EAST TEXAS BANCSHARES, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN
401k plan membership statisitcs for EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN
| Measure | Date | Value |
|---|
| 2023: EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-01-01 | 127 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 122 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-01-01 | 0 |
| Total of all active and inactive participants | 2023-01-01 | 122 |
| 2022: EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 128 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 127 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 127 |
| 2021: EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 131 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 128 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 128 |
| 2020: EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 135 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 131 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 131 |
| 2019: EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 135 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 135 |
| 2018: EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 138 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 138 |
| 2017: EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 129 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 132 |
| Total of all active and inactive participants | 2017-01-01 | 132 |
| Total participants | 2017-01-01 | 132 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| 2016: EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 138 |
| Total of all active and inactive participants | 2016-01-01 | 138 |
| Total participants | 2016-01-01 | 138 |
| 2015: EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 131 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 132 |
| Total of all active and inactive participants | 2015-01-01 | 132 |
| Total participants | 2015-01-01 | 0 |
| 2014: EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 134 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 131 |
| Total of all active and inactive participants | 2014-01-01 | 131 |
| Total participants | 2014-01-01 | 0 |
| 2013: EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 126 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 128 |
| Total of all active and inactive participants | 2013-01-01 | 128 |
| Total participants | 2013-01-01 | 128 |
| 2012: EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 137 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 136 |
| Total of all active and inactive participants | 2012-01-01 | 136 |
| Total participants | 2012-01-01 | 0 |
| 2011: EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 126 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 134 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 2 |
| Total of all active and inactive participants | 2011-01-01 | 137 |
| Total participants | 2011-01-01 | 137 |
| 2010: EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 125 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 1 |
| Total of all active and inactive participants | 2010-01-01 | 126 |
| Total participants | 2010-01-01 | 126 |
| 2009: EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 134 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 138 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 1 |
| Total of all active and inactive participants | 2009-01-01 | 139 |
| Total participants | 2009-01-01 | 139 |
| Measure | Date | Value |
|---|
| 2018 : EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2018 401k financial data |
|---|
| Total income from all sources (including contributions) | 2018-12-31 | $957,565 |
| Total of all expenses incurred | 2018-12-31 | $957,565 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $871,222 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $957,565 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $86,343 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
| Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
| Value of fidelity bond cover | 2018-12-31 | $4,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Contributions received from participants | 2018-12-31 | $87,196 |
| Administrative expenses (other) incurred | 2018-12-31 | $30,657 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Value of net income/loss | 2018-12-31 | $0 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $220,732 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Contributions received in cash from employer | 2018-12-31 | $870,369 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $650,490 |
| Contract administrator fees | 2018-12-31 | $55,686 |
| Did the plan have assets held for investment | 2018-12-31 | 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 | 2018-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | Yes |
| 2017 : EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2017 401k financial data |
|---|
| Total income from all sources (including contributions) | 2017-12-31 | $846,089 |
| Total of all expenses incurred | 2017-12-31 | $846,089 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $752,618 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $846,089 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $93,471 |
| 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 | Yes |
| Value of fidelity bond cover | 2017-12-31 | $4,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Contributions received from participants | 2017-12-31 | $89,321 |
| Administrative expenses (other) incurred | 2017-12-31 | $22,429 |
| 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 | $0 |
| 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 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $209,833 |
| 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 | $756,768 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $542,785 |
| Contract administrator fees | 2017-12-31 | $71,042 |
| 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 | Yes |
| 2016 : EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2016 401k financial data |
|---|
| Total income from all sources (including contributions) | 2016-12-31 | $1,059,865 |
| Total of all expenses incurred | 2016-12-31 | $1,059,865 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $972,584 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $1,059,865 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $87,281 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
| Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
| Value of fidelity bond cover | 2016-12-31 | $4,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Income. Received or receivable in cash from other sources (including rollovers) | 2016-12-31 | $163,620 |
| Administrative expenses (other) incurred | 2016-12-31 | $22,271 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Value of net income/loss | 2016-12-31 | $0 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $194,280 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $896,245 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $778,304 |
| Contract administrator fees | 2016-12-31 | $65,010 |
| Did the plan have assets held for investment | 2016-12-31 | 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 | 2016-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | Yes |
| 2015 : EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2015 401k financial data |
|---|
| Total income from all sources (including contributions) | 2015-12-31 | $734,732 |
