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HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 401k Plan overview

Plan NameHEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP.
Plan identification number 501

HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 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

EBP STOCKMAN FINANCIAL CORP 401 (K) PLAN has sponsored the creation of one or more 401k plans.

Company Name:EBP STOCKMAN FINANCIAL CORP 401 (K) PLAN
Employer identification number (EIN):810399040
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01JERALD L. ANDERSON
5012016-01-01JERALD L. ANDERSON
5012015-01-01JERALD L. ANDERSON
5012014-01-01JERALD L. ANDERSON
5012013-01-01JERALD L. ANDERSON
5012012-01-01JERALD L. ANDERSON
5012011-01-01JERALD L. ANDERSON
5012010-01-01JERALD L. ANDERSON
5012009-01-01JERALD L. ANDERSON

Plan Statistics for HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP.

401k plan membership statisitcs for HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP.

Measure Date Value
2022: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2022 401k membership
Total participants, beginning-of-year2022-01-01621
Total number of active participants reported on line 7a of the Form 55002022-01-01574
Number of retired or separated participants receiving benefits2022-01-0110
Total of all active and inactive participants2022-01-01584
Total participants2022-01-01584
2021: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2021 401k membership
Total participants, beginning-of-year2021-01-01625
Total number of active participants reported on line 7a of the Form 55002021-01-01616
Number of retired or separated participants receiving benefits2021-01-015
Total of all active and inactive participants2021-01-01621
2020: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2020 401k membership
Total participants, beginning-of-year2020-01-01589
Total number of active participants reported on line 7a of the Form 55002020-01-01586
Number of retired or separated participants receiving benefits2020-01-014
Total of all active and inactive participants2020-01-01590
2019: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2019 401k membership
Total participants, beginning-of-year2019-01-01558
Total number of active participants reported on line 7a of the Form 55002019-01-01569
Number of retired or separated participants receiving benefits2019-01-015
Total of all active and inactive participants2019-01-01574
2018: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2018 401k membership
Total participants, beginning-of-year2018-01-01558
Total number of active participants reported on line 7a of the Form 55002018-01-01553
Number of retired or separated participants receiving benefits2018-01-014
Total of all active and inactive participants2018-01-01557
2017: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2017 401k membership
Total participants, beginning-of-year2017-01-01504
Total number of active participants reported on line 7a of the Form 55002017-01-01515
Number of retired or separated participants receiving benefits2017-01-013
Total of all active and inactive participants2017-01-01518
2016: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2016 401k membership
Total participants, beginning-of-year2016-01-01496
Total number of active participants reported on line 7a of the Form 55002016-01-01502
Number of retired or separated participants receiving benefits2016-01-012
Total of all active and inactive participants2016-01-01504
2015: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2015 401k membership
Total participants, beginning-of-year2015-01-01455
Total number of active participants reported on line 7a of the Form 55002015-01-01491
Number of retired or separated participants receiving benefits2015-01-015
Total of all active and inactive participants2015-01-01496
2014: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2014 401k membership
Total participants, beginning-of-year2014-01-01428
Total number of active participants reported on line 7a of the Form 55002014-01-01447
Number of retired or separated participants receiving benefits2014-01-018
Total of all active and inactive participants2014-01-01455
2013: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2013 401k membership
Total participants, beginning-of-year2013-01-01401
Total number of active participants reported on line 7a of the Form 55002013-01-01423
Number of retired or separated participants receiving benefits2013-01-019
Total of all active and inactive participants2013-01-01432
2012: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2012 401k membership
Total participants, beginning-of-year2012-01-01356
Total number of active participants reported on line 7a of the Form 55002012-01-01400
Number of retired or separated participants receiving benefits2012-01-015
Total of all active and inactive participants2012-01-01405
2011: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2011 401k membership
Total participants, beginning-of-year2011-01-01347
Total number of active participants reported on line 7a of the Form 55002011-01-01358
Number of retired or separated participants receiving benefits2011-01-011
Total of all active and inactive participants2011-01-01359
2010: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2010 401k membership
Total participants, beginning-of-year2010-01-01320
Total number of active participants reported on line 7a of the Form 55002010-01-01334
Number of retired or separated participants receiving benefits2010-01-011
Total of all active and inactive participants2010-01-01335
2009: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2009 401k membership
Total participants, beginning-of-year2009-01-01269
Total number of active participants reported on line 7a of the Form 55002009-01-01313
Number of retired or separated participants receiving benefits2009-01-017
Total of all active and inactive participants2009-01-01320

Financial Data on HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP.

