401k Plan data: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK plan

SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 401k Plan overview

Plan Name	SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK
Plan identification number	004

SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

CORNERSTONE BANK has sponsored the creation of one or more 401k plans.

Company Name: CORNERSTONE BANK

Employer identification number (EIN): 041856390

NAIC Classification: 522120
NAIC Description: Savings Institutions

Additional information about CORNERSTONE BANK

Jurisdiction of Incorporation: Commonwealth of Massachusetts Corporations Division

Incorporation Date:

Company Identification Number: 000949932

More information about CORNERSTONE BANK

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
004 2022-01-01 MARIA SALVATORE 2023-10-13
004 2021-01-01 MARIA SALVATORE 2022-10-12
004 2020-01-01 MARIA SALVATORE 2021-10-05
004 2019-01-01 MARIA SALVATORE 2020-10-08
004 2018-01-01 MARIA SALVATORE 2019-10-15
004 2017-01-01 THOMAS FORESE, JR.

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
004	2022-01-01	MARIA SALVATORE	2023-10-13
004	2021-01-01	MARIA SALVATORE	2022-10-12
004	2020-01-01	MARIA SALVATORE	2021-10-05
004	2019-01-01	MARIA SALVATORE	2020-10-08
004	2018-01-01	MARIA SALVATORE	2019-10-15
004	2017-01-01	THOMAS FORESE, JR.

Plan Statistics for SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK

401k plan membership statisitcs for SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK

Measure Date Value
2022: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2022 401k membership
Total participants, beginning-of-year 2022-01-01 215
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 158
Number of retired or separated participants receiving benefits 2022-01-01 2
Number of other retired or separated participants entitled to future benefits 2022-01-01 49
Total of all active and inactive participants 2022-01-01 209
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 209
Number of participants with account balances 2022-01-01 207
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 4
2021: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2021 401k membership
Total participants, beginning-of-year 2021-01-01 202
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 164
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 47
Total of all active and inactive participants 2021-01-01 211
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 211
Number of participants with account balances 2021-01-01 208
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2020 401k membership
Total participants, beginning-of-year 2020-01-01 214
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 158
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 43
Total of all active and inactive participants 2020-01-01 201
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 201
Number of participants with account balances 2020-01-01 197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2019 401k membership
Total participants, beginning-of-year 2019-01-01 252
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 170
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 44
Total of all active and inactive participants 2019-01-01 214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 214
Number of participants with account balances 2019-01-01 209
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2018 401k membership
Total participants, beginning-of-year 2018-01-01 140
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 177
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 75
Total of all active and inactive participants 2018-01-01 252
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 252
Number of participants with account balances 2018-01-01 244
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2017 401k membership
Total participants, beginning-of-year 2017-01-01 149
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 107
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 33
Total of all active and inactive participants 2017-01-01 140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 140
Number of participants with account balances 2017-01-01 115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0

Measure	Date	Value
2022: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2022 401k membership
Total participants, beginning-of-year	2022-01-01	215
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	158
Number of retired or separated participants receiving benefits	2022-01-01	2
Number of other retired or separated participants entitled to future benefits	2022-01-01	49
Total of all active and inactive participants	2022-01-01	209
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	209
Number of participants with account balances	2022-01-01	207
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	4
2021: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2021 401k membership
Total participants, beginning-of-year	2021-01-01	202
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	164
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	47
Total of all active and inactive participants	2021-01-01	211
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	211
Number of participants with account balances	2021-01-01	208
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2020 401k membership
Total participants, beginning-of-year	2020-01-01	214
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	158
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	43
Total of all active and inactive participants	2020-01-01	201
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	201
Number of participants with account balances	2020-01-01	197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2019 401k membership
Total participants, beginning-of-year	2019-01-01	252
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	170
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	44
Total of all active and inactive participants	2019-01-01	214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	214
Number of participants with account balances	2019-01-01	209
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2018 401k membership
Total participants, beginning-of-year	2018-01-01	140
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	177
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	75
Total of all active and inactive participants	2018-01-01	252
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	252
Number of participants with account balances	2018-01-01	244
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2017 401k membership
Total participants, beginning-of-year	2017-01-01	149
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	107
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	33
Total of all active and inactive participants	2017-01-01	140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	140
Number of participants with account balances	2017-01-01	115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0

