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| Plan Name | NORTH COUNTRY INSURANCE COMPANY 401K PROFIT SHARING PLAN |
| Plan identification number | 003 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | FAIR BUSINESS COUNCIL OF ROCHESTER |
| Employer identification number (EIN): | 160350460 |
| NAIC Classification: | 524210 |
| NAIC Description: | Insurance Agencies and Brokerages |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 003 | 2022-01-01 | MARC E. LADOUCEUR | 2023-10-02 | MARC E. LADOUCEUR | 2023-10-02 |
| Measure | Date | Value |
|---|---|---|
| 2022: NORTH COUNTRY INSURANCE COMPANY 401K PROFIT SHARING PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-01-01 | 24 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 18 |
| 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 | 3 |
| Total of all active and inactive participants | 2022-01-01 | 21 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2022-01-01 | 0 |
| Total participants | 2022-01-01 | 21 |
| Number of participants with account balances | 2022-01-01 | 19 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2022-01-01 | 0 |
| Measure | Date | Value |
|---|---|---|
| 2022 : NORTH COUNTRY INSURANCE COMPANY 401K PROFIT SHARING PLAN 2022 401k financial data | ||
| Total income from all sources | 2022-12-31 | $-302,774 |
| Expenses. Total of all expenses incurred | 2022-12-31 | $344,535 |
| Benefits paid (including direct rollovers) | 2022-12-31 | $342,700 |
| Total plan assets at end of year | 2022-12-31 | $3,084,788 |
| Total plan assets at beginning of year | 2022-12-31 | $3,732,097 |
| Value of fidelity bond covering the plan | 2022-12-31 | $3,000,000 |
| Total contributions received or receivable from participants | 2022-12-31 | $82,918 |
| Expenses. Other expenses not covered elsewhere | 2022-12-31 | $1,547 |
| Other income received | 2022-12-31 | $-441,330 |
| Net income (gross income less expenses) | 2022-12-31 | $-647,309 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $3,084,788 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $3,732,097 |
| Assets. Value of participant loans | 2022-12-31 | $39,435 |
| Total contributions received or receivable from employer(s) | 2022-12-31 | $55,638 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $288 |
| 2022: NORTH COUNTRY INSURANCE COMPANY 401K PROFIT SHARING PLAN 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 |
| FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 ) | |||||||||||||||||||
| Policy contract number | 386100-01 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
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| MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 ) | |||||||||||||||||||
| Policy contract number | 3308018 | ||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||
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