Measure Date Value
2022 : HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$932,784
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$716,464
Total income from all sources (including contributions)2022-12-31$9,195,185
Total of all expenses incurred2022-12-31$8,024,716
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$7,870,374
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$9,173,782
Value of total assets at end of year2022-12-31$6,484,466
Value of total assets at beginning of year2022-12-31$5,097,677
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$154,342
Total interest from all sources2022-12-31$21,403
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$3,337,914
Assets. Other investments not covered elsewhere at end of year2022-12-31$79,914
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$21,472
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$243,545
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$368,360
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$65,784
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$135,464
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$1,170,469
Value of net assets at end of year (total assets less liabilities)2022-12-31$5,551,682
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$4,381,213
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$6,161,007
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$4,729,317
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$4,729,317
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$21,403
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$1,614,251
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$5,814,396
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$6,256,123
Contract administrator fees2022-12-31$154,342
Liabilities. Value of benefit claims payable at end of year2022-12-31$867,000
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$581,000
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31FORVIS, LLP
Accountancy firm EIN2022-12-31440160260
2021 : HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$716,464
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$743,550
Total income from all sources (including contributions)2021-12-31$8,477,686
Total of all expenses incurred2021-12-31$7,917,046
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$7,771,599
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$8,472,473
Value of total assets at end of year2021-12-31$5,097,677
Value of total assets at beginning of year2021-12-31$4,564,123
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$145,447
Total interest from all sources2021-12-31$5,213
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$3,018,097
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$62,230
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$368,360
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$406,511
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$135,464
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$124,550
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$560,640
Value of net assets at end of year (total assets less liabilities)2021-12-31$4,381,213
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$3,820,573
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$4,729,317
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$4,157,612
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$4,157,612
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$5,213
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$1,116,164
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$5,392,146
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$6,655,435
Contract administrator fees2021-12-31$145,447
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-12-31No
Liabilities. Value of benefit claims payable at end of year2021-12-31$581,000
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$619,000
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31EIDE BAILLY LLP
Accountancy firm EIN2021-12-31450250958
2020 : HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$743,550
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$596,096
Total income from all sources (including contributions)2020-12-31$8,432,242
Total of all expenses incurred2020-12-31$7,168,840
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$7,026,286
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$8,420,797
Value of total assets at end of year2020-12-31$4,564,123
Value of total assets at beginning of year2020-12-31$3,153,267
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$142,554
Total interest from all sources2020-12-31$11,445
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$3,087,629
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$88,746
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$406,511
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$355,502
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$124,550
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$108,096
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$1,263,402
Value of net assets at end of year (total assets less liabilities)2020-12-31$3,820,573
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$2,557,171
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$4,157,612
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$2,797,765
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$2,797,765
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$11,445
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$857,171
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$5,244,422
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$6,169,115
Contract administrator fees2020-12-31$142,554
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-12-31No
Liabilities. Value of benefit claims payable at end of year2020-12-31$619,000
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$488,000
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31EIDE BAILLY LLP
Accountancy firm EIN2020-12-31450250958
2019 : HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$596,096
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$490,215
Total income from all sources (including contributions)2019-12-31$7,420,014
Total of all expenses incurred2019-12-31$6,768,150
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$6,631,505
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$7,394,594
Value of total assets at end of year2019-12-31$3,153,267
Value of total assets at beginning of year2019-12-31$2,395,522
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$136,645
Total interest from all sources2019-12-31$25,420
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$2,554,942
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$68,537
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$355,502
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$232,550
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$108,096
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$92,715
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$651,864
Value of net assets at end of year (total assets less liabilities)2019-12-31$2,557,171
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,905,307
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$2,797,765
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$2,162,972
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$2,162,972
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$25,420
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$1,017,393
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$4,771,115
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$5,614,112
Contract administrator fees2019-12-31$136,645
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Liabilities. Value of benefit claims payable at end of year2019-12-31$488,000
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$397,500
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31EIDE BAILLY LLP
Accountancy firm EIN2019-12-31450250958
2018 : HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$490,215
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$562,839
Total income from all sources (including contributions)2018-12-31$6,519,717
Total of all expenses incurred2018-12-31$6,710,752
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$6,580,927
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$6,509,207
Value of total assets at end of year2018-12-31$2,395,522
Value of total assets at beginning of year2018-12-31$2,659,181
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$129,825
Total interest from all sources2018-12-31$10,510
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$2,372,348
