401k Plan data: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN plan

MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 401k Plan overview

Plan Name	MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN
Plan identification number	001

MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.

401k Sponsoring company profile

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

Company Name: EVERSIGHT

Employer identification number (EIN): 382117115

NAIC Classification: 621900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 JULIE COLLINS
001 2016-01-01 JULIE COLLINS JULIE COLLINS 2017-07-31
001 2015-01-01 JULIE COLLINS
001 2014-01-01 JULIE COLLINS
001 2013-01-01 JULIE COLLINS
001 2012-01-01 JULIE COLLINS
001 2011-01-01 JULIE COLLINS
001 2010-01-01 JULIE COLLINS 2011-10-06 JULIE COLLINS 2011-10-10

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	JULIE COLLINS
001	2016-01-01	JULIE COLLINS		JULIE COLLINS	2017-07-31
001	2015-01-01	JULIE COLLINS
001	2014-01-01	JULIE COLLINS
001	2013-01-01	JULIE COLLINS
001	2012-01-01	JULIE COLLINS
001	2011-01-01	JULIE COLLINS
001	2010-01-01	JULIE COLLINS	2011-10-06	JULIE COLLINS	2011-10-10

Plan Statistics for MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN

401k plan membership statisitcs for MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN

Measure Date Value
2022: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 277
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 124
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 168
Total of all active and inactive participants 2022-01-01 292
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 1
Total participants 2022-01-01 293
Number of participants with account balances 2022-01-01 291
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 4
2021: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 271
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 119
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 157
Total of all active and inactive participants 2021-01-01 276
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 2
Total participants 2021-01-01 278
Number of participants with account balances 2021-01-01 275
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 5
2020: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 258
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 108
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 162
Total of all active and inactive participants 2020-01-01 270
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 1
Total participants 2020-01-01 271
Number of participants with account balances 2020-01-01 256
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 253
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 130
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 135
Total of all active and inactive participants 2019-01-01 265
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 1
Total participants 2019-01-01 266
Number of participants with account balances 2019-01-01 258
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 233
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 134
Number of other retired or separated participants entitled to future benefits 2018-01-01 118
Total of all active and inactive participants 2018-01-01 252
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 1
Total participants 2018-01-01 253
Number of participants with account balances 2018-01-01 247
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 244
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 138
Number of other retired or separated participants entitled to future benefits 2017-01-01 94
Total of all active and inactive participants 2017-01-01 232
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 1
Total participants 2017-01-01 233
Number of participants with account balances 2017-01-01 227
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 218
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 151
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 93
Total of all active and inactive participants 2016-01-01 244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 244
Number of participants with account balances 2016-01-01 238
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 207
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 132
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 86
Total of all active and inactive participants 2015-01-01 218
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 218
Number of participants with account balances 2015-01-01 213
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 184
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 144
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 63
Total of all active and inactive participants 2014-01-01 207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 207
Number of participants with account balances 2014-01-01 204
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 152
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 132
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 52
Total of all active and inactive participants 2013-01-01 184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 184
Number of participants with account balances 2013-01-01 175
2012: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 142
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 108
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 44
Total of all active and inactive participants 2012-01-01 152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 152
Number of participants with account balances 2012-01-01 142
2011: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 125
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 93
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 49
Total of all active and inactive participants 2011-01-01 142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 142
Number of participants with account balances 2011-01-01 128

Measure	Date	Value
2022: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	277
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	124
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	168
Total of all active and inactive participants	2022-01-01	292
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	1
Total participants	2022-01-01	293
Number of participants with account balances	2022-01-01	291
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	4
2021: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	271
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	119
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	157
Total of all active and inactive participants	2021-01-01	276
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	2
Total participants	2021-01-01	278
Number of participants with account balances	2021-01-01	275
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	5
2020: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	258
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	108
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	162
Total of all active and inactive participants	2020-01-01	270
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	1
Total participants	2020-01-01	271
Number of participants with account balances	2020-01-01	256
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	253
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	130
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	135
Total of all active and inactive participants	2019-01-01	265
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	1
Total participants	2019-01-01	266
Number of participants with account balances	2019-01-01	258
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	233
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	134
Number of other retired or separated participants entitled to future benefits	2018-01-01	118
Total of all active and inactive participants	2018-01-01	252
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	1
Total participants	2018-01-01	253
Number of participants with account balances	2018-01-01	247
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	244
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	138
Number of other retired or separated participants entitled to future benefits	2017-01-01	94
Total of all active and inactive participants	2017-01-01	232
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	233
Number of participants with account balances	2017-01-01	227
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	218
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	151
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	93
Total of all active and inactive participants	2016-01-01	244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	244
Number of participants with account balances	2016-01-01	238
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	207
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	132
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	86
Total of all active and inactive participants	2015-01-01	218
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	218
Number of participants with account balances	2015-01-01	213
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	184
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	144
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	63
Total of all active and inactive participants	2014-01-01	207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	207
Number of participants with account balances	2014-01-01	204
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	152
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	132
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	52
Total of all active and inactive participants	2013-01-01	184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	184
Number of participants with account balances	2013-01-01	175
2012: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	142
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	108
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	44
Total of all active and inactive participants	2012-01-01	152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	152
Number of participants with account balances	2012-01-01	142
2011: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	125
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	93
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	49
Total of all active and inactive participants	2011-01-01	142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	142
Number of participants with account balances	2011-01-01	128

