FIRST STATE BANK OF UVALDE has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN
401k plan membership statisitcs for FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2021: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 0 |
| Total participants | 2021-01-01 | 0 |
| 2020: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 0 |
| Total participants | 2020-01-01 | 0 |
| 2019: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 102 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 99 |
| Total of all active and inactive participants | 2019-01-01 | 99 |
| Total participants | 2019-01-01 | 99 |
| Number of participants with account balances | 2019-01-01 | 0 |
| 2018: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 102 |
| Total of all active and inactive participants | 2018-01-01 | 102 |
| Total participants | 2018-01-01 | 102 |
| 2017: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 102 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 104 |
| Total of all active and inactive participants | 2017-01-01 | 104 |
| Total participants | 2017-01-01 | 104 |
| 2016: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 98 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 102 |
| Total of all active and inactive participants | 2016-01-01 | 102 |
| Total participants | 2016-01-01 | 0 |
| 2015: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 105 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 98 |
| Total of all active and inactive participants | 2015-01-01 | 98 |
| Total participants | 2015-01-01 | 0 |
| 2014: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 105 |
| Total of all active and inactive participants | 2014-01-01 | 105 |
| Total participants | 2014-01-01 | 0 |
| 2013: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 104 |
| Total of all active and inactive participants | 2013-01-01 | 104 |
| Total participants | 2013-01-01 | 0 |
| 2012: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 102 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 104 |
| Total of all active and inactive participants | 2012-01-01 | 104 |
| Total participants | 2012-01-01 | 0 |
| 2011: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 105 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 102 |
| Total of all active and inactive participants | 2011-01-01 | 102 |
| Total participants | 2011-01-01 | 102 |
| 2010: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 108 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 105 |
| Total of all active and inactive participants | 2010-01-01 | 105 |
| Total participants | 2010-01-01 | 105 |
| 2009: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 107 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 108 |
| Total of all active and inactive participants | 2009-01-01 | 108 |
| Total participants | 2009-01-01 | 108 |
| Measure | Date | Value |
|---|
| 2021 : FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2021 401k financial data |
|---|
| Total income from all sources | 2021-12-31 | $13 |
| Expenses. Total of all expenses incurred | 2021-12-31 | $232,614 |
| Total plan assets at end of year | 2021-12-31 | $0 |
| Total plan assets at beginning of year | 2021-12-31 | $232,601 |
| Expenses. Other expenses not covered elsewhere | 2021-12-31 | $232,614 |
| Other income received | 2021-12-31 | $13 |
| Net income (gross income less expenses) | 2021-12-31 | $-232,601 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $232,601 |
| 2020 : FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2020 401k financial data |
|---|
| Total income from all sources | 2020-12-31 | $9,647 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $52,012 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $52,012 |
| Total plan assets at end of year | 2020-12-31 | $232,601 |
| Total plan assets at beginning of year | 2020-12-31 | $274,966 |
| Contributions received from other sources (not participants or employers) | 2020-12-31 | $8,348 |
| Other income received | 2020-12-31 | $1,299 |
| Net income (gross income less expenses) | 2020-12-31 | $-42,365 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $232,601 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $274,966 |
| 2019 : FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2019 401k financial data |
|---|
| Total income from all sources | 2019-12-31 | $1,702,537 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $1,681,198 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $1,221,288 |
| Total plan assets at end of year | 2019-12-31 | $274,966 |
| Total plan assets at beginning of year | 2019-12-31 | $253,627 |
| Total contributions received or receivable from participants | 2019-12-31 | $124,413 |
| Expenses. Other expenses not covered elsewhere | 2019-12-31 | $459,910 |
| Contributions received from other sources (not participants or employers) | 2019-12-31 | $115,739 |
| Other income received | 2019-12-31 | $4,885 |
| Net income (gross income less expenses) | 2019-12-31 | $21,339 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $274,966 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $253,627 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $1,457,500 |
| 2018 : FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2018 401k financial data |
|---|
| Total income from all sources | 2018-12-31 | $1,989,296 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $2,040,469 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $1,500,760 |
| Total plan assets at end of year | 2018-12-31 | $253,627 |
| Total plan assets at beginning of year | 2018-12-31 | $304,800 |
| Total contributions received or receivable from participants | 2018-12-31 | $104,545 |
| Expenses. Other expenses not covered elsewhere | 2018-12-31 | $539,709 |
| Contributions received from other sources (not participants or employers) | 2018-12-31 | $47,785 |
| Other income received | 2018-12-31 | $43,966 |
| Net income (gross income less expenses) | 2018-12-31 | $-51,173 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $253,627 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $304,800 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $1,793,000 |
| 2017 : FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2017 401k financial data |
|---|
| Total income from all sources (including contributions) | 2017-12-31 | $2,337,989 |
| Total of all expenses incurred | 2017-12-31 | $2,394,569 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $2,034,632 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $2,376,208 |
| Value of total assets at end of year | 2017-12-31 | $304,800 |
| Value of total assets at beginning of year | 2017-12-31 | $361,380 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $359,937 |
| Total interest from all sources | 2017-12-31 | $2,204 |
| 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 | No |
| 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 | $106,873 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2017-12-31 | $871,785 |
| Other income not declared elsewhere | 2017-12-31 | $-40,423 |
| Administrative expenses (other) incurred | 2017-12-31 | $359,937 |
| 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 | $-56,580 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $304,800 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $361,380 |
| 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 common/collective trusts at end of year | 2017-12-31 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-12-31 | $304,800 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-12-31 | $361,380 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-12-31 | $361,380 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-12-31 | $2,204 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $2,034,632 |
| 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 | $1,397,550 |
| 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 | 2017-12-31 | No |
| Did the plan have assets held for investment | 2017-12-31 | No |
| 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 |
| 2016 : FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $2,319,425 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $2,245,966 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $1,838,304 |
| Total plan assets at end of year | 2016-12-31 | $361,380 |
| Total plan assets at beginning of year | 2016-12-31 | $287,921 |
