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FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 401k Plan overview

Plan NameFARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN
Plan identification number 501

FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Other welfare benefit cover

401k Sponsoring company profile

F& M TRUST COMPANY has sponsored the creation of one or more 401k plans.

Company Name:F& M TRUST COMPANY
Employer identification number (EIN):230570230
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-10-01
5012020-10-01
5012019-10-01
5012018-10-01
5012017-10-01
5012016-10-01LEVI CROUSE
5012015-10-01LEVI CROUSE
5012014-10-01LEVI CROUSE
5012013-10-01LEVI CROUSE
5012012-10-01LEVI CROUSE
5012011-10-01KAREN CARMACK
5012010-10-01KAREN CARMACK
5012009-07-01KAREN CARMACK

Plan Statistics for FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN

401k plan membership statisitcs for FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN

Measure Date Value
2021: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01228
Total number of active participants reported on line 7a of the Form 55002021-10-01230
Number of retired or separated participants receiving benefits2021-10-010
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01230
2020: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01254
Total number of active participants reported on line 7a of the Form 55002020-10-01241
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-01241
2019: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01242
Total number of active participants reported on line 7a of the Form 55002019-10-01254
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-01254
2018: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01249
Total number of active participants reported on line 7a of the Form 55002018-10-01241
Number of retired or separated participants receiving benefits2018-10-011
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-01242
2017: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01236
Total number of active participants reported on line 7a of the Form 55002017-10-01248
Number of retired or separated participants receiving benefits2017-10-011
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01249
2016: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01235
Total number of active participants reported on line 7a of the Form 55002016-10-01235
Number of retired or separated participants receiving benefits2016-10-011
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01236
2015: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01206
Total number of active participants reported on line 7a of the Form 55002015-10-01229
Number of retired or separated participants receiving benefits2015-10-016
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-01235
2014: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01217
Total number of active participants reported on line 7a of the Form 55002014-10-01199
Number of retired or separated participants receiving benefits2014-10-017
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01206
2013: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01224
Total number of active participants reported on line 7a of the Form 55002013-10-01217
Number of retired or separated participants receiving benefits2013-10-010
Number of other retired or separated participants entitled to future benefits2013-10-010
Total of all active and inactive participants2013-10-01217
2012: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01223
Total number of active participants reported on line 7a of the Form 55002012-10-01222
Number of retired or separated participants receiving benefits2012-10-012
Number of other retired or separated participants entitled to future benefits2012-10-010
Total of all active and inactive participants2012-10-01224
2011: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-01224
Total number of active participants reported on line 7a of the Form 55002011-10-01219
Number of retired or separated participants receiving benefits2011-10-014
Number of other retired or separated participants entitled to future benefits2011-10-010
Total of all active and inactive participants2011-10-01223
2010: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year2010-10-01224
Total number of active participants reported on line 7a of the Form 55002010-10-01211
Number of retired or separated participants receiving benefits2010-10-017
Total of all active and inactive participants2010-10-01218
2009: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01225
Total number of active participants reported on line 7a of the Form 55002009-07-01215
Number of retired or separated participants receiving benefits2009-07-016
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01221

Financial Data on FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN

Measure Date Value
2022 : FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-09-30$302,454
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-09-30$39,279
Total income from all sources (including contributions)2022-09-30$2,501,546
Total loss/gain on sale of assets2022-09-30$0
Total of all expenses incurred2022-09-30$2,564,157
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-09-30$1,822,546
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-09-30$2,500,460
Value of total assets at end of year2022-09-30$772,500
Value of total assets at beginning of year2022-09-30$571,936
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-09-30$741,611
Total interest from all sources2022-09-30$1,086
Total dividends received (eg from common stock, registered investment company shares)2022-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-09-30No
Was this plan covered by a fidelity bond2022-09-30No
If this is an individual account plan, was there a blackout period2022-09-30No
Were there any nonexempt tranactions with any party-in-interest2022-09-30No
Contributions received from participants2022-09-30$523,831
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-09-30$142,656
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-09-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-09-30$248,826
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-09-30$0
Administrative expenses (other) incurred2022-09-30$631,928
Liabilities. Value of operating payables at end of year2022-09-30$53,628
Liabilities. Value of operating payables at beginning of year2022-09-30$5,356
Total non interest bearing cash at end of year2022-09-30$120,056