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$97,098
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$232,550
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$118,454
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$92,715
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$85,339
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-191,035
Value of net assets at end of year (total assets less liabilities)2018-12-31$1,905,307
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$2,096,342
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$2,162,972
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$2,540,727
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$2,540,727
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$10,510
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$1,149,378
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$4,039,761
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$5,431,549
Contract administrator fees2018-12-31$129,825
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Liabilities. Value of benefit claims payable at end of year2018-12-31$397,500
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$477,500
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31EIDE BAILLY LLP
Accountancy firm EIN2018-12-31450250958
2017 : HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$562,839
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$578,074
Total income from all sources (including contributions)2017-12-31$5,818,919
Total of all expenses incurred2017-12-31$5,868,058
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$5,744,569
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$5,810,475
Value of total assets at end of year2017-12-31$2,659,181
Value of total assets at beginning of year2017-12-31$2,723,555
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$123,489
Total interest from all sources2017-12-31$8,444
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$2,173,214
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$41,612
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$118,454
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$94,346
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$85,339
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$228,074
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-49,139
Value of net assets at end of year (total assets less liabilities)2017-12-31$2,096,342
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$2,145,481
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$2,540,727
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$2,629,209
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$2,629,209
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$8,444
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$840,033
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$3,595,649
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$4,904,536
Contract administrator fees2017-12-31$123,489
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Liabilities. Value of benefit claims payable at end of year2017-12-31$477,500
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$350,000
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31EIDE BAILLY LLP
Accountancy firm EIN2017-12-31450250958
2016 : HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$578,074
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$441,175
Total income from all sources (including contributions)2016-12-31$5,446,195
Total of all expenses incurred2016-12-31$5,214,062
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$5,094,170
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$5,438,853
Value of total assets at end of year2016-12-31$2,723,555
Value of total assets at beginning of year2016-12-31$2,354,523
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$119,892
Total interest from all sources2016-12-31$7,342
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$2,002,697
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$47,802
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$94,346
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$466,660
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$228,074
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$61,175
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$232,133
Value of net assets at end of year (total assets less liabilities)2016-12-31$2,145,481
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$1,913,348
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$2,629,209
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$1,887,863
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$1,887,863
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$7,342
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$856,354
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$3,388,354
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$4,237,816
Contract administrator fees2016-12-31$119,892
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Liabilities. Value of benefit claims payable at end of year2016-12-31$350,000
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$380,000
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31EIDE BAILLY LLP
Accountancy firm EIN2016-12-31450250958
2015 : HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$441,175
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$638,586
Total income from all sources (including contributions)2015-12-31$5,188,814
Total of all expenses incurred2015-12-31$4,891,545
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$4,779,695
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$5,181,910
Value of total assets at end of year2015-12-31$2,354,523
Value of total assets at beginning of year2015-12-31$2,254,665
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$111,850
Total interest from all sources2015-12-31$6,904
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$1,887,304
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$57,798
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$466,660
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$181,990
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$61,175
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$208,586
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$297,269
Value of net assets at end of year (total assets less liabilities)2015-12-31$1,913,348
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$1,616,079
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$1,887,863
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$2,072,675
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$2,072,675
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$6,904
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$904,513
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$3,236,808
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$3,875,182
Contract administrator fees2015-12-31$111,850
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Liabilities. Value of benefit claims payable at end of year2015-12-31$380,000
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$430,000
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31EIDE BAILLY LLP
Accountancy firm EIN2015-12-31450250958
2014 : HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$638,586
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$608,708
Total income from all sources (including contributions)2014-12-31$4,924,670
Total of all expenses incurred2014-12-31$3,990,664
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$3,888,845
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$4,919,620
Value of total assets at end of year2014-12-31$2,254,665
Value of total assets at beginning of year2014-12-31$1,290,781
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$101,819
Total interest from all sources2014-12-31$5,050
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$1,715,372
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$51,757
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$181,990
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$50,123
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$208,586
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$48,708
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$934,006
Value of net assets at end of year (total assets less liabilities)2014-12-31$1,616,079
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$682,073
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$2,072,675
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$1,240,658
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$1,240,658
