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FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 401k Plan overview

Plan NameFIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST
Plan identification number 001

FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Money purchase (other than target benefit)
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Prototype plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion or notification letter; and under which a seperate funding medium (for example, a seperate trust or custodial account) is established for the use of each adopting employer.

401k Sponsoring company profile

FIRST STATE BANK & TRUST COMPANY has sponsored the creation of one or more 401k plans.

Company Name:FIRST STATE BANK & TRUST COMPANY
Employer identification number (EIN):750270360
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012024-01-01KEVIN SMITH
0012023-01-01
0012023-01-01KEVIN SMITH
0012022-01-01
0012022-01-01KEVIN SMITH
0012021-01-01
0012021-01-01KEVIN SMITH
0012020-01-01
0012019-01-01
0012018-01-01KEVIN SMITH DAVID MURPHY2019-06-21
0012017-01-01KEVIN SMITH DAVID MURPHY2018-06-20
0012016-01-01KEVIN SMITH DAVID MURPHY2017-05-25
0012015-01-01KEVIN SMITH DAVID MURPHY2016-07-28
0012014-01-01KEVIN SMITH DAVID MURPHY2015-10-14
0012013-01-01KEVIN SMITH DAVID MURPHY2014-07-30
0012012-01-01KEVIN SMITH JIM PAYNE2013-08-01
0012011-01-01KEVIN SMITH JIM PAYNE2012-07-31
0012009-01-01JIM PAYNE KEVIN SMITH2010-08-02

