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FIRST STATE FINANCIAL, INC. 401k Plan overview

Plan NameFIRST STATE FINANCIAL, INC.
Plan identification number 501

FIRST STATE FINANCIAL, INC. 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

401k Sponsoring company profile

FIRST STATE BANK OF THE SOUTHEAST, INC. has sponsored the creation of one or more 401k plans.

Company Name:FIRST STATE BANK OF THE SOUTHEAST, INC.
Employer identification number (EIN):610192880
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIRST STATE FINANCIAL, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012015-01-01PATRICIA HOSKINS

Plan Statistics for FIRST STATE FINANCIAL, INC.

401k plan membership statisitcs for FIRST STATE FINANCIAL, INC.

Measure Date Value
2015: FIRST STATE FINANCIAL, INC. 2015 401k membership
Total participants, beginning-of-year2015-01-01101
Total number of active participants reported on line 7a of the Form 55002015-01-01104
Total of all active and inactive participants2015-01-01104

Form 5500 Responses for FIRST STATE FINANCIAL, INC.

2015: FIRST STATE FINANCIAL, INC. 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01First time form 5500 has been submittedYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number
Policy instance 1
Number of Individuals Covered104
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $13,430
Total amount of fees paid to insurance companyUSD $2,806
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,565
Amount paid for insurance broker fees2806
Insurance broker nameHORIZON PLANNING GROUP
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number
Policy instance 2
Number of Individuals Covered78
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $14,709
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,915
Insurance broker nameKEYSTONE INSURANCE & BENEFITS

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