401k Plan data: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST plan

SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 401k Plan overview

Plan Name	SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST
Plan identification number	501

SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability cover

401k Sponsoring company profile

HERITAGE COMMUNITY BANK has sponsored the creation of one or more 401k plans.

Company Name: HERITAGE COMMUNITY BANK

Employer identification number (EIN): 582471826

NAIC Classification: 522110
NAIC Description: Commercial Banking

Additional information about HERITAGE COMMUNITY BANK

Jurisdiction of Incorporation: Georgia Department of States Corporations Division

Incorporation Date:

Company Identification Number: 731874

More information about HERITAGE COMMUNITY BANK

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2018-01-01
501 2017-01-01
501 2016-01-01
501 2015-01-01
501 2014-01-01
501 2013-01-01 CURTIS A TYNER 2014-07-23
501 2012-01-01 CURTIS A TYNER 2013-07-29
501 2011-01-01 CURTIS A TYNER 2012-07-10
501 2009-01-01 CURTIS A TYNER

Plan Statistics for SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST

401k plan membership statisitcs for SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST

Measure Date Value
2009: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2009 401k membership
Total participants, beginning-of-year 2009-01-01 31
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 32
Total of all active and inactive participants 2009-01-01 32
Total participants 2009-01-01 32

Measure	Date	Value
2009: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2009 401k membership
Total participants, beginning-of-year	2009-01-01	31
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	32
Total of all active and inactive participants	2009-01-01	32
Total participants	2009-01-01	32

Financial Data on SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST

Measure	Date	Value
2010 : SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2010 401k financial data
Total plan liabilities at end of year	2010-12-31	$10,226
Total plan liabilities at beginning of year	2010-12-31	$17,456
Total income from all sources	2010-12-31	$236,776
Expenses. Total of all expenses incurred	2010-12-31	$215,239
Benefits paid (including direct rollovers)	2010-12-31	$191,879
Total plan assets at end of year	2010-12-31	$39,943
Total plan assets at beginning of year	2010-12-31	$25,636
Value of fidelity bond covering the plan	2010-12-31	$1,000,000
Other income received	2010-12-31	$538
Net income (gross income less expenses)	2010-12-31	$21,537
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$29,717
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$8,180
Total contributions received or receivable from employer(s)	2010-12-31	$236,238
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$23,360

Form 5500 Responses for SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST

2009: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30016141-0034

Policy instance

Insurance contract or identification number	30016141-0034
Number of Individuals Covered	9
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $46
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,409
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $46
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	SCBA SERVICES

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

348118-0048

Policy instance

Insurance contract or identification number	348118-0048
Number of Individuals Covered	34
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,271
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,271
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	THORNE CORPORATION

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

105531-0048

Policy instance

Insurance contract or identification number	105531-0048
Number of Individuals Covered	34
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $669
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $8,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $669
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	THORNE CORPORATION

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

285958-0048

Policy instance

Insurance contract or identification number	285958-0048
Number of Individuals Covered	6
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $445
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,491
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $445
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	THORNE CORPORATION

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TSO5469906

Policy instance

Insurance contract or identification number	TSO5469906
Number of Individuals Covered	56
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $500
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $500
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	2
Insurance broker name	SC BANKERS EMPLOYEE BENEFIT TRUST

BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )

Policy contract number

03-55075

Policy instance

Insurance contract or identification number	03-55075
Number of Individuals Covered	13
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )

Policy contract number

03-51236-69-7

Policy instance

Insurance contract or identification number	03-51236-69-7
Number of Individuals Covered	19
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	HERITAGE COMMUNITY BANK
Employer identification number (EIN):	582471826
NAIC Classification:	522110
NAIC Description:	Commercial Banking

Jurisdiction of Incorporation:	Georgia Department of States Corporations Division
Incorporation Date:
Company Identification Number:	731874

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2018-01-01
501	2017-01-01
501	2016-01-01
501	2015-01-01
501	2014-01-01
501	2013-01-01	CURTIS A TYNER	2014-07-23
501	2012-01-01	CURTIS A TYNER	2013-07-29
501	2011-01-01	CURTIS A TYNER	2012-07-10
501	2009-01-01	CURTIS A TYNER