Financial Data on FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST

Measure Date Value
2023 : FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2023 401k financial data
Total income from all sources2023-12-31$605,640
Expenses. Total of all expenses incurred2023-12-31$720,825
Benefits paid (including direct rollovers)2023-12-31$720,825
Total plan assets at end of year2023-12-31$9,442,361
Total plan assets at beginning of year2023-12-31$9,557,546
Value of fidelity bond covering the plan2023-12-31$5,000,000
Total contributions received or receivable from participants2023-12-31$108,033
Other income received2023-12-31$209,465
Net income (gross income less expenses)2023-12-31$-115,185
Net plan assets at end of year (total assets less liabilities)2023-12-31$9,442,361
Net plan assets at beginning of year (total assets less liabilities)2023-12-31$9,557,546
Total contributions received or receivable from employer(s)2023-12-31$288,142
2022 : FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2022 401k financial data
Total income from all sources2022-12-31$569,779
Expenses. Total of all expenses incurred2022-12-31$249,596
Benefits paid (including direct rollovers)2022-12-31$249,596
Total plan assets at end of year2022-12-31$9,557,546
Total plan assets at beginning of year2022-12-31$9,237,363
Value of fidelity bond covering the plan2022-12-31$5,000,000
Total contributions received or receivable from participants2022-12-31$98,140
Other income received2022-12-31$209,933
Net income (gross income less expenses)2022-12-31$320,183
Net plan assets at end of year (total assets less liabilities)2022-12-31$9,557,546
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$9,237,363
Total contributions received or receivable from employer(s)2022-12-31$261,706
2021 : FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2021 401k financial data
Total income from all sources2021-12-31$565,201
Expenses. Total of all expenses incurred2021-12-31$225,964
Benefits paid (including direct rollovers)2021-12-31$225,964
Total plan assets at end of year2021-12-31$9,237,363
Total plan assets at beginning of year2021-12-31$8,898,126
Value of fidelity bond covering the plan2021-12-31$5,000,000
Total contributions received or receivable from participants2021-12-31$93,959
Other income received2021-12-31$220,679
Net income (gross income less expenses)2021-12-31$339,237
Net plan assets at end of year (total assets less liabilities)2021-12-31$9,237,363
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$8,898,126
Total contributions received or receivable from employer(s)2021-12-31$250,563
2020 : FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2020 401k financial data
Total income from all sources2020-12-31$521,370
Expenses. Total of all expenses incurred2020-12-31$72,278
Benefits paid (including direct rollovers)2020-12-31$72,278
Total plan assets at end of year2020-12-31$8,898,126
Total plan assets at beginning of year2020-12-31$8,449,034
Value of fidelity bond covering the plan2020-12-31$5,000,000
Total contributions received or receivable from participants2020-12-31$83,423
Other income received2020-12-31$215,486
Net income (gross income less expenses)2020-12-31$449,092
Net plan assets at end of year (total assets less liabilities)2020-12-31$8,898,126
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$8,449,034
Total contributions received or receivable from employer(s)2020-12-31$222,461
2019 : FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2019 401k financial data
Total income from all sources2019-12-31$538,508
Expenses. Total of all expenses incurred2019-12-31$559,525
Benefits paid (including direct rollovers)2019-12-31$559,525
Total plan assets at end of year2019-12-31$8,449,034
Total plan assets at beginning of year2019-12-31$8,470,051
Value of fidelity bond covering the plan2019-12-31$5,000,000
Total contributions received or receivable from participants2019-12-31$83,329
Other income received2019-12-31$229,883
Net income (gross income less expenses)2019-12-31$-21,017
Net plan assets at end of year (total assets less liabilities)2019-12-31$8,449,034
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$8,470,051
Total contributions received or receivable from employer(s)2019-12-31$225,296
2018 : FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2018 401k financial data
Total income from all sources2018-12-31$535,135
Expenses. Total of all expenses incurred2018-12-31$240,927
Benefits paid (including direct rollovers)2018-12-31$240,927
Total plan assets at end of year2018-12-31$8,470,051
Total plan assets at beginning of year2018-12-31$8,175,843
Value of fidelity bond covering the plan2018-12-31$5,000,000
Total contributions received or receivable from participants2018-12-31$83,333
Other income received2018-12-31$229,819
Net income (gross income less expenses)2018-12-31$294,208
Net plan assets at end of year (total assets less liabilities)2018-12-31$8,470,051
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$8,175,843
Total contributions received or receivable from employer(s)2018-12-31$221,983
2017 : FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2017 401k financial data
Total income from all sources2017-12-31$570,426
Expenses. Total of all expenses incurred2017-12-31$1,051,962
Benefits paid (including direct rollovers)2017-12-31$1,051,962
Total plan assets at end of year2017-12-31$8,175,843
Total plan assets at beginning of year2017-12-31$8,657,379
Value of fidelity bond covering the plan2017-12-31$5,000,000
Total contributions received or receivable from participants2017-12-31$88,524
Other income received2017-12-31$246,027
Net income (gross income less expenses)2017-12-31$-481,536
Net plan assets at end of year (total assets less liabilities)2017-12-31$8,175,843
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$8,657,379
Total contributions received or receivable from employer(s)2017-12-31$235,875
2016 : FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2016 401k financial data
Total income from all sources2016-12-31$575,349
Expenses. Total of all expenses incurred2016-12-31$2,630
Benefits paid (including direct rollovers)2016-12-31$2,630
Total plan assets at end of year2016-12-31$8,657,379
Total plan assets at beginning of year2016-12-31$8,084,660
Value of fidelity bond covering the plan2016-12-31$7,000,000
Total contributions received or receivable from participants2016-12-31$84,492
Other income received2016-12-31$265,674
Net income (gross income less expenses)2016-12-31$572,719
Net plan assets at end of year (total assets less liabilities)2016-12-31$8,657,379
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$8,084,660
Total contributions received or receivable from employer(s)2016-12-31$225,183
2015 : FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2015 401k financial data
Total income from all sources2015-12-31$725,773
Expenses. Total of all expenses incurred2015-12-31$145,436
Benefits paid (including direct rollovers)2015-12-31$145,436
Total plan assets at end of year2015-12-31$8,084,660
Total plan assets at beginning of year2015-12-31$7,504,323
Value of fidelity bond covering the plan2015-12-31$7,000,000
Total contributions received or receivable from participants2015-12-31$81,370
Contributions received from other sources (not participants or employers)2015-12-31$176,537
Other income received2015-12-31$250,878
Net income (gross income less expenses)2015-12-31$580,337
Net plan assets at end of year (total assets less liabilities)2015-12-31$8,084,660
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$7,504,323
Total contributions received or receivable from employer(s)2015-12-31$216,988
2014 : FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2014 401k financial data
Total income from all sources2014-12-31$521,831
Expenses. Total of all expenses incurred2014-12-31$48,800
Benefits paid (including direct rollovers)2014-12-31$48,800
Total plan assets at end of year2014-12-31$7,504,323
Total plan assets at beginning of year2014-12-31$7,031,292
Value of fidelity bond covering the plan2014-12-31$7,000,000
Total contributions received or receivable from participants2014-12-31$76,620
Other income received2014-12-31$240,895
Net income (gross income less expenses)2014-12-31$473,031
Net plan assets at end of year (total assets less liabilities)2014-12-31$7,504,323
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$7,031,292
Total contributions received or receivable from employer(s)2014-12-31$204,316
2013 : FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2013 401k financial data
Total income from all sources2013-12-31$586,968
Expenses. Total of all expenses incurred2013-12-31$732,647
Benefits paid (including direct rollovers)2013-12-31$732,647
Total plan assets at end of year2013-12-31$7,031,295
Total plan assets at beginning of year2013-12-31$7,176,974
Value of fidelity bond covering the plan2013-12-31$7,000,000
Total contributions received or receivable from participants2013-12-31$86,675
Other income received2013-12-31$269,161
Net income (gross income less expenses)2013-12-31$-145,679
Net plan assets at end of year (total assets less liabilities)2013-12-31$7,031,295
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$7,176,974
Total contributions received or receivable from employer(s)2013-12-31$231,132
2012 : FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2012 401k financial data
Total income from all sources2012-12-31$1,335,181
Expenses. Total of all expenses incurred2012-12-31$13,172
Benefits paid (including direct rollovers)2012-12-31$13,172
Total plan assets at end of year2012-12-31$7,176,974
Total plan assets at beginning of year2012-12-31$5,854,965
Value of fidelity bond covering the plan2012-12-31$5,000,000
Total contributions received or receivable from participants2012-12-31$70,143
Other income received2012-12-31$254,270
Net income (gross income less expenses)2012-12-31$1,322,009
Net plan assets at end of year (total assets less liabilities)2012-12-31$7,176,974
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$5,854,965
Total contributions received or receivable from employer(s)2012-12-31$1,010,768
2011 : FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2011 401k financial data
Total income from all sources2011-12-31$522,056
Expenses. Total of all expenses incurred2011-12-31$50,000
Benefits paid (including direct rollovers)2011-12-31$50,000
Total plan assets at end of year2011-12-31$5,854,965
Total plan assets at beginning of year2011-12-31$5,382,909
Value of fidelity bond covering the plan2011-12-31$50,000
Total contributions received or receivable from participants2011-12-31$60,338
Other income received2011-12-31$255,676
Net income (gross income less expenses)2011-12-31$472,056
Net plan assets at end of year (total assets less liabilities)2011-12-31$5,854,965
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$5,382,909
Total contributions received or receivable from employer(s)2011-12-31$206,042
2010 : FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2010 401k financial data
Total income from all sources2010-12-31$540,143
Expenses. Total of all expenses incurred2010-12-31$62,903
Benefits paid (including direct rollovers)2010-12-31$62,903
Total plan assets at end of year2010-12-31$5,382,909
Total plan assets at beginning of year2010-12-31$4,905,669
Value of fidelity bond covering the plan2010-12-31$50,000
Total contributions received or receivable from participants2010-12-31$74,113
Other income received2010-12-31$249,417
Net income (gross income less expenses)2010-12-31$477,240
Net plan assets at end of year (total assets less liabilities)2010-12-31$5,382,909
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$4,905,669
Total contributions received or receivable from employer(s)2010-12-31$216,613

