| Plan Name | CITIZENS BANK OF LAFAYETTE EMPLOYEE BENEFITS PLAN |
| Plan identification number | 525 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | CITIZENS BANK OF LAFAYETTE |
| Employer identification number (EIN): | 620123135 |
| NAIC Classification: | 522110 |
| NAIC Description: | Commercial Banking |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 525 | 2022-08-01 | ||||
| 525 | 2022-08-01 | PATTY SNYDER |
| Measure | Date | Value |
|---|---|---|
| 2022: CITIZENS BANK OF LAFAYETTE EMPLOYEE BENEFITS PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-08-01 | 227 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-08-01 | 235 |
| Number of retired or separated participants receiving benefits | 2022-08-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-08-01 | 0 |
| Total of all active and inactive participants | 2022-08-01 | 235 |
| 2022: CITIZENS BANK OF LAFAYETTE EMPLOYEE BENEFITS PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-08-01 | Type of plan entity | Single employer plan |
| 2022-08-01 | Submission has been amended | No |
| 2022-08-01 | This submission is the final filing | No |
| 2022-08-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-08-01 | Plan is a collectively bargained plan | No |
| 2022-08-01 | Plan funding arrangement – Insurance | Yes |
| 2022-08-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-08-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |
| Policy contract number | 3345149 |
| Policy instance | 1 |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) | |
| Policy contract number | 1114592 |
| Policy instance | 2 |
| UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) | |
| Policy contract number | 146269 |
| Policy instance | 3 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00489305 |
| Policy instance | 4 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |
| Policy contract number | 3345149 |
| Policy instance | 5 |