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COUNTRY CLUB BANK CAFETERIA PLAN 401k Plan overview

Plan NameCOUNTRY CLUB BANK CAFETERIA PLAN
Plan identification number 501

COUNTRY CLUB BANK CAFETERIA PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

COUNTRY CLUB BANK has sponsored the creation of one or more 401k plans.

Company Name:COUNTRY CLUB BANK
Employer identification number (EIN):440574255
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COUNTRY CLUB BANK CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012024-01-01EVA YOURTEE
5012023-01-01
5012023-01-01EVA YOURTEE
5012022-01-01
5012022-01-01EVA YOURTEE
5012021-01-01
5012021-01-01EVA YOURTEE
5012020-01-01
5012019-01-01
5012018-01-01EVA WISE TONI WALSH2019-06-19
5012017-01-01EVA WISE TONI WALSH2018-10-11
5012016-01-01EVA WISE TONI WALSH2017-08-09
5012015-01-01EVA WISE TONI WALSH2016-07-21
5012014-01-01EVA WISE TONI WALSH2015-07-21
5012013-01-01EVA WISE TONI WALSH2014-07-31
5012012-01-01CINDY KERSHNER CINDY KERSHNER2013-06-28
5012011-01-01CINDY KERSHNER CINDY KERSHNER2012-07-20
5012010-01-01CINDY KERSHNER CINDY KERSHNER2011-07-26
5012009-01-01CINDY KERSHNER CINDY KERSHNER2010-07-29

Form 5500 Responses for COUNTRY CLUB BANK CAFETERIA PLAN

2023: COUNTRY CLUB BANK CAFETERIA PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: COUNTRY CLUB BANK CAFETERIA PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: COUNTRY CLUB BANK CAFETERIA PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: COUNTRY CLUB BANK CAFETERIA PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: COUNTRY CLUB BANK CAFETERIA PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: COUNTRY CLUB BANK CAFETERIA PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: COUNTRY CLUB BANK CAFETERIA PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: COUNTRY CLUB BANK CAFETERIA PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: COUNTRY CLUB BANK CAFETERIA PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: COUNTRY CLUB BANK CAFETERIA PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: COUNTRY CLUB BANK CAFETERIA PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: COUNTRY CLUB BANK CAFETERIA PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: COUNTRY CLUB BANK CAFETERIA PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: COUNTRY CLUB BANK CAFETERIA PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: COUNTRY CLUB BANK CAFETERIA PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

CURALINC HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 62419 )
Policy contract numberEAP
Policy instance 6
Insurance contract or identification numberEAP
Number of Individuals Covered448
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $6,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number700919
Policy instance 5
Insurance contract or identification number700919
Number of Individuals Covered216
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $15,814
Total amount of fees paid to insurance companyUSD $2,108
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY AD&D
Welfare Benefit Premiums Paid to CarrierUSD $105,425
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FRESHBENIES (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberBENIES534
Policy instance 4
Insurance contract or identification numberBENIES534
Number of Individuals Covered143
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Other welfare benefits providedTELEHEALTH
Welfare Benefit Premiums Paid to CarrierUSD $34,551
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )
Policy contract number22620000
Policy instance 3
Insurance contract or identification number22620000
Number of Individuals Covered572
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $4,458
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $232,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number700918
Policy instance 2
Insurance contract or identification number700918
Number of Individuals Covered408
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of fees paid to insurance companyUSD $1,747
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $87,340
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number41001, 81001
Policy instance 1
Insurance contract or identification number41001, 81001
Number of Individuals Covered498
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,296
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10199441001
Policy instance 1
Insurance contract or identification number10199441001
Number of Individuals Covered519
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,299
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number700918
Policy instance 2
Insurance contract or identification number700918
Number of Individuals Covered422
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of fees paid to insurance companyUSD $1,527
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $76,339
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )
Policy contract number22620000
Policy instance 3
Insurance contract or identification number22620000
Number of Individuals Covered612
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $8,569
Total amount of fees paid to insurance companyUSD $2,043
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $206,765
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FRESHBENIES (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberBENIES534
Policy instance 4
Insurance contract or identification numberBENIES534
Number of Individuals Covered168
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Other welfare benefits providedTELEHEALTH
Welfare Benefit Premiums Paid to CarrierUSD $20,801
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number700919
Policy instance 5
Insurance contract or identification number700919
Number of Individuals Covered211
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $14,844
Total amount of fees paid to insurance companyUSD $1,979
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY AD&D
Welfare Benefit Premiums Paid to CarrierUSD $98,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10199441001
Policy instance 1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number700918
Policy instance 2
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )
Policy contract number22620000
Policy instance 3
FRESHBENIES (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberBENIES534
Policy instance 4
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number700919
Policy instance 5
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10199441001
Policy instance 1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number700918
Policy instance 2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0869252
Policy instance 3
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number37665000
Policy instance 4
FRESHBENIES (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberBENIES534
Policy instance 5
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number700919
Policy instance 6
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number700919
Policy instance 6
FRESHBENIES (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberBENIES534
Policy instance 5
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number37665000
Policy instance 4
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0869252
Policy instance 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number700918
Policy instance 2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10199441001
Policy instance 1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number700919
Policy instance 6
FRESHBENIES (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberBENIES534
Policy instance 5
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number37665000
Policy instance 4
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0869252
Policy instance 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number700918
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 )
Policy contract number30037352
Policy instance 1
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 )
Policy contract number30037352
Policy instance 1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number700918
Policy instance 2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0869252
Policy instance 3
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number37665000
Policy instance 4
FRESHBENIES (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberBENIES534
Policy instance 5
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number700919
Policy instance 6
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0869252
Policy instance 3
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number5052510000
Policy instance 4
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 )
Policy contract number30037352
Policy instance 1
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5321229
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 )
Policy contract number30037352
Policy instance 2
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5321229
Policy instance 1
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0869252
Policy instance 4
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number5052510000
Policy instance 3
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5321229
Policy instance 1
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number633803
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 )
Policy contract number30037352
Policy instance 3
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5321229
Policy instance 1
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number705197
Policy instance 2
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number705197
Policy instance 2
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5321229
Policy instance 1
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5321229
Policy instance 2
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number708426
Policy instance 1

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