Form 5500 Responses for FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST

2023: FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 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 – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 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 – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 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 – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 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 – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: FIRST STATE BANK OF CARTHAGE EMPLOYEE MONEY PURCHASE PLAN & TRUST 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 – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PAN AMERICAN ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 93459 )
Policy contract number900082
Policy instance 2
Insurance contract or identification number900082
Number of Individuals Covered22
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number781032
Policy instance 1
Insurance contract or identification number781032
Number of Individuals Covered60
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PAN AMERICAN ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 93459 )
Policy contract number900082
Policy instance 2
Insurance contract or identification number900082
Number of Individuals Covered24
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number781032
Policy instance 1
Insurance contract or identification number781032
Number of Individuals Covered60
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PAN AMERICAN ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 93459 )
Policy contract number900082
Policy instance 2
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number781032
Policy instance 1
PAN AMERICAN ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 93459 )
Policy contract number900082
Policy instance 2
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number781032
Policy instance 1
PAN AMERICAN ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 93459 )
Policy contract number900082
Policy instance 2
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number781032
Policy instance 1
PAN AMERICAN ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 93459 )
Policy contract number900082
Policy instance 2
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number781032
Policy instance 1
PAN AMERICAN ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 93459 )
Policy contract number900082
Policy instance 2
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number781032
Policy instance 1

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