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$5,050
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$716,546
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$3,152,491
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$3,172,299
Contract administrator fees2014-12-31$101,819
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31No
Liabilities. Value of benefit claims payable at end of year2014-12-31$430,000
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$560,000
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31EIDE BAILLY LLP
Accountancy firm EIN2014-12-31450250958
2013 : HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$608,708
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$393,057
Total income from all sources (including contributions)2013-12-31$4,351,288
Total of all expenses incurred2013-12-31$4,319,762
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$4,225,528
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$4,348,636
Value of total assets at end of year2013-12-31$1,290,781
Value of total assets at beginning of year2013-12-31$1,043,604
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$94,234
Total interest from all sources2013-12-31$2,652
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$1,561,381
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$56,202
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$50,123
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$139,079
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$48,708
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$58,057
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$31,526
Value of net assets at end of year (total assets less liabilities)2013-12-31$682,073
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$650,547
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$1,240,658
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$904,525
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$904,525
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$2,652
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$580,381
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$2,731,053
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$3,645,147
Contract administrator fees2013-12-31$94,234
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Liabilities. Value of benefit claims payable at end of year2013-12-31$560,000
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$335,000
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31EIDE BAILLY LLP
Accountancy firm EIN2013-12-31450250958
2012 : HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$393,057
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$228,817
Total income from all sources (including contributions)2012-12-31$3,272,886
Total of all expenses incurred2012-12-31$3,488,995
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$3,404,183
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$3,269,083
Value of total assets at end of year2012-12-31$1,043,604
Value of total assets at beginning of year2012-12-31$1,095,473
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$84,812
Total interest from all sources2012-12-31$3,803
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$1,396,054
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$62,597
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$139,079
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$103,373
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$58,057
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$35,817
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-216,109
Value of net assets at end of year (total assets less liabilities)2012-12-31$650,547
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$866,656
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$904,525
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$992,100
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$992,100
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$3,803
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$524,653
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$1,810,432
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$2,879,530
Contract administrator fees2012-12-31$84,812
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Liabilities. Value of benefit claims payable at end of year2012-12-31$335,000
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$193,000
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31EIDE BAILLY LLP
Accountancy firm EIN2012-12-31450250958
2011 : HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$228,817
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$293,893
Total income from all sources (including contributions)2011-12-31$2,777,307
Total of all expenses incurred2011-12-31$3,041,954
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$2,971,937
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$2,769,438
Value of total assets at end of year2011-12-31$1,095,473
Value of total assets at beginning of year2011-12-31$1,425,196
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$70,017
Total interest from all sources2011-12-31$7,869
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$1,172,464
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$32,096
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$103,373
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$136,762
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$35,817
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$35,877
Liabilities. Value of operating payables at beginning of year2011-12-31$16
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-264,647
Value of net assets at end of year (total assets less liabilities)2011-12-31$866,656
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$1,131,303
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$992,100
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$1,288,434
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$1,288,434
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$7,869
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$422,944
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$1,564,878
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$2,548,993
Contract administrator fees2011-12-31$70,017
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Liabilities. Value of benefit claims payable at end of year2011-12-31$193,000
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$258,000
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31EIDE BAILLY LLP
Accountancy firm EIN2011-12-31450250958
2010 : HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$293,893
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$252,181
Total income from all sources (including contributions)2010-12-31$2,596,685
Total of all expenses incurred2010-12-31$2,753,400
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$2,677,528
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$2,583,776
Value of total assets at end of year2010-12-31$1,425,196
Value of total assets at beginning of year2010-12-31$1,540,199
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$75,872
Total interest from all sources2010-12-31$12,909
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$1,138,212
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$37,749
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$136,762
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$62,249
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$35,877
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$31,181
Liabilities. Value of operating payables at end of year2010-12-31$16
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-156,715
Value of net assets at end of year (total assets less liabilities)2010-12-31$1,131,303
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$1,288,018
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$1,288,434
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$1,477,950
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$1,477,950
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$12,909
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$420,831
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$1,407,815
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$2,256,697
Contract administrator fees2010-12-31$75,872
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Liabilities. Value of benefit claims payable at end of year2010-12-31$258,000
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$221,000
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31EIDE BAILLY LLP
Accountancy firm EIN2010-12-31450250958

