401k Plan data: PETROLEUM CONTAINMENT, INC HEALTH AND WELFARE BENEFIT PLAN plan

PETROLEUM CONTAINMENT, INC HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	PETROLEUM CONTAINMENT, INC HEALTH AND WELFARE BENEFIT PLAN
Plan identification number	501

PETROLEUM CONTAINMENT, INC HEALTH AND 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

PETROLEUM CONTAINMENT, INC. has sponsored the creation of one or more 401k plans.

Company Name: PETROLEUM CONTAINMENT, INC.

Employer identification number (EIN): 592427312

NAIC Classification: 326100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PETROLEUM CONTAINMENT, INC HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01 TANYA PRILL 2024-07-16

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-01-01	TANYA PRILL	2024-07-16

Form 5500 Responses for PETROLEUM CONTAINMENT, INC HEALTH AND WELFARE BENEFIT PLAN

2023: PETROLEUM CONTAINMENT, INC HEALTH AND WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	First time form 5500 has been submitted	Yes
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

1L5394

Policy instance

Insurance contract or identification number	1L5394
Number of Individuals Covered	173
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $4,823
Total amount of fees paid to insurance company	USD $1,190
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $54,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

958539

Policy instance

Insurance contract or identification number	958539
Number of Individuals Covered	111
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $7,188
Total amount of fees paid to insurance company	USD $2,595
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to Carrier	USD $53,884
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	PETROLEUM CONTAINMENT, INC.
Employer identification number (EIN):	592427312
NAIC Classification:	326100