| Total contributions received or receivable from participants | 2016-12-31 | $102,848 |
| Expenses. Other expenses not covered elsewhere | 2016-12-31 | $407,662 |
| Contributions received from other sources (not participants or employers) | 2016-12-31 | $416,094 |
| Other income received | 2016-12-31 | $483 |
| Net income (gross income less expenses) | 2016-12-31 | $73,459 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $361,380 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $287,921 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $1,800,000 |
| 2021: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | This submission is the final filing | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | This submission is the final filing | Yes |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT 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 benefit arrangement – Insurance | Yes |
| 2018: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT 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 benefit arrangement – Insurance | Yes |
| 2014: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT 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 benefit arrangement – Insurance | Yes |
| 2013: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT 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 benefit arrangement – Insurance | Yes |
| 2012: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT 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 benefit arrangement – Insurance | Yes |
| 2011: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT 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 benefit arrangement – Insurance | Yes |
| 2010: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: FIRST STATE BANK OF UVALDE EMPLOYEE BENEFIT PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 596125 |
| Policy instance | 7 |
| Insurance contract or identification number | 596125 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 927489 |
| Policy instance | 6 |
| Insurance contract or identification number | 927489 | | Number of Individuals Covered | 99 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $35,816 | | Welfare Benefit Premiums Paid to Carrier | USD $358,168 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $35,816 | | Insurance broker organization code? | 3 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCCLOT40572 |
| Policy instance | 5 |
| Insurance contract or identification number | HCCLOT40572 | | Number of Individuals Covered | 99 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,306 | | Total amount of fees paid to insurance company | USD $470 | | Other welfare benefits provided | TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $13,079 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $653 | | Amount paid for insurance broker fees | 235 | | Additional information about fees paid to insurance broker | OVERRIDE | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 596125 |
| Policy instance | 4 |
| Insurance contract or identification number | 596125 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2020-01-01 | | Total amount of commissions paid to insurance broker | USD $3,473 | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | Yes | | Other welfare benefits provided | LIFE STYLE ADD, LIFSTYLE LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $19,822 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Other information about contract | LIFE STYLE ADD, LIFSTYLE LIFE | | Commission paid to Insurance Broker | USD $3,473 | | Additional information about fees paid to insurance broker | OVERRIDE | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 545982 |
| Policy instance | 3 |
| Insurance contract or identification number | 545982 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2020-01-01 | | Total amount of commissions paid to insurance broker | USD $580 | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | Yes | | Other welfare benefits provided | ADD, LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $5,046 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Other information about contract | ADD, LIFE | | Commission paid to Insurance Broker | USD $580 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 596124 |
| Policy instance | 2 |
| Insurance contract or identification number | 596124 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2020-01-01 | | Total amount of commissions paid to insurance broker | USD $1,049 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | STD | | Welfare Benefit Premiums Paid to Carrier | USD $8,995 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,049 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 501013 |
| Policy instance | 1 |
| Insurance contract or identification number | 501013 | | Number of Individuals Covered | 116 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2020-01-01 | | Total amount of commissions paid to insurance broker | USD $2,105 | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | FLEX LTD | | Welfare Benefit Premiums Paid to Carrier | USD $21,498 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Other information about contract | FLEX LTD | | Commission paid to Insurance Broker | USD $2,105 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 596125 |
| Policy instance | 5 |
| Insurance contract or identification number | 596125 | | Number of Individuals Covered | 70 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2018-01-01 | | Total amount of commissions paid to insurance broker | USD $39,927 | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | Yes | | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $39,927 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Other information about contract | LIFESTYLE ADD, LIFESTYLE LIFE | | Commission paid to Insurance Broker | USD $39,927 | | Insurance broker organization code? | 3 | | Insurance broker name | CHRISTOPHER L SNODGRASS |
|
| BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 ) |
| Policy contract number | ERLL17101280001 |
| Policy instance | 4 |
| Insurance contract or identification number | ERLL17101280001 | | Number of Individuals Covered | 104 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $32,566 | | Welfare Benefit Premiums Paid to Carrier | USD $325,666 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $32,566 | | Insurance broker organization code? | 3 | | Insurance broker name | CHRIS SNODGRASS |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 947-4825 |
| Policy instance | 3 |
| Insurance contract or identification number | 947-4825 | | Number of Individuals Covered | 104 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $2,022 | | Other welfare benefits provided | TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $20,238 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,011 | | Insurance broker organization code? | 3 | | Insurance broker name | CHRIS SNODGRASS |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 545982 |
| Policy instance | 2 |
| Insurance contract or identification number | 545982 | | Number of Individuals Covered | 115 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2018-01-01 | | Total amount of commissions paid to insurance broker | USD $903 | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | Yes | | Other welfare benefits provided | ADD. LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $9,032 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Other information about contract | ADD, LIFE | | Commission paid to Insurance Broker | USD $903 | | Insurance broker organization code? | 3 | | Insurance broker name | CHRISTOPHER L SNODGRASS |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 501013 |
| Policy instance | 1 |
| Insurance contract or identification number | 501013 | | Number of Individuals Covered | 115 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2018-01-01 | | Total amount of commissions paid to insurance broker | USD $27,144 | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | Yes | | Other welfare benefits provided | FLEX LTD | | Welfare Benefit Premiums Paid to Carrier | USD $27,144 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Other information about contract | FLEX LTD | | Commission paid to Insurance Broker | USD $27,144 | | Insurance broker organization code? | 3 | | Insurance broker name | CHRISTOPHER L SNODGRASS |
|