Total non interest bearing cash at beginning of year2022-09-30$34,279
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Value of net income/loss2022-09-30$-62,611
Value of net assets at end of year (total assets less liabilities)2022-09-30$470,046
Value of net assets at beginning of year (total assets less liabilities)2022-09-30$532,657
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-09-30No
Were any leases to which the plan was party in default or uncollectible2022-09-30No
Investment advisory and management fees2022-09-30$88,132
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-09-30$509,788
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-09-30$537,657
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-09-30$537,657
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-09-30$1,086
Expenses. Payments to insurance carriers foe the provision of benefits2022-09-30$1,822,546
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-09-30No
Was there a failure to transmit to the plan any participant contributions2022-09-30No
Has the plan failed to provide any benefit when due under the plan2022-09-30No
Contributions received in cash from employer2022-09-30$1,976,629
Contract administrator fees2022-09-30$21,551
Liabilities. Value of benefit claims payable at end of year2022-09-30$0
Liabilities. Value of benefit claims payable at beginning of year2022-09-30$33,923
Did the plan have assets held for investment2022-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-09-30No
Opinion of an independent qualified public accountant for this plan2022-09-30Unqualified
Accountancy firm name2022-09-30YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2022-09-30251589048
2021 : FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-09-30$39,279
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-09-30$188,915
Total income from all sources (including contributions)2021-09-30$1,798,891
Total loss/gain on sale of assets2021-09-30$0
Total of all expenses incurred2021-09-30$2,553,824
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-09-30$1,868,079
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-09-30$1,796,347
Value of total assets at end of year2021-09-30$571,936
Value of total assets at beginning of year2021-09-30$1,476,505
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-09-30$685,745
Total interest from all sources2021-09-30$2,544
Total dividends received (eg from common stock, registered investment company shares)2021-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-09-30No
Was this plan covered by a fidelity bond2021-09-30No
If this is an individual account plan, was there a blackout period2021-09-30No
Were there any nonexempt tranactions with any party-in-interest2021-09-30No
Contributions received from participants2021-09-30$447,957
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-09-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-09-30$167,546
Administrative expenses (other) incurred2021-09-30$560,160
Liabilities. Value of operating payables at end of year2021-09-30$5,356
Liabilities. Value of operating payables at beginning of year2021-09-30$460
Total non interest bearing cash at end of year2021-09-30$34,279
Total non interest bearing cash at beginning of year2021-09-30$80,140
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-09-30No
Value of net income/loss2021-09-30$-754,933
Value of net assets at end of year (total assets less liabilities)2021-09-30$532,657
Value of net assets at beginning of year (total assets less liabilities)2021-09-30$1,287,590
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-09-30No
Were any leases to which the plan was party in default or uncollectible2021-09-30No
Investment advisory and management fees2021-09-30$84,122
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-09-30$537,657
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-09-30$1,396,365
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-09-30$1,396,365
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-09-30$2,544
Expenses. Payments to insurance carriers foe the provision of benefits2021-09-30$1,868,079
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-09-30No
Was there a failure to transmit to the plan any participant contributions2021-09-30No
Has the plan failed to provide any benefit when due under the plan2021-09-30No
Contributions received in cash from employer2021-09-30$1,348,390
Contract administrator fees2021-09-30$41,463
Liabilities. Value of benefit claims payable at end of year2021-09-30$33,923
Liabilities. Value of benefit claims payable at beginning of year2021-09-30$20,909
Did the plan have assets held for investment2021-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-09-30No
Opinion of an independent qualified public accountant for this plan2021-09-30Unqualified
Accountancy firm name2021-09-30YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2021-09-30251589048
2020 : FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-09-30$0
Total income from all sources (including contributions)2020-09-30$0
Total loss/gain on sale of assets2020-09-30$0
Total of all expenses incurred2020-09-30$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-09-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-09-30$0
Value of total assets at end of year2020-09-30$0
Value of total assets at beginning of year2020-09-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-09-30$0
Total interest from all sources2020-09-30$0
Total dividends received (eg from common stock, registered investment company shares)2020-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-09-30No
Was this plan covered by a fidelity bond2020-09-30Yes
Value of fidelity bond cover2020-09-30$500,000
If this is an individual account plan, was there a blackout period2020-09-30No
Were there any nonexempt tranactions with any party-in-interest2020-09-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-09-30No
Value of net income/loss2020-09-30$0
Value of net assets at end of year (total assets less liabilities)2020-09-30$0
Value of net assets at beginning of year (total assets less liabilities)2020-09-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-09-30No
Were any leases to which the plan was party in default or uncollectible2020-09-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-09-30No
Was there a failure to transmit to the plan any participant contributions2020-09-30No
Has the plan failed to provide any benefit when due under the plan2020-09-30No