Financial Data on SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK

Measure	Date	Value
2022 : SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-1,703,280
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$2,108,411
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$2,042,092
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$2,727,763
Value of total assets at end of year	2022-12-31	$23,789,223
Value of total assets at beginning of year	2022-12-31	$27,600,914
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$66,319
Total interest from all sources	2022-12-31	$31,500
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$405,136
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$405,136
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$1,172,924
Participant contributions at end of year	2022-12-31	$379,898
Participant contributions at beginning of year	2022-12-31	$363,733
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$35,302
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-3,811,691
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$23,789,223
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$27,600,914
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$11,754,879
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$26,315,254
Interest on participant loans	2022-12-31	$17,375
Interest earned on other investments	2022-12-31	$14,125
Value of interest in common/collective trusts at end of year	2022-12-31	$10,361,265
Value of interest in common/collective trusts at beginning of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$1,100,132
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$739,648
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-5,100,444
Net investment gain or loss from common/collective trusts	2022-12-31	$232,765
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$1,519,537
Employer contributions (assets) at end of year	2022-12-31	$193,049
Employer contributions (assets) at beginning of year	2022-12-31	$182,279
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$2,042,092
Contract administrator fees	2022-12-31	$66,319
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	WOLF & COMPANY, P.C.
Accountancy firm EIN	2022-12-31	042689883
2021 : SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$5,709,440
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,768,112
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,693,648
Expenses. Certain deemed distributions of participant loans	2021-12-31	$3,547
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$2,460,195
Value of total assets at end of year	2021-12-31	$27,600,914
Value of total assets at beginning of year	2021-12-31	$23,659,586
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$70,917
Total interest from all sources	2021-12-31	$40,323
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$1,140,584
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$1,140,584
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$1,040,433
Participant contributions at end of year	2021-12-31	$363,733
Participant contributions at beginning of year	2021-12-31	$370,020
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$24,577
Administrative expenses (other) incurred	2021-12-31	$70,917
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$3,941,328
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$27,600,914
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$23,659,586
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$26,315,254
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$21,437,104
Interest on participant loans	2021-12-31	$17,858
Interest earned on other investments	2021-12-31	$22,465
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$739,648
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$1,629,913
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$2,068,338
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$1,419,762
Employer contributions (assets) at end of year	2021-12-31	$182,279
Employer contributions (assets) at beginning of year	2021-12-31	$197,972
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,693,648
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	WOLF & COMPANY, P.C.
Accountancy firm EIN	2021-12-31	042689883
2020 : SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$6,003,920
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$2,083,005
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$2,022,420
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$2,826,613
Value of total assets at end of year	2020-12-31	$23,659,586
Value of total assets at beginning of year	2020-12-31	$19,738,671
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$60,585
Total interest from all sources	2020-12-31	$51,280
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$505,728
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$505,728
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$1,063,508
Participant contributions at end of year	2020-12-31	$370,020
Participant contributions at beginning of year	2020-12-31	$392,064
Participant contributions at end of year	2020-12-31	$24,577
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$231,653
Administrative expenses (other) incurred	2020-12-31	$60,585
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$3,920,915
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$23,659,586
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$19,738,671
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$21,437,104
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$18,094,285
Interest on participant loans	2020-12-31	$22,166
Interest earned on other investments	2020-12-31	$29,114
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$1,629,913
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$1,084,853
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$2,620,299
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$1,531,452
Employer contributions (assets) at end of year	2020-12-31	$197,972
Employer contributions (assets) at beginning of year	2020-12-31	$167,469
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$2,022,420
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	WOLF & COMPANY, P.C.
Accountancy firm EIN	2020-12-31	042689883
2019 : SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$6,113,670
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$1,296,793
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,190,950
Value of total corrective distributions	2019-12-31	$60,225
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$2,942,870
Value of total assets at end of year	2019-12-31	$19,738,671
Value of total assets at beginning of year	2019-12-31	$14,921,794
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$45,618
Total interest from all sources	2019-12-31	$18,137
