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| Plan Name | EXPERIENCE WORKS, INC. WELFARE BENEFIT PLAN |
| Plan identification number | 514 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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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 |
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.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 514 | 2017-07-01 | ||||
| 514 | 2016-07-01 | ||||
| 514 | 2015-07-01 |
| Measure | Date | Value |
|---|---|---|
| 2017: EXPERIENCE WORKS, INC. WELFARE BENEFIT PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-07-01 | 312 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 66 |
| Number of retired or separated participants receiving benefits | 2017-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-07-01 | 0 |
| Total of all active and inactive participants | 2017-07-01 | 66 |
| 2016: EXPERIENCE WORKS, INC. WELFARE BENEFIT PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-07-01 | 257 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 300 |
| Number of retired or separated participants receiving benefits | 2016-07-01 | 5 |
| Number of other retired or separated participants entitled to future benefits | 2016-07-01 | 7 |
| Total of all active and inactive participants | 2016-07-01 | 312 |
| 2015: EXPERIENCE WORKS, INC. WELFARE BENEFIT PLAN 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-07-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 238 |
| Number of retired or separated participants receiving benefits | 2015-07-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2015-07-01 | 17 |
| Total of all active and inactive participants | 2015-07-01 | 257 |
| 2017: EXPERIENCE WORKS, INC. WELFARE BENEFIT PLAN 2017 form 5500 responses | ||
|---|---|---|
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Submission has been amended | No |
| 2017-07-01 | This submission is the final filing | No |
| 2017-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-07-01 | Plan is a collectively bargained plan | No |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: EXPERIENCE WORKS, INC. WELFARE BENEFIT PLAN 2016 form 5500 responses | ||
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Submission has been amended | No |
| 2016-07-01 | This submission is the final filing | No |
| 2016-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-07-01 | Plan is a collectively bargained plan | No |
| 2016-07-01 | Plan funding arrangement – Insurance | Yes |
| 2016-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: EXPERIENCE WORKS, INC. WELFARE BENEFIT PLAN 2015 form 5500 responses | ||
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | First time form 5500 has been submitted | Yes |
| 2015-07-01 | Submission has been amended | No |
| 2015-07-01 | This submission is the final filing | No |
| 2015-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-07-01 | Plan is a collectively bargained plan | No |
| 2015-07-01 | Plan funding arrangement – Insurance | Yes |
| 2015-07-01 | Plan benefit arrangement – Insurance | Yes |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | GL 156086 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 1TEM | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 67063 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | TMO5595946 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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