Did the plan have assets held for investment2020-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-09-30No
Opinion of an independent qualified public accountant for this plan2020-09-30Unqualified
Accountancy firm name2020-09-30YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2020-09-30251589048
2019 : FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-09-30$172,396
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-09-30$19,575
Total income from all sources (including contributions)2019-09-30$2,092,494
Total loss/gain on sale of assets2019-09-30$0
Total of all expenses incurred2019-09-30$2,101,085
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-09-30$1,443,744
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-09-30$2,072,521
Value of total assets at end of year2019-09-30$1,205,534
Value of total assets at beginning of year2019-09-30$1,061,304
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-09-30$657,341
Total interest from all sources2019-09-30$19,973
Total dividends received (eg from common stock, registered investment company shares)2019-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-09-30No
Was this plan covered by a fidelity bond2019-09-30No
If this is an individual account plan, was there a blackout period2019-09-30No
Were there any nonexempt tranactions with any party-in-interest2019-09-30No
Contributions received from participants2019-09-30$422,168
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-09-30$156,519
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-09-30$0
Administrative expenses (other) incurred2019-09-30$506,915
Liabilities. Value of operating payables at end of year2019-09-30$1,140
Liabilities. Value of operating payables at beginning of year2019-09-30$4,595
Total non interest bearing cash at end of year2019-09-30$55,909
Total non interest bearing cash at beginning of year2019-09-30$5,719
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-09-30No
Value of net income/loss2019-09-30$-8,591
Value of net assets at end of year (total assets less liabilities)2019-09-30$1,033,138
Value of net assets at beginning of year (total assets less liabilities)2019-09-30$1,041,729
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-09-30No
Were any leases to which the plan was party in default or uncollectible2019-09-30No
Investment advisory and management fees2019-09-30$77,771
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-09-30$1,149,625
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-09-30$1,055,585
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-09-30$1,055,585
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-09-30$19,973
Expenses. Payments to insurance carriers foe the provision of benefits2019-09-30$1,443,744
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-09-30No
Was there a failure to transmit to the plan any participant contributions2019-09-30No
Has the plan failed to provide any benefit when due under the plan2019-09-30No
Contributions received in cash from employer2019-09-30$1,650,353
Contract administrator fees2019-09-30$72,655
Liabilities. Value of benefit claims payable at end of year2019-09-30$14,737
Liabilities. Value of benefit claims payable at beginning of year2019-09-30$14,980
Did the plan have assets held for investment2019-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-09-30No
Opinion of an independent qualified public accountant for this plan2019-09-30Unqualified
Accountancy firm name2019-09-30YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2019-09-30251589048
2018 : FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-09-30$19,575
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-09-30$232,642
Total income from all sources (including contributions)2018-09-30$2,424,901
Total loss/gain on sale of assets2018-09-30$0
Total of all expenses incurred2018-09-30$1,765,769
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-09-30$1,149,853
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-09-30$2,410,164
Value of total assets at end of year2018-09-30$1,061,304
Value of total assets at beginning of year2018-09-30$615,239
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-09-30$615,916
Total interest from all sources2018-09-30$14,737
Total dividends received (eg from common stock, registered investment company shares)2018-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-09-30No
Was this plan covered by a fidelity bond2018-09-30Yes
Value of fidelity bond cover2018-09-30$500,000
If this is an individual account plan, was there a blackout period2018-09-30No
Were there any nonexempt tranactions with any party-in-interest2018-09-30No
Contributions received from participants2018-09-30$436,060
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-09-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-09-30$204,881
Administrative expenses (other) incurred2018-09-30$452,186
Liabilities. Value of operating payables at end of year2018-09-30$4,595
Liabilities. Value of operating payables at beginning of year2018-09-30$0
Total non interest bearing cash at end of year2018-09-30$5,719
Total non interest bearing cash at beginning of year2018-09-30$56,689
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-09-30No
Value of net income/loss2018-09-30$659,132
Value of net assets at end of year (total assets less liabilities)2018-09-30$1,041,729
Value of net assets at beginning of year (total assets less liabilities)2018-09-30$382,597
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-09-30No
Were any leases to which the plan was party in default or uncollectible2018-09-30No
Investment advisory and management fees2018-09-30$75,913
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-09-30$1,055,585
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-09-30$558,550
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-09-30$558,550
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-09-30$14,737
Expenses. Payments to insurance carriers foe the provision of benefits2018-09-30$1,149,853
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-09-30No
Was there a failure to transmit to the plan any participant contributions2018-09-30No
Has the plan failed to provide any benefit when due under the plan2018-09-30No
Contributions received in cash from employer2018-09-30$1,974,104
Contract administrator fees2018-09-30$87,817
Liabilities. Value of benefit claims payable at end of year2018-09-30$14,980
Liabilities. Value of benefit claims payable at beginning of year2018-09-30$27,761
Did the plan have assets held for investment2018-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-09-30No