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$541,410
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$541,410
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$878,288
Participant contributions at end of year	2019-12-31	$392,064
Participant contributions at beginning of year	2019-12-31	$359,832
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$687,292
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$4,816,877
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$19,738,671
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$14,921,794
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Investment advisory and management fees	2019-12-31	$45,618
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$18,094,285
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$12,396,420
Interest on participant loans	2019-12-31	$18,137
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$1,084,853
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$2,005,113
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$2,611,253
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$1,377,290
Employer contributions (assets) at end of year	2019-12-31	$167,469
Employer contributions (assets) at beginning of year	2019-12-31	$160,429
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,190,950
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	WOLF & COMPANY, P.C.
Accountancy firm EIN	2019-12-31	042689883
2018 : SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total transfer of assets to this plan	2018-12-31	$6,546,094
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$411,168
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$789,344
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$787,689
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,418,947
Value of total assets at end of year	2018-12-31	$14,921,794
Value of total assets at beginning of year	2018-12-31	$8,753,876
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$1,655
Total interest from all sources	2018-12-31	$16,979
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$467,512
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$467,512
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$491,274
Participant contributions at end of year	2018-12-31	$359,832
Participant contributions at beginning of year	2018-12-31	$333,566
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$29,607
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-378,176
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$14,921,794
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$8,753,876
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$12,396,420
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$0
Interest on participant loans	2018-12-31	$16,979
Value of interest in common/collective trusts at end of year	2018-12-31	$0
Value of interest in common/collective trusts at beginning of year	2018-12-31	$8,420,310
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$2,005,113
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-2,038,611
Net investment gain or loss from common/collective trusts	2018-12-31	$546,341
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$898,066
Employer contributions (assets) at end of year	2018-12-31	$160,429
Employer contributions (assets) at beginning of year	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$787,689
Contract administrator fees	2018-12-31	$1,655
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2018-12-31	Yes
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	WOLF & COMPANY, P.C.
Accountancy firm EIN	2018-12-31	042689883
2017 : SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$1,846,208
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$1,017,366
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,008,812
Expenses. Certain deemed distributions of participant loans	2017-12-31	$8,554
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$611,293
Value of total assets at end of year	2017-12-31	$8,753,876
Value of total assets at beginning of year	2017-12-31	$7,925,034
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$0
Total interest from all sources	2017-12-31	$11,276
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$385,834
Participant contributions at end of year	2017-12-31	$333,566
Participant contributions at beginning of year	2017-12-31	$264,919
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$26,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$828,842
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$8,753,876
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$7,925,034
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Interest on participant loans	2017-12-31	$11,276
Value of interest in common/collective trusts at end of year	2017-12-31	$8,420,310
Value of interest in common/collective trusts at beginning of year	2017-12-31	$7,660,115
Net investment gain or loss from common/collective trusts	2017-12-31	$1,223,639
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$199,459
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,008,812
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	No
Opinion of an independent qualified public accountant for this plan	2017-12-31	Unqualified
Accountancy firm name	2017-12-31	JOHNSON OCONNOR FERON & CARUCCI LLP
Accountancy firm EIN	2017-12-31	203985546

Form 5500 Responses for SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK

2022: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: SBERA 401(K) PLAN AS ADOPTED BY SOUTHBRIDGE SAVINGS BANK 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

504762-01

Policy instance

Insurance contract or identification number	504762-01
Number of Individuals Covered	207
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

504762-01

Policy instance

Insurance contract or identification number	504762-01
Number of Individuals Covered	27
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

504762-01

Policy instance

Insurance contract or identification number	504762-01
Number of Individuals Covered	197
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

504762-01

Policy instance

Insurance contract or identification number	504762-01
Number of Individuals Covered	209
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

504762-01

Policy instance

Insurance contract or identification number	504762-01
Number of Individuals Covered	244
Insurance policy start date	2018-09-01
Insurance policy end date	2018-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	CORNERSTONE BANK
Employer identification number (EIN):	041856390
NAIC Classification:	522120
NAIC Description:	Savings Institutions

Jurisdiction of Incorporation:	Commonwealth of Massachusetts Corporations Division
Incorporation Date:
Company Identification Number:	000949932