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SYMMETRY ENERGY SOLUTIONS, LLC HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan NameSYMMETRY ENERGY SOLUTIONS, LLC HEALTH AND WELFARE BENEFIT PLAN
Plan identification number 501

SYMMETRY ENERGY SOLUTIONS, LLC HEALTH AND WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare 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

SYMMETRY ENERGY SOLUTIONS, LLC has sponsored the creation of one or more 401k plans.

Company Name:SYMMETRY ENERGY SOLUTIONS, LLC
Employer identification number (EIN):721309319
NAIC Classification:525990
NAIC Description:Other Financial Vehicles

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SYMMETRY ENERGY SOLUTIONS, LLC HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01STEVEN TYLER2023-07-20
5012021-01-01STEVEN TYLER2022-06-15
5012021-01-01STEVEN TYLER2022-07-26
5012020-06-01ALEX ANTESTENIS2021-07-28

Plan Statistics for SYMMETRY ENERGY SOLUTIONS, LLC HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for SYMMETRY ENERGY SOLUTIONS, LLC HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2022: SYMMETRY ENERGY SOLUTIONS, LLC HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01368
Total number of active participants reported on line 7a of the Form 55002022-01-01241
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01241
Number of employers contributing to the scheme2022-01-010
2021: SYMMETRY ENERGY SOLUTIONS, LLC HEALTH AND WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01232
Total number of active participants reported on line 7a of the Form 55002021-01-01268
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01268
Number of employers contributing to the scheme2021-01-010
2020: SYMMETRY ENERGY SOLUTIONS, LLC HEALTH AND WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01280
Total number of active participants reported on line 7a of the Form 55002020-06-01232
Number of retired or separated participants receiving benefits2020-06-010
Number of other retired or separated participants entitled to future benefits2020-06-010
Total of all active and inactive participants2020-06-01232
Number of employers contributing to the scheme2020-06-010

Form 5500 Responses for SYMMETRY ENERGY SOLUTIONS, LLC HEALTH AND WELFARE BENEFIT PLAN

2022: SYMMETRY ENERGY SOLUTIONS, LLC HEALTH AND WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: SYMMETRY ENERGY SOLUTIONS, LLC HEALTH AND WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: SYMMETRY ENERGY SOLUTIONS, LLC HEALTH AND WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01First time form 5500 has been submittedYes
2020-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan funding arrangement – General assets of the sponsorYes
2020-06-01Plan benefit arrangement – InsuranceYes
2020-06-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

ALPHA DENTAL PROGRAMS, INC. (National Association of Insurance Commissioners NAIC id number: 95163 )
Policy contract number79344
Policy instance 4
Insurance contract or identification number79344
Number of Individuals Covered13
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $969
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,689
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $969
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number70189
Policy instance 3
Insurance contract or identification number70189
Number of Individuals Covered241
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,920
Total amount of fees paid to insurance companyUSD $8,815
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, BUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $266,133
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees8789
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $4,920
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30098447
Policy instance 2
Insurance contract or identification number30098447
Number of Individuals Covered183
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,673
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $52,113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,362
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number21004
Policy instance 1
Insurance contract or identification number21004
Number of Individuals Covered484
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $20,621
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $206,213
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $20,621
Amount paid for insurance broker fees0
Insurance broker organization code?3
ALPHA DENTAL PROGRAMS, INC. (National Association of Insurance Commissioners NAIC id number: 95163 )
Policy contract number79344
Policy instance 4
Insurance contract or identification number79344
Number of Individuals Covered50
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,042
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,058
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $1,042
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number70189
Policy instance 3
Insurance contract or identification number70189
Number of Individuals Covered268
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $9,574
Total amount of fees paid to insurance companyUSD $9,605
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, BUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $326,868
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,574
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30098447
Policy instance 2
Insurance contract or identification number30098447
Number of Individuals Covered184
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,139
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,147
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,864
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number21004
Policy instance 1
Insurance contract or identification number21004
Number of Individuals Covered522
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $21,362
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $203,989
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $21,362
Amount paid for insurance broker fees0
Insurance broker organization code?3
ALPHA DENTAL PROGRAMS, INC. (National Association of Insurance Commissioners NAIC id number: 95163 )
Policy contract number79344
Policy instance 4
Insurance contract or identification number79344
Number of Individuals Covered26
Insurance policy start date2020-06-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $483
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,834
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $483
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number70189
Policy instance 3
Insurance contract or identification number70189
Number of Individuals Covered268
Insurance policy start date2020-06-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $7,777
Total amount of fees paid to insurance companyUSD $26
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, BUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $195,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,777
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATION FEES
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30098447
Policy instance 2
Insurance contract or identification number30098447
Number of Individuals Covered197
Insurance policy start date2020-06-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $2,240
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,927
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,446
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number21004
Policy instance 1
Insurance contract or identification number21004
Number of Individuals Covered581
Insurance policy start date2020-06-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $13,452
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $134,522
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $13,452
Amount paid for insurance broker fees0
Insurance broker organization code?3

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