Opinion of an independent qualified public accountant for this plan2018-09-30Unqualified
Accountancy firm name2018-09-30YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2018-09-30251589048
2017 : FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-09-30$232,642
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-09-30$207,996
Total income from all sources (including contributions)2017-09-30$2,335,873
Total loss/gain on sale of assets2017-09-30$0
Total of all expenses incurred2017-09-30$2,394,578
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-09-30$1,703,745
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-09-30$2,333,622
Value of total assets at end of year2017-09-30$615,239
Value of total assets at beginning of year2017-09-30$649,298
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-09-30$690,833
Total interest from all sources2017-09-30$2,251
Total dividends received (eg from common stock, registered investment company shares)2017-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-09-30No
Was this plan covered by a fidelity bond2017-09-30Yes
Value of fidelity bond cover2017-09-30$500,000
If this is an individual account plan, was there a blackout period2017-09-30No
Were there any nonexempt tranactions with any party-in-interest2017-09-30No
Contributions received from participants2017-09-30$2,029,068
Income. Received or receivable in cash from other sources (including rollovers)2017-09-30$304,554
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-09-30$204,881
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-09-30$186,565
Administrative expenses (other) incurred2017-09-30$501,773
Total non interest bearing cash at end of year2017-09-30$56,689
Total non interest bearing cash at beginning of year2017-09-30$190,921
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-09-30No
Value of net income/loss2017-09-30$-58,705
Value of net assets at end of year (total assets less liabilities)2017-09-30$382,597
Value of net assets at beginning of year (total assets less liabilities)2017-09-30$441,302
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-09-30No
Were any leases to which the plan was party in default or uncollectible2017-09-30No
Investment advisory and management fees2017-09-30$73,496
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-09-30$558,550
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-09-30$458,377
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-09-30$458,377
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-09-30$2,251
Expenses. Payments to insurance carriers foe the provision of benefits2017-09-30$1,703,745
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-09-30No
Was there a failure to transmit to the plan any participant contributions2017-09-30No
Has the plan failed to provide any benefit when due under the plan2017-09-30No
Contract administrator fees2017-09-30$115,564
Liabilities. Value of benefit claims payable at end of year2017-09-30$27,761
Liabilities. Value of benefit claims payable at beginning of year2017-09-30$21,431
Did the plan have assets held for investment2017-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-09-30No
Opinion of an independent qualified public accountant for this plan2017-09-30Unqualified
Accountancy firm name2017-09-30YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2017-09-30251589048
2016 : FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-09-30$207,996
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-09-30$197,999
Total income from all sources (including contributions)2016-09-30$2,067,933
Total loss/gain on sale of assets2016-09-30$0
Total of all expenses incurred2016-09-30$2,153,568
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-09-30$1,521,016
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-09-30$2,066,370
Value of total assets at end of year2016-09-30$649,298
Value of total assets at beginning of year2016-09-30$724,936
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-09-30$632,552
Total interest from all sources2016-09-30$1,563
Total dividends received (eg from common stock, registered investment company shares)2016-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-09-30No
Was this plan covered by a fidelity bond2016-09-30Yes
Value of fidelity bond cover2016-09-30$500,000
If this is an individual account plan, was there a blackout period2016-09-30No
Were there any nonexempt tranactions with any party-in-interest2016-09-30No
Contributions received from participants2016-09-30$410,106
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-09-30$186,565
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-09-30$160,192
Administrative expenses (other) incurred2016-09-30$440,146
Total non interest bearing cash at end of year2016-09-30$190,921
Total non interest bearing cash at beginning of year2016-09-30$51,004
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-09-30No
Value of net income/loss2016-09-30$-85,635
Value of net assets at end of year (total assets less liabilities)2016-09-30$441,302
Value of net assets at beginning of year (total assets less liabilities)2016-09-30$526,937
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-09-30No
Were any leases to which the plan was party in default or uncollectible2016-09-30No
Investment advisory and management fees2016-09-30$70,687
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-09-30$458,377
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-09-30$673,932
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-09-30$673,932
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-09-30$1,563
Expenses. Payments to insurance carriers foe the provision of benefits2016-09-30$1,521,016
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-09-30No
Was there a failure to transmit to the plan any participant contributions2016-09-30No
Has the plan failed to provide any benefit when due under the plan2016-09-30No
Contributions received in cash from employer2016-09-30$1,656,264
Contract administrator fees2016-09-30$121,719
Liabilities. Value of benefit claims payable at end of year2016-09-30$21,431
Liabilities. Value of benefit claims payable at beginning of year2016-09-30$37,807
Did the plan have assets held for investment2016-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-09-30No
Opinion of an independent qualified public accountant for this plan2016-09-30Unqualified
Accountancy firm name2016-09-30YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2016-09-30251589048
2015 : FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-09-30$197,999
