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FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN 401k Plan overview

Plan NameFIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN
Plan identification number 502

FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

FIRST NATIONAL BANK OF WATERLOO has sponsored the creation of one or more 401k plans.

Company Name:FIRST NATIONAL BANK OF WATERLOO
Employer identification number (EIN):370573575
NAIC Classification:522120
NAIC Description:Savings Institutions

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01DEANNA ROESSLER2023-05-10
5022021-01-01DEANNA ROESSLER2022-08-22
5022020-01-01DEANNA ROESSLER2022-08-22
5022018-01-01DEANNA ROESSLER2022-08-22
5022017-01-01DEANNA ROESSLER2022-08-23
5022016-01-01DEANNA ROESSLER2022-08-23

Plan Statistics for FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN

401k plan membership statisitcs for FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN

Measure Date Value
2022: FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01145
Total number of active participants reported on line 7a of the Form 55002022-01-01148
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01148
Number of employers contributing to the scheme2022-01-010
2021: FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01125
Total number of active participants reported on line 7a of the Form 55002021-01-01142
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01142
Number of employers contributing to the scheme2021-01-010
2020: FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01118
Total number of active participants reported on line 7a of the Form 55002020-01-01125
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01125
Number of employers contributing to the scheme2020-01-010
2018: FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01116
Total number of active participants reported on line 7a of the Form 55002018-01-01111
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01111
Number of employers contributing to the scheme2018-01-010
2017: FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01103
Total number of active participants reported on line 7a of the Form 55002017-01-01116
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01116
Number of employers contributing to the scheme2017-01-010
2016: FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01108
Total number of active participants reported on line 7a of the Form 55002016-01-01103
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01103
Number of employers contributing to the scheme2016-01-010

Form 5500 Responses for FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN

2022: FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2018: FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: FIRST NATIONAL BANK OF WATERLOO LIFE AND DISABILITY PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01First time form 5500 has been submittedYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B92V
Policy instance 1
Insurance contract or identification numberGLUG0B92V
Number of Individuals Covered147
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $8,463
Total amount of fees paid to insurance companyUSD $6,662
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $84,624
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,463
Amount paid for insurance broker fees6662
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B9V
Policy instance 1
Insurance contract or identification numberGLUG0B9V
Number of Individuals Covered142
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $8,215
Total amount of fees paid to insurance companyUSD $5,891
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $82,143
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,215
Amount paid for insurance broker fees5891
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B92V
Policy instance 1
Insurance contract or identification numberGLUG0B92V
Number of Individuals Covered125
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $7,320
Total amount of fees paid to insurance companyUSD $2,049
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $73,192
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,320
Amount paid for insurance broker fees2049
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B92V
Policy instance 1
Insurance contract or identification numberGLUG0B92V
Number of Individuals Covered111
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,981
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $49,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,981
Amount paid for insurance broker fees0
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM606087
Policy instance 1
Insurance contract or identification numberSGM606087
Number of Individuals Covered116
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,222
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $41,480
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $6,222
Amount paid for insurance broker fees0
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM606087
Policy instance 1
Insurance contract or identification numberSGM606087
Number of Individuals Covered103
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $5,186
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $34,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $5,186
Amount paid for insurance broker fees0
Insurance broker organization code?3

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