Financial Data on MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN

Measure	Date	Value
2022 : MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total transfer of assets to this plan	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-1,900,805
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$1,194,857
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,163,315
Expenses. Certain deemed distributions of participant loans	2022-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,092,073
Value of total assets at end of year	2022-12-31	$19,929,562
Value of total assets at beginning of year	2022-12-31	$23,025,224
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$31,542
Total interest from all sources	2022-12-31	$160,835
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$235,937
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$235,937
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$574,303
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$2,378
Other income not declared elsewhere	2022-12-31	$20,448
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-3,095,662
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$19,929,562
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$23,025,224
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$15,071,236
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$18,308,760
Value of interest in pooled separate accounts at end of year	2022-12-31	$757,415
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$745,503
Interest earned on other investments	2022-12-31	$160,835
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$4,100,911
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$3,970,961
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-3,471,724
Net investment gain/loss from pooled separate accounts	2022-12-31	$61,626
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$515,392
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$1,163,315
Contract administrator fees	2022-12-31	$31,542
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	RETIREMENT PLAN AUDIT SERVICES, LLC
Accountancy firm EIN	2022-12-31	861928438
2021 : MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2021 401k financial data
Total income from all sources (including contributions)	2021-12-31	$3,744,273
Total of all expenses incurred	2021-12-31	$654,851
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$628,229
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,107,876
Value of total assets at end of year	2021-12-31	$23,025,224
Value of total assets at beginning of year	2021-12-31	$19,935,802
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$26,622
Total interest from all sources	2021-12-31	$133,041
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$424,424
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$424,424
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$509,774
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$115,593
Other income not declared elsewhere	2021-12-31	$13,053
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$3,089,422
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$23,025,224
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$19,935,802
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$26,622
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$18,308,760
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$15,584,201
Value of interest in pooled separate accounts at end of year	2021-12-31	$745,503
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$545,156
Interest earned on other investments	2021-12-31	$133,041
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$3,970,961
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$3,806,445
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$1,963,426
Net investment gain/loss from pooled separate accounts	2021-12-31	$102,453
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$482,509
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$628,229
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	YEO & YEO, PC
Accountancy firm EIN	2021-12-31	382706146
2020 : MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2020 401k financial data
Total income from all sources (including contributions)	2020-12-31	$3,390,513
Total of all expenses incurred	2020-12-31	$1,411,982
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,389,562
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$952,037
Value of total assets at end of year	2020-12-31	$19,935,802
Value of total assets at beginning of year	2020-12-31	$17,957,271
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$22,420
Total interest from all sources	2020-12-31	$144,432
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$238,648
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$238,648
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$475,658
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$12,956
Other income not declared elsewhere	2020-12-31	$11,307
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$1,978,531
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$19,935,802
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$17,957,271
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Investment advisory and management fees	2020-12-31	$22,420
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$15,584,201
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$13,593,004
Value of interest in pooled separate accounts at end of year	2020-12-31	$545,156
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$622,358
Interest earned on other investments	2020-12-31	$144,432
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$3,806,445
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$3,741,909
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$2,049,801
Net investment gain/loss from pooled separate accounts	2020-12-31	$-5,712
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$463,423
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$1,389,562
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	YEO & YEO, PC
Accountancy firm EIN	2020-12-31	382706146
2019 : MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-12-31	$3,770,941
Total of all expenses incurred	2019-12-31	$1,252,232
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,230,657
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$961,560
Value of total assets at end of year	2019-12-31	$17,957,271
Value of total assets at beginning of year	2019-12-31	$15,438,562
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$21,575
Total interest from all sources	2019-12-31	$139,126
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$200,038
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$200,038
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$429,165
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$61,179
Other income not declared elsewhere	2019-12-31	$14,476
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$2,518,709
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$17,957,271
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$15,438,562
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Investment advisory and management fees	2019-12-31	$14,445
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$13,593,004
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$11,219,307
Value of interest in pooled separate accounts at end of year	2019-12-31	$622,358
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$648,925
Interest earned on other investments	2019-12-31	$139,126
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$3,741,909
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$3,570,330
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$2,421,368
Net investment gain/loss from pooled separate accounts	2019-12-31	$34,373
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$471,216