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-09-30$224,226
Total income from all sources (including contributions)2015-09-30$2,066,577
Total loss/gain on sale of assets2015-09-30$0
Total of all expenses incurred2015-09-30$2,029,880
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-09-30$1,471,329
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-09-30$2,064,855
Value of total assets at end of year2015-09-30$724,936
Value of total assets at beginning of year2015-09-30$714,466
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-09-30$558,551
Total interest from all sources2015-09-30$1,722
Total dividends received (eg from common stock, registered investment company shares)2015-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-09-30No
Was this plan covered by a fidelity bond2015-09-30Yes
Value of fidelity bond cover2015-09-30$500,000
If this is an individual account plan, was there a blackout period2015-09-30No
Were there any nonexempt tranactions with any party-in-interest2015-09-30No
Contributions received from participants2015-09-30$252,421
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-09-30$160,192
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-09-30$208,630
Administrative expenses (other) incurred2015-09-30$360,112
Total non interest bearing cash at end of year2015-09-30$51,004
Total non interest bearing cash at beginning of year2015-09-30$53,124
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-09-30No
Value of net income/loss2015-09-30$36,697
Value of net assets at end of year (total assets less liabilities)2015-09-30$526,937
Value of net assets at beginning of year (total assets less liabilities)2015-09-30$490,240
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-09-30No
Were any leases to which the plan was party in default or uncollectible2015-09-30No
Investment advisory and management fees2015-09-30$75,550
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-09-30$673,932
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-09-30$661,342
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-09-30$661,342
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-09-30$1,722
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-09-30No
Was there a failure to transmit to the plan any participant contributions2015-09-30No
Has the plan failed to provide any benefit when due under the plan2015-09-30No
Contributions received in cash from employer2015-09-30$1,812,434
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-09-30$1,471,329
Contract administrator fees2015-09-30$122,889
Liabilities. Value of benefit claims payable at end of year2015-09-30$37,807
Liabilities. Value of benefit claims payable at beginning of year2015-09-30$15,596
Did the plan have assets held for investment2015-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-09-30No
Opinion of an independent qualified public accountant for this plan2015-09-30Unqualified
Accountancy firm name2015-09-30YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2015-09-30251589048
2014 : FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-09-30$224,226
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-09-30$202,271
Total income from all sources (including contributions)2014-09-30$2,220,541
Total loss/gain on sale of assets2014-09-30$0
Total of all expenses incurred2014-09-30$1,766,990
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-09-30$1,227,752
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-09-30$2,219,611
Value of total assets at end of year2014-09-30$714,466
Value of total assets at beginning of year2014-09-30$238,960
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-09-30$539,238
Total interest from all sources2014-09-30$930
Total dividends received (eg from common stock, registered investment company shares)2014-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-09-30No
Was this plan covered by a fidelity bond2014-09-30Yes
Value of fidelity bond cover2014-09-30$500,000
If this is an individual account plan, was there a blackout period2014-09-30No
Were there any nonexempt tranactions with any party-in-interest2014-09-30No
Contributions received from participants2014-09-30$293,016
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-09-30$208,630
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-09-30$164,063
Administrative expenses (other) incurred2014-09-30$343,587
Total non interest bearing cash at end of year2014-09-30$53,124
Total non interest bearing cash at beginning of year2014-09-30$57,960
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Value of net income/loss2014-09-30$453,551
Value of net assets at end of year (total assets less liabilities)2014-09-30$490,240
Value of net assets at beginning of year (total assets less liabilities)2014-09-30$36,689
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-09-30No
Were any leases to which the plan was party in default or uncollectible2014-09-30No
Investment advisory and management fees2014-09-30$73,466
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-09-30$661,342
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-09-30$181,000
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-09-30$181,000
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-09-30$930
Expenses. Payments to insurance carriers foe the provision of benefits2014-09-30$1,227,752
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-09-30No
Was there a failure to transmit to the plan any participant contributions2014-09-30No
Has the plan failed to provide any benefit when due under the plan2014-09-30No
Contributions received in cash from employer2014-09-30$1,926,595
Contract administrator fees2014-09-30$122,185
Liabilities. Value of benefit claims payable at end of year2014-09-30$15,596
Liabilities. Value of benefit claims payable at beginning of year2014-09-30$38,208
Did the plan have assets held for investment2014-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-09-30No
Opinion of an independent qualified public accountant for this plan2014-09-30Unqualified
Accountancy firm name2014-09-30YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2014-09-30251589048
2013 : FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-09-30$202,271
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-09-30$140,263
Total income from all sources (including contributions)2013-09-30$2,338,751
Total loss/gain on sale of assets2013-09-30$0
Total of all expenses incurred2013-09-30$2,736,444
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-09-30$2,193,250
