401k Plan data: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS plan

EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 401k Plan overview

Plan Name	EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS
Plan identification number	508

EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision

401k Sponsoring company profile

EXPERIENCE WORKS, INC. has sponsored the creation of one or more 401k plans.

Company Name: EXPERIENCE WORKS, INC.

Employer identification number (EIN): 520817955

NAIC Classification: 813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about EXPERIENCE WORKS, INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1993-08-20

Company Identification Number: 0009671307

Legal Registered Office Address: 900 AUSTIN AVE STE 303

WACO
United States of America (USA)
76701

More information about EXPERIENCE WORKS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
508 2014-07-01
508 2013-07-01 FANNY CASTELLAR, HR BENEFITS ADMIN
508 2012-07-01 FANNY CASTELLAR, HR BENEFITS ADMIN
508 2011-07-01 WILLIAM DODSON, DIR HUMAN RESOURCES
508 2010-07-01 WILLIAM DODSON, DIR HUMAN RESOURCES
508 2009-07-01 WILLIAM DODSON, DIR HUMAN RESOURCES 2011-04-15
508 2009-07-01 WILLIAM DODSON, DIR HUMAN RESOURCES

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
508	2014-07-01
508	2013-07-01	FANNY CASTELLAR, HR BENEFITS ADMIN
508	2012-07-01	FANNY CASTELLAR, HR BENEFITS ADMIN
508	2011-07-01	WILLIAM DODSON, DIR HUMAN RESOURCES
508	2010-07-01	WILLIAM DODSON, DIR HUMAN RESOURCES
508	2009-07-01		WILLIAM DODSON, DIR HUMAN RESOURCES	2011-04-15
508	2009-07-01	WILLIAM DODSON, DIR HUMAN RESOURCES

Plan Statistics for EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS

401k plan membership statisitcs for EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS

Measure Date Value
2014: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2014 401k membership
Total participants, beginning-of-year 2014-07-01 266
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 0
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 0
Total of all active and inactive participants 2014-07-01 0
2013: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2013 401k membership
Total participants, beginning-of-year 2013-07-01 263
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 258
Number of retired or separated participants receiving benefits 2013-07-01 8
Total of all active and inactive participants 2013-07-01 266
2012: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2012 401k membership
Total participants, beginning-of-year 2012-07-01 266
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 257
Number of retired or separated participants receiving benefits 2012-07-01 6
Total of all active and inactive participants 2012-07-01 263
2011: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2011 401k membership
Total participants, beginning-of-year 2011-07-01 399
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 262
Number of retired or separated participants receiving benefits 2011-07-01 4
Total of all active and inactive participants 2011-07-01 266
2010: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2010 401k membership
Total participants, beginning-of-year 2010-07-01 409
Total number of active participants reported on line 7a of the Form 5500 2010-07-01 397
Number of retired or separated participants receiving benefits 2010-07-01 2
Total of all active and inactive participants 2010-07-01 399
2009: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2009 401k membership
Total participants, beginning-of-year 2009-07-01 289
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 406
Number of retired or separated participants receiving benefits 2009-07-01 3
Total of all active and inactive participants 2009-07-01 409

Measure	Date	Value
2014: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2014 401k membership
Total participants, beginning-of-year	2014-07-01	266
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	0
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	0
2013: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2013 401k membership
Total participants, beginning-of-year	2013-07-01	263
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	258
Number of retired or separated participants receiving benefits	2013-07-01	8
Total of all active and inactive participants	2013-07-01	266
2012: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2012 401k membership
Total participants, beginning-of-year	2012-07-01	266
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	257
Number of retired or separated participants receiving benefits	2012-07-01	6
Total of all active and inactive participants	2012-07-01	263
2011: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2011 401k membership
Total participants, beginning-of-year	2011-07-01	399
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	262
Number of retired or separated participants receiving benefits	2011-07-01	4
Total of all active and inactive participants	2011-07-01	266
2010: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2010 401k membership
Total participants, beginning-of-year	2010-07-01	409
Total number of active participants reported on line 7a of the Form 5500	2010-07-01	397
Number of retired or separated participants receiving benefits	2010-07-01	2
Total of all active and inactive participants	2010-07-01	399
2009: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2009 401k membership
Total participants, beginning-of-year	2009-07-01	289
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	406
Number of retired or separated participants receiving benefits	2009-07-01	3
Total of all active and inactive participants	2009-07-01	409

Form 5500 Responses for EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS

2014: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	Yes
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2010 form 5500 responses
2010-07-01	Type of plan entity	Single employer plan
2010-07-01	Submission has been amended	No
2010-07-01	This submission is the final filing	No
2010-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-07-01	Plan is a collectively bargained plan	No
2010-07-01	Plan funding arrangement – Insurance	Yes
2010-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-07-01	Plan benefit arrangement – Insurance	Yes
2010-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: EXPERIENCE WORKS, INC.-STAFF HEALTH BENEFITS 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	EXPERIENCE WORKS, INC.
Employer identification number (EIN):	520817955
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1993-08-20
Company Identification Number:	0009671307
Legal Registered Office Address:	900 AUSTIN AVE STE 303 WACO United States of America (USA) 76701