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,230,657
Contract administrator fees	2019-12-31	$7,130
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	YEO & YEO, PC
Accountancy firm EIN	2019-12-31	382706146
2018 : MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$311,216
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$1,343,723
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,326,202
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,012,771
Value of total assets at end of year	2018-12-31	$15,438,562
Value of total assets at beginning of year	2018-12-31	$16,471,069
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$17,521
Total interest from all sources	2018-12-31	$136,883
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$79,933
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$79,933
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$497,727
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$2,503
Other income not declared elsewhere	2018-12-31	$17,361
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-1,032,507
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$15,438,562
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$16,471,069
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$11,219,307
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$11,125,545
Value of interest in pooled separate accounts at end of year	2018-12-31	$648,925
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$1,843,293
Interest earned on other investments	2018-12-31	$136,883
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$3,570,330
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$3,502,231
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-967,327
Net investment gain/loss from pooled separate accounts	2018-12-31	$31,595
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$512,541
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$1,326,202
Contract administrator fees	2018-12-31	$17,521
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2018-12-31	Yes
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	YEO & YEO, PC
Accountancy firm EIN	2018-12-31	382706146
2017 : MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$3,210,933
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$1,128,830
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,128,830
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,040,428
Value of total assets at end of year	2017-12-31	$16,471,069
Value of total assets at beginning of year	2017-12-31	$14,388,966
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$0
Total interest from all sources	2017-12-31	$127,888
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$493,183
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$33,748
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$2,082,103
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$16,471,069
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$14,388,966
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$11,125,545
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$9,288,828
Value of interest in pooled separate accounts at end of year	2017-12-31	$1,843,293
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$1,910,073
Interest earned on other investments	2017-12-31	$127,888
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$3,502,231
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$3,190,065
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$2,042,617
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$513,497
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,128,830
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	YEO & YEO, P.C,
Accountancy firm EIN	2017-12-31	382706146
2016 : MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$1,906,556
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$828,029
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$828,029
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,038,432
Value of total assets at end of year	2016-12-31	$14,388,966
Value of total assets at beginning of year	2016-12-31	$13,310,439
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$0
Total interest from all sources	2016-12-31	$124,184
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$482,544
Participant contributions at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$26,961
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$1,078,527
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$14,388,966
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$13,310,439
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$9,288,828
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$8,630,543
Value of interest in pooled separate accounts at end of year	2016-12-31	$1,910,073
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$1,702,794
Interest earned on other investments	2016-12-31	$124,184
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$3,190,065
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$2,977,102
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$743,940
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$528,927
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$828,029
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	YEO & YEO, P.C.
Accountancy firm EIN	2016-12-31	382706146
2015 : MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$1,185,328
Total of all expenses incurred	2015-12-31	$642,738
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$642,640
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,040,965
Value of total assets at end of year	2015-12-31	$13,310,439
Value of total assets at beginning of year	2015-12-31	$12,767,849
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$98
Total interest from all sources	2015-12-31	$110,104
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$424,935
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$98,093
Administrative expenses (other) incurred	2015-12-31	$98
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$542,590
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$13,310,439
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$12,767,849
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$8,630,543
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$8,306,875
Value of interest in pooled separate accounts at end of year	2015-12-31	$1,702,794
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$1,622,141
Interest earned on other investments	2015-12-31	$110,104
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$2,977,102
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$2,838,833
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$34,259
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$517,937
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$642,640
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	YEO & YEO, P.C.
Accountancy firm EIN	2015-12-31	382706146
2014 : MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$1,756,019
Total of all expenses incurred	2014-12-31	$230,150
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$230,058
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$962,390
Value of total assets at end of year	2014-12-31	$12,767,849
Value of total assets at beginning of year	2014-12-31	$11,241,980
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$92
Total interest from all sources	2014-12-31	$101,622
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$425,737
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$36,236
Administrative expenses (other) incurred	2014-12-31	$92
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$1,525,869
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$12,767,849
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$11,241,980
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$8,306,875