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-09-30$1,716,534
Value of total assets at end of year2013-09-30$238,960
Value of total assets at beginning of year2013-09-30$574,645
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-09-30$543,194
Total interest from all sources2013-09-30$781
Total dividends received (eg from common stock, registered investment company shares)2013-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-09-30No
Was this plan covered by a fidelity bond2013-09-30Yes
Value of fidelity bond cover2013-09-30$500,000
If this is an individual account plan, was there a blackout period2013-09-30No
Were there any nonexempt tranactions with any party-in-interest2013-09-30No
Contributions received from participants2013-09-30$274,018
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-09-30$164,063
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-09-30$99,035
Other income not declared elsewhere2013-09-30$621,436
Administrative expenses (other) incurred2013-09-30$340,700
Total non interest bearing cash at end of year2013-09-30$57,960
Total non interest bearing cash at beginning of year2013-09-30$111,256
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-09-30No
Value of net income/loss2013-09-30$-397,693
Value of net assets at end of year (total assets less liabilities)2013-09-30$36,689
Value of net assets at beginning of year (total assets less liabilities)2013-09-30$434,382
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-09-30No
Were any leases to which the plan was party in default or uncollectible2013-09-30No
Investment advisory and management fees2013-09-30$74,174
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-09-30$181,000
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-09-30$463,389
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-09-30$463,389
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-09-30$781
Expenses. Payments to insurance carriers foe the provision of benefits2013-09-30$2,193,250
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-09-30No
Was there a failure to transmit to the plan any participant contributions2013-09-30No
Has the plan failed to provide any benefit when due under the plan2013-09-30No
Contributions received in cash from employer2013-09-30$1,442,516
Contract administrator fees2013-09-30$128,320
Liabilities. Value of benefit claims payable at end of year2013-09-30$38,208
Liabilities. Value of benefit claims payable at beginning of year2013-09-30$41,228
Did the plan have assets held for investment2013-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-09-30No
Opinion of an independent qualified public accountant for this plan2013-09-30Unqualified
Accountancy firm name2013-09-30YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2013-09-30251589048
2012 : FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-09-30$140,263
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-09-30$170,981
Total income from all sources (including contributions)2012-09-30$1,982,465
Total loss/gain on sale of assets2012-09-30$0
Total of all expenses incurred2012-09-30$1,943,724
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-09-30$1,456,047
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-09-30$1,825,639
Value of total assets at end of year2012-09-30$574,645
Value of total assets at beginning of year2012-09-30$566,622
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-09-30$487,677
Total interest from all sources2012-09-30$5,966
Total dividends received (eg from common stock, registered investment company shares)2012-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-09-30No
Was this plan covered by a fidelity bond2012-09-30Yes
Value of fidelity bond cover2012-09-30$500,000
If this is an individual account plan, was there a blackout period2012-09-30No
Were there any nonexempt tranactions with any party-in-interest2012-09-30No
Contributions received from participants2012-09-30$292,396
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-09-30$99,035
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-09-30$170,981
Other income not declared elsewhere2012-09-30$150,860
Administrative expenses (other) incurred2012-09-30$290,529
Total non interest bearing cash at end of year2012-09-30$111,256
Total non interest bearing cash at beginning of year2012-09-30$42,390
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-09-30No
Value of net income/loss2012-09-30$38,741
Value of net assets at end of year (total assets less liabilities)2012-09-30$434,382
Value of net assets at beginning of year (total assets less liabilities)2012-09-30$395,641
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-09-30No
Were any leases to which the plan was party in default or uncollectible2012-09-30No
Investment advisory and management fees2012-09-30$71,845
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-09-30$463,389
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-09-30$524,232
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-09-30$524,232
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-09-30$5,966
Expenses. Payments to insurance carriers foe the provision of benefits2012-09-30$1,456,047
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-09-30No
Was there a failure to transmit to the plan any participant contributions2012-09-30No
Has the plan failed to provide any benefit when due under the plan2012-09-30No
Contributions received in cash from employer2012-09-30$1,533,243
Contract administrator fees2012-09-30$125,303
Liabilities. Value of benefit claims payable at end of year2012-09-30$41,228
Did the plan have assets held for investment2012-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-09-30No
Opinion of an independent qualified public accountant for this plan2012-09-30Unqualified
Accountancy firm name2012-09-30YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2012-09-30251589048
2011 : FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-09-30$170,981
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-09-30$153,460
Total income from all sources (including contributions)2011-09-30$1,976,267
Total loss/gain on sale of assets2011-09-30$0
Total of all expenses incurred2011-09-30$1,914,774
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-09-30$1,430,367
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-09-30$1,718,526
Value of total assets at end of year2011-09-30$566,622
Value of total assets at beginning of year2011-09-30$487,608
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-09-30$484,407