| Total of all expenses incurred | 2015-12-31 | $734,732 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $647,358 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $734,732 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $87,374 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
| Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
| Value of fidelity bond cover | 2015-12-31 | $4,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
| Administrative expenses (other) incurred | 2015-12-31 | $21,372 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Value of net income/loss | 2015-12-31 | $0 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $186,448 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
| Contributions received in cash from employer | 2015-12-31 | $734,732 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $460,910 |
| Contract administrator fees | 2015-12-31 | $66,002 |
| Did the plan have assets held for investment | 2015-12-31 | 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 | 2015-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | Yes |
| 2014 : EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2014 401k financial data |
|---|
| Total income from all sources (including contributions) | 2014-12-31 | $820,491 |
| Total of all expenses incurred | 2014-12-31 | $820,491 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $732,144 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $820,491 |
| Value of total assets at beginning of year | 2014-12-31 | $0 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $88,347 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
| Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
| Value of fidelity bond cover | 2014-12-31 | $4,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
| Income. Received or receivable in cash from other sources (including rollovers) | 2014-12-31 | $18,780 |
| Administrative expenses (other) incurred | 2014-12-31 | $23,371 |
| Total non interest bearing cash at beginning of year | 2014-12-31 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Value of net income/loss | 2014-12-31 | $0 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $0 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $192,526 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
| Contributions received in cash from employer | 2014-12-31 | $801,711 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $539,618 |
| Contract administrator fees | 2014-12-31 | $64,976 |
| Did the plan have assets held for investment | 2014-12-31 | 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 | 2014-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | Yes |
| 2013 : EAST TEXAS BANCSHARES, INC. LIFE INSURANCE PLAN 2013 401k financial data |
|---|
| Total income from all sources (including contributions) | 2013-12-31 | $914,175 |
| Total of all expenses incurred | 2013-12-31 | $914,175 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $822,440 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $914,175 |
| Value of total assets at end of year | 2013-12-31 | $0 |
| Value of total assets at beginning of year | 2013-12-31 | $0 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $91,735 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
| Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
| Value of fidelity bond cover | 2013-12-31 | $4,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
| Administrative expenses (other) incurred | 2013-12-31 | $20,598 |
| Total non interest bearing cash at end of year | 2013-12-31 | $0 |
| Total non interest bearing cash at beginning of year | 2013-12-31 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Value of net income/loss | 2013-12-31 | $0 |
| Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $0 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $0 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $220,829 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
| Contributions received in cash from employer | 2013-12-31 | $914,175 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $601,611 |
| Contract administrator fees | 2013-12-31 | $71,137 |
| Did the plan have assets held for investment | 2013-12-31 | 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 | 2013-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | Yes |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0ANK4 |
| Policy instance | 2 |
| Insurance contract or identification number | GLUG0ANK4 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $5,013 | | Total amount of fees paid to insurance company | USD $3,559 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $33,420 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0ANK4 |
| Policy instance | 1 |
| Insurance contract or identification number | GLTD0ANK4 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $2,821 | | Total amount of fees paid to insurance company | USD $2,008 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,808 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0ANK4 |
| Policy instance | 2 |
| Insurance contract or identification number | GLUG0ANK4 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $5,084 | | Total amount of fees paid to insurance company | USD $1,830 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $33,896 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0ANK4 |
| Policy instance | 1 |
| Insurance contract or identification number | GLTD0ANK4 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $2,869 | | Total amount of fees paid to insurance company | USD $1,030 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,124 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0ANK4 |
| Policy instance | 2 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0ANK4 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0ANK4 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0ANK4 |
| Policy instance | 2 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0ANK4 |
| Policy instance | 2 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0ANK4 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0ANK4 |
| Policy instance | 2 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0ANK4 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0ANK4 |
| Policy instance | 2 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0ANK4 |
| Policy instance | 1 |
| UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
| Policy contract number | SGR1521 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0ANK4 |
| Policy instance | 2 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0ANK4 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000ANK4 |
| Policy instance | 2 |
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL19157 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000ANK4 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000ANK4 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000ANK4 |
| Policy instance | 2 |
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL19157 |
| Policy instance | 1 |
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL19157 |
| Policy instance | 1 |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | H64391 |
| Policy instance | 1 |
| PERICO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85561 ) |
| Policy contract number | PX01066 |
| Policy instance | 1 |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | H64391 |
| Policy instance | 2 |
| PERICO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85561 ) |
| Policy contract number | PX01066 |
| Policy instance | 1 |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | H64391 |
| Policy instance | 2 |
