

NATRON ENERGY INC HEALTH & WELFARE BENEFIT 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)

401k Sponsoring company profile

NATRON ENERGY INC has sponsored the creation of one or more 401k plans.

Company Name: NATRON ENERGY INC

Employer identification number (EIN): 455350907

NAIC Classification: 335900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NATRON ENERGY INC HEALTH & WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2023-12-01 MARGUERITE DINNO 2024-06-14
502 2022-12-01 MARGUERITE DINNO 2024-06-25

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2023-12-01	MARGUERITE DINNO	2024-06-14
502	2022-12-01	MARGUERITE DINNO	2024-06-25

Form 5500 Responses for NATRON ENERGY INC HEALTH & WELFARE BENEFIT PLAN

2023: NATRON ENERGY INC HEALTH & WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-12-01	Type of plan entity	Single employer plan
2023-12-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2023-12-01	Plan funding arrangement – Insurance	Yes
2023-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-12-01	Plan benefit arrangement – Insurance	Yes
2023-12-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: NATRON ENERGY INC HEALTH & WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-12-01	Type of plan entity	Single employer plan
2022-12-01	Plan funding arrangement – Insurance	Yes
2022-12-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

730614

Policy instance

Insurance contract or identification number	730614
Number of Individuals Covered	85
Insurance policy start date	2023-12-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $3,625
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $61,689
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

0651283

Policy instance

Insurance contract or identification number	0651283
Number of Individuals Covered	182
Insurance policy start date	2023-12-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

30104301

Policy instance

Insurance contract or identification number	30104301
Number of Individuals Covered	177
Insurance policy start date	2023-12-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $91
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,020
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5999329

Policy instance

Insurance contract or identification number	5999329
Number of Individuals Covered	182
Insurance policy start date	2023-12-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )

Policy contract number

W0043054

Policy instance

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

730614

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

30104301

Policy instance

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5999329

Policy instance

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Company Name:	NATRON ENERGY INC
Employer identification number (EIN):	455350907
NAIC Classification:	335900