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| Plan Name | BLUESTONE BANK LIFE AND DISABILITY PLAN |
| Plan identification number | 511 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | BLUESTONE BANK |
| Employer identification number (EIN): | 110418820 |
| NAIC Classification: | 522110 |
| NAIC Description: | Commercial Banking |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 511 | 2023-01-01 | CHRISTINE MOSCARITOLO | 2024-02-29 | ||
| 511 | 2022-01-01 | CHRISTINE MOSCARITOLO | 2023-07-10 | ||
| 511 | 2021-01-01 | CHRISTINE MOSCARITOLO | 2022-06-21 | ||
| 511 | 2021-01-01 | CHRISTINE MOSCARITOLO | 2023-03-06 |
| Measure | Date | Value |
|---|---|---|
| 2023: BLUESTONE BANK LIFE AND DISABILITY PLAN 2023 401k membership | ||
| Total participants, beginning-of-year | 2023-01-01 | 160 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 148 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-01-01 | 0 |
| Total of all active and inactive participants | 2023-01-01 | 148 |
| Number of employers contributing to the scheme | 2023-01-01 | 0 |
| 2022: BLUESTONE BANK LIFE AND DISABILITY PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-01-01 | 169 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 160 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 160 |
| Number of employers contributing to the scheme | 2022-01-01 | 0 |
| 2021: BLUESTONE BANK LIFE AND DISABILITY PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-01-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 0 |
| 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 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 0 |
| Number of employers contributing to the scheme | 2021-01-01 | 0 |
| 2023: BLUESTONE BANK LIFE AND DISABILITY PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: BLUESTONE BANK LIFE AND DISABILITY PLAN 2022 form 5500 responses | ||
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: BLUESTONE BANK LIFE AND DISABILITY PLAN 2021 form 5500 responses | ||
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | First time form 5500 has been submitted | Yes |
| 2021-01-01 | Submission has been amended | Yes |
| 2021-01-01 | This submission is the final filing | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |||||||||||||||||||||||||||||||||||||||||
| Policy contract number | GLUG0BTLS | ||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||
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| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |||||||||||||||||||||||||||||||||||||||||
| Policy contract number | GLUG0BTLS | ||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||
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| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |||||||||||||||||||||||||||||||||||||||||
| Policy contract number | GLUG0BTLS | ||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||
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