Total interest from all sources2011-09-30$5,067
Total dividends received (eg from common stock, registered investment company shares)2011-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-09-30No
Was this plan covered by a fidelity bond2011-09-30Yes
Value of fidelity bond cover2011-09-30$1,555,810
If this is an individual account plan, was there a blackout period2011-09-30No
Were there any nonexempt tranactions with any party-in-interest2011-09-30No
Contributions received from participants2011-09-30$254,464
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-09-30$1,430,367
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-09-30$170,981
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-09-30$153,460
Other income not declared elsewhere2011-09-30$252,674
Administrative expenses (other) incurred2011-09-30$287,583
Total non interest bearing cash at end of year2011-09-30$42,390
Total non interest bearing cash at beginning of year2011-09-30$152,769
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-09-30No
Value of net income/loss2011-09-30$61,493
Value of net assets at end of year (total assets less liabilities)2011-09-30$395,641
Value of net assets at beginning of year (total assets less liabilities)2011-09-30$334,148
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-09-30No
Were any leases to which the plan was party in default or uncollectible2011-09-30No
Investment advisory and management fees2011-09-30$71,159
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-09-30$524,232
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-09-30$334,839
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-09-30$334,839
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-09-30$5,067
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-09-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-09-30No
Was there a failure to transmit to the plan any participant contributions2011-09-30No
Has the plan failed to provide any benefit when due under the plan2011-09-30No
Contributions received in cash from employer2011-09-30$1,464,062
Contract administrator fees2011-09-30$125,665
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-09-30No
Did the plan have assets held for investment2011-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-09-30No
Opinion of an independent qualified public accountant for this plan2011-09-30Unqualified
Accountancy firm name2011-09-30YOUNG, OAKES, BROWN & CO., P.C.
Accountancy firm EIN2011-09-30251589048
2010 : FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-09-30$153,460
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-09-30$134,744
Total income from all sources (including contributions)2010-09-30$422,876
Total loss/gain on sale of assets2010-09-30$0
Total of all expenses incurred2010-09-30$397,706
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-09-30$349,719
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-09-30$415,331
Value of total assets at end of year2010-09-30$487,608
Value of total assets at beginning of year2010-09-30$443,722
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-09-30$47,987
Total interest from all sources2010-09-30$1,339
Total dividends received (eg from common stock, registered investment company shares)2010-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-09-30No
Was this plan covered by a fidelity bond2010-09-30Yes
Value of fidelity bond cover2010-09-30$1,555,810
If this is an individual account plan, was there a blackout period2010-09-30No
Were there any nonexempt tranactions with any party-in-interest2010-09-30No
Contributions received from participants2010-09-30$53,129
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-09-30$349,719
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-09-30$153,460
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-09-30$134,744
Other income not declared elsewhere2010-09-30$6,206
Total non interest bearing cash at end of year2010-09-30$152,769
Total non interest bearing cash at beginning of year2010-09-30$38,083
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-09-30No
Value of net income/loss2010-09-30$25,170
Value of net assets at end of year (total assets less liabilities)2010-09-30$334,148
Value of net assets at beginning of year (total assets less liabilities)2010-09-30$308,978
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2010-09-30No
Were any leases to which the plan was party in default or uncollectible2010-09-30No
Investment advisory and management fees2010-09-30$16,805
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-09-30$334,839
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-09-30$405,639
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-09-30$405,639
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-09-30$1,339
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-09-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-09-30No
Was there a failure to transmit to the plan any participant contributions2010-09-30No
Has the plan failed to provide any benefit when due under the plan2010-09-30No
Contributions received in cash from employer2010-09-30$362,202
Contract administrator fees2010-09-30$31,182
Did the plan have assets held for investment2010-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-09-30No
Opinion of an independent qualified public accountant for this plan2010-09-30Unqualified
Accountancy firm name2010-09-30YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2010-09-30251589048

Form 5500 Responses for FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN

2021: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Submission has been amendedNo
2021-10-01This submission is the final filingNo
2021-10-01This return/report is a short plan year return/report (less than 12 months)No
2021-10-01Plan is a collectively bargained planNo
2021-10-01Plan funding arrangement – TrustYes
2021-10-01Plan funding arrangement – General assets of the sponsorYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement - TrustYes
2021-10-01Plan benefit arrangement – General assets of the sponsorYes
2020: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Submission has been amendedNo
2020-10-01This submission is the final filingNo
2020-10-01This return/report is a short plan year return/report (less than 12 months)No
2020-10-01Plan is a collectively bargained planNo
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan funding arrangement – TrustYes
2020-10-01Plan funding arrangement – General assets of the sponsorYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement - TrustYes