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$7,608,766
Value of interest in pooled separate accounts at end of year	2014-12-31	$1,622,141
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$1,242,550
Interest earned on other investments	2014-12-31	$101,622
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$2,838,833
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$2,390,664
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$572,536
Net investment gain/loss from pooled separate accounts	2014-12-31	$119,471
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$500,417
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$230,058
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	YEO & YEO, P.C.
Accountancy firm EIN	2014-12-31	382706146
2013 : MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$2,650,383
Total of all expenses incurred	2013-12-31	$219,047
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$218,985
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$905,498
Value of total assets at end of year	2013-12-31	$11,241,980
Value of total assets at beginning of year	2013-12-31	$8,810,644
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$62
Total interest from all sources	2013-12-31	$92,566
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$387,272
Participant contributions at beginning of year	2013-12-31	$14,124
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$90,229
Administrative expenses (other) incurred	2013-12-31	$62
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$2,431,336
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$11,241,980
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$8,810,644
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$7,608,766
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$5,823,895
Value of interest in pooled separate accounts at end of year	2013-12-31	$1,242,550
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$623,464
Interest earned on other investments	2013-12-31	$92,566
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$129,827
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$129,827
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$2,390,664
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$2,203,994
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$1,483,780
Net investment gain/loss from pooled separate accounts	2013-12-31	$168,539
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$427,997
Employer contributions (assets) at beginning of year	2013-12-31	$15,340
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$218,985
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	YEO & YEO, P.C.
Accountancy firm EIN	2013-12-31	382706146
2012 : MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$1,978,806
Total of all expenses incurred	2012-12-31	$56,618
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$56,618
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,129,621
Value of total assets at end of year	2012-12-31	$8,810,644
Value of total assets at beginning of year	2012-12-31	$6,888,456
Total interest from all sources	2012-12-31	$83,313
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$250,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$302,855
Participant contributions at end of year	2012-12-31	$14,124
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$491,482
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$1,922,188
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$8,810,644
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$6,888,456
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$5,823,895
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$4,554,055
Value of interest in pooled separate accounts at end of year	2012-12-31	$623,464
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$293,400
Interest earned on other investments	2012-12-31	$83,313
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$129,827
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$2,203,994
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$2,041,001
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$732,899
Net investment gain/loss from pooled separate accounts	2012-12-31	$32,973
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$335,284
Employer contributions (assets) at end of year	2012-12-31	$15,340
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$56,618
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	YEO & YEO, P.C.
Accountancy firm EIN	2012-12-31	382706146
2011 : MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$550,811
Total of all expenses incurred	2011-12-31	$136,315
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$136,315
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$560,759
Value of total assets at end of year	2011-12-31	$6,888,456
Value of total assets at beginning of year	2011-12-31	$6,473,960
Total interest from all sources	2011-12-31	$76,577
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$250,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$239,816
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$44,485
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$414,496
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$6,888,456
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$6,473,960
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$4,554,055
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$4,493,172
Value of interest in pooled separate accounts at end of year	2011-12-31	$293,400
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$214,773
Interest earned on other investments	2011-12-31	$76,577
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$2,041,001
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$1,766,015
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-117,837
Net investment gain/loss from pooled separate accounts	2011-12-31	$31,312
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$276,458
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$136,315
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	YEO & YEO, P.C.
Accountancy firm EIN	2011-12-31	382706146

Form 5500 Responses for MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN

2022: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: MIDWEST EYE BANKS 403(B) DC PLAN AND MIDWEST EYE BANKS 403(B) TDA PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

337071

Policy instance

Insurance contract or identification number	337071
Number of Individuals Covered	171
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

337071

Policy instance

Insurance contract or identification number	337071
Number of Individuals Covered	178
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

337071

Policy instance

Insurance contract or identification number	337071
Number of Individuals Covered	181
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

337071

Policy instance

Insurance contract or identification number	337071
Number of Individuals Covered	183
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

058842-H

Policy instance

Insurance contract or identification number	058842-H
Number of Individuals Covered	51
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	716
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP PROGRAM
Insurance broker organization code?	3
Insurance broker name	SOUTHFIELD REGIONAL OFFICE

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

337071

Policy instance

Insurance contract or identification number	337071
Number of Individuals Covered	197
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

337072

Policy instance

Insurance contract or identification number	337072
Number of Individuals Covered	17
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	EVERSIGHT
Employer identification number (EIN):	382117115
NAIC Classification:	621900