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| Plan Name | ENERGY MAINTENANCE SERVICES GROUP HEALTH AND WELFARE PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | EMS ENERGY SOLUTIONS, LLC |
| Employer identification number (EIN): | 821718569 |
| NAIC Classification: | 221100 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2018-04-01 | JASON SETTE | 2019-08-09 | ||
| 501 | 2017-04-01 |
| Measure | Date | Value |
|---|---|---|
| 2018: ENERGY MAINTENANCE SERVICES GROUP HEALTH AND WELFARE PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-04-01 | 352 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-04-01 | 0 |
| Number of retired or separated participants receiving benefits | 2018-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-04-01 | 0 |
| Total of all active and inactive participants | 2018-04-01 | 0 |
| Number of employers contributing to the scheme | 2018-04-01 | 0 |
| 2017: ENERGY MAINTENANCE SERVICES GROUP HEALTH AND WELFARE PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-04-01 | 527 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-04-01 | 352 |
| Number of retired or separated participants receiving benefits | 2017-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-04-01 | 0 |
| Total of all active and inactive participants | 2017-04-01 | 352 |
| Number of employers contributing to the scheme | 2017-04-01 | 0 |
| 2018: ENERGY MAINTENANCE SERVICES GROUP HEALTH AND WELFARE PLAN 2018 form 5500 responses | ||
|---|---|---|
| 2018-04-01 | Type of plan entity | Single employer plan |
| 2018-04-01 | This submission is the final filing | Yes |
| 2018-04-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2018-04-01 | Plan funding arrangement – Insurance | Yes |
| 2018-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: ENERGY MAINTENANCE SERVICES GROUP HEALTH AND WELFARE PLAN 2017 form 5500 responses | ||
| 2017-04-01 | Type of plan entity | Single employer plan |
| 2017-04-01 | Plan funding arrangement – Insurance | Yes |
| 2017-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) | |||||||||||||||||||||||||
| Policy contract number | 30012935 | ||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||
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| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||||||||
| Policy contract number | 0847707 | ||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |||||||||||||||||||||||||
| Policy contract number | 5926602 | ||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||
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