2020-10-01Plan benefit arrangement – General assets of the sponsorYes
2019: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Submission has been amendedNo
2019-10-01This submission is the final filingNo
2019-10-01This return/report is a short plan year return/report (less than 12 months)No
2019-10-01Plan is a collectively bargained planNo
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan funding arrangement – TrustYes
2019-10-01Plan funding arrangement – General assets of the sponsorYes
2019-10-01Plan benefit arrangement – InsuranceYes
2019-10-01Plan benefit arrangement - TrustYes
2019-10-01Plan benefit arrangement – General assets of the sponsorYes
2018: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Submission has been amendedNo
2018-10-01This submission is the final filingNo
2018-10-01This return/report is a short plan year return/report (less than 12 months)No
2018-10-01Plan is a collectively bargained planNo
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan funding arrangement – TrustYes
2018-10-01Plan funding arrangement – General assets of the sponsorYes
2018-10-01Plan benefit arrangement – InsuranceYes
2018-10-01Plan benefit arrangement - TrustYes
2018-10-01Plan benefit arrangement – General assets of the sponsorYes
2017: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Submission has been amendedNo
2017-10-01This submission is the final filingNo
2017-10-01This return/report is a short plan year return/report (less than 12 months)No
2017-10-01Plan is a collectively bargained planNo
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – TrustYes
2017-10-01Plan funding arrangement – General assets of the sponsorYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement - TrustYes
2017-10-01Plan benefit arrangement – General assets of the sponsorYes
2016: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – TrustYes
2016-10-01Plan funding arrangement – General assets of the sponsorYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement - TrustYes
2016-10-01Plan benefit arrangement – General assets of the sponsorYes
2015: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – TrustYes
2015-10-01Plan funding arrangement – General assets of the sponsorYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement - TrustYes
2015-10-01Plan benefit arrangement – General assets of the sponsorYes
2014: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – TrustYes
2014-10-01Plan funding arrangement – General assets of the sponsorYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement - TrustYes
2014-10-01Plan benefit arrangement – General assets of the sponsorYes
2013: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – TrustYes
2013-10-01Plan funding arrangement – General assets of the sponsorYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement - TrustYes
2013-10-01Plan benefit arrangement – General assets of the sponsorYes
2012: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan funding arrangement – TrustYes
2012-10-01Plan funding arrangement – General assets of the sponsorYes
2012-10-01Plan benefit arrangement – InsuranceYes
2012-10-01Plan benefit arrangement - TrustYes
2012-10-01Plan benefit arrangement – General assets of the sponsorYes
2011: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Submission has been amendedNo
2011-10-01This submission is the final filingNo
2011-10-01This return/report is a short plan year return/report (less than 12 months)No
2011-10-01Plan is a collectively bargained planNo
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan funding arrangement – TrustYes
2011-10-01Plan funding arrangement – General assets of the sponsorYes
2011-10-01Plan benefit arrangement – InsuranceYes
2011-10-01Plan benefit arrangement - TrustYes
2011-10-01Plan benefit arrangement – General assets of the sponsorYes
2010: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2010 form 5500 responses
2010-10-01Type of plan entitySingle employer plan
2010-10-01Submission has been amendedNo
2010-10-01This submission is the final filingNo
2010-10-01This return/report is a short plan year return/report (less than 12 months)No
2010-10-01Plan is a collectively bargained planNo
2010-10-01Plan funding arrangement – InsuranceYes
2010-10-01Plan funding arrangement – TrustYes
2010-10-01Plan funding arrangement – General assets of the sponsorYes
2010-10-01Plan benefit arrangement – InsuranceYes
2010-10-01Plan benefit arrangement - TrustYes
2010-10-01Plan benefit arrangement – General assets of the sponsorYes
2009: FARMERS & MERCHANTS TRUST COMPANY GROUP HEALTH PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan funding arrangement – General assets of the sponsorYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement - TrustYes
2009-07-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

NVA VISION (National Association of Insurance Commissioners NAIC id number: 11686 )
Policy contract number4148
Policy instance 1
Insurance contract or identification number4148
Number of Individuals Covered241
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $1,276
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $25,515
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,276
Insurance broker organization code?3
NVA VISION (National Association of Insurance Commissioners NAIC id number: 11686 )
Policy contract number4148
Policy instance 1
Insurance contract or identification number4148
Number of Individuals Covered254
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $1,284
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $25,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,284
Insurance broker organization code?3
NVA VISION (National Association of Insurance Commissioners NAIC id number: 11686 )
Policy contract number4148
Policy instance 1
Insurance contract or identification number4148
Number of Individuals Covered241
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $1,210
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $24,208
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,210
Insurance broker organization code?3
NVA VISION (National Association of Insurance Commissioners NAIC id number: 11686 )
Policy contract number4148
Policy instance 1
Insurance contract or identification number4148
Number of Individuals Covered248
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $1,250
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $24,999
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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