Form 5500 Responses for HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP.

2022: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 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 funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: HEALTH BENEFITS PLAN FOR THE EMPLOYEES OF STOCKMAN FINANCIAL CORP. 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL35299
Policy instance 4
Insurance contract or identification numberHCL35299
Number of Individuals Covered565
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $159,227
Welfare Benefit Premiums Paid to CarrierUSD $1,352,131
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $159,227
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX965855
Policy instance 3
Insurance contract or identification numberFLX965855
Number of Individuals Covered1029
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $30,510
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $206,853
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,510
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960782
Policy instance 2
Insurance contract or identification numberFLK960782
Number of Individuals Covered683
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $7,613
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,256
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,613
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK967430
Policy instance 1
Insurance contract or identification numberOK967430
Number of Individuals Covered787
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $199
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,330
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $199
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL35299
Policy instance 4
Insurance contract or identification numberHCL35299
Number of Individuals Covered553
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $104,211
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $884,950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $104,211
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960782
Policy instance 2
Insurance contract or identification numberFLK960782
Number of Individuals Covered653
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $641
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,270
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $641
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 967430
Policy instance 3
Insurance contract or identification numberOK 967430
Number of Individuals Covered763
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $15
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX965855
Policy instance 5
Insurance contract or identification numberFLX965855
Number of Individuals Covered941
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $25,633
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $184,279
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,633
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 967430
Policy instance 7
Insurance contract or identification numberOK 967430
Number of Individuals Covered763
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $203
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,458
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $203
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960782
Policy instance 6
Insurance contract or identification numberFLK960782
Number of Individuals Covered653
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $8,813
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,813
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX965855
Policy instance 1
Insurance contract or identification numberFLX965855
Number of Individuals Covered941
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,081
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedSUPPLEMENTAL/DEPENDENT
Welfare Benefit Premiums Paid to CarrierUSD $13,874
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,081
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960782
Policy instance 2
Insurance contract or identification numberFLK960782
Number of Individuals Covered635
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $7,144
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,625
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,144
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL35299
Policy instance 4
Insurance contract or identification numberHCL35299
Number of Individuals Covered547
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $90,746
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $691,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $90,746
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 967430
Policy instance 3
Insurance contract or identification numberOK 967430
Number of Individuals Covered751
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $169
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $169
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX965855
Policy instance 1
Insurance contract or identification numberFLX965855
Number of Individuals Covered935
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $22,337
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedSUPPLEMENTAL/DEPENDENT
Welfare Benefit Premiums Paid to CarrierUSD $148,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,337
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX965855
Policy instance 1
Insurance contract or identification numberFLX965855
Number of Individuals Covered878
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $20,089
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedSUPPLEMENTAL/DEPENDENT
Welfare Benefit Premiums Paid to CarrierUSD $133,930
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,089
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 967430
Policy instance 3
Insurance contract or identification numberOK 967430
Number of Individuals Covered701
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $162
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $162
Insurance broker organization code?3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-013776-000
Policy instance 4
Insurance contract or identification number16-013776-000
Number of Individuals Covered519
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $74,779
Total amount of fees paid to insurance companyUSD $14,874
Welfare Benefit Premiums Paid to CarrierUSD $787,150
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $74,779
Amount paid for insurance broker fees14874
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960782
Policy instance 2
Insurance contract or identification numberFLK960782
Number of Individuals Covered583
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,227
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,002
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,227
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX965855
Policy instance 1
Insurance contract or identification numberFLX965855
Number of Individuals Covered837
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $22,050
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedSUPPLEMENTAL/DEPENDENT
Welfare Benefit Premiums Paid to CarrierUSD $146,997
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,050
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960782
Policy instance 2
Insurance contract or identification numberFLK960782
Number of Individuals Covered535
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,984
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,558
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,984
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 967430
Policy instance 3
Insurance contract or identification numberOK 967430
Number of Individuals Covered655
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $172
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,145
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $172
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberERR1157-17
Policy instance 4
Insurance contract or identification numberERR1157-17
Number of Individuals Covered463
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $83,045
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $692,042
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $83,045
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberERR1157-15
Policy instance 4
Insurance contract or identification numberERR1157-15
Number of Individuals Covered450
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $93,318
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $777,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $93,318
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 967430
Policy instance 3
Insurance contract or identification numberOK 967430
Number of Individuals Covered607
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $157
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $157
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960782
Policy instance 2
Insurance contract or identification numberFLK960782
Number of Individuals Covered473
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $6,233
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,556
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,233
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX965855
Policy instance 1
Insurance contract or identification numberFLX965855
Number of Individuals Covered799
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $18,924
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedSUPPLEMENTAL/DEPENDENT
Welfare Benefit Premiums Paid to CarrierUSD $126,160
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,924
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 967430
Policy instance 4
Insurance contract or identification numberOK 967430
Number of Individuals Covered569
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $137
Total amount of fees paid to insurance companyUSD $15
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $915
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $137
Amount paid for insurance broker fees15
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX965855
Policy instance 2
Insurance contract or identification numberFLX965855
Number of Individuals Covered569
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $16,806
Total amount of fees paid to insurance companyUSD $1,827
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedSUPPLEMENTAL/DEPENDENT
Welfare Benefit Premiums Paid to CarrierUSD $112,041
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,806
Amount paid for insurance broker fees1827
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
LIFEWISE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 94188 )
Policy contract numberMT-400064-9999
Policy instance 1
Insurance contract or identification numberMT-400064-9999
Number of Individuals Covered418
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $89,240
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $594,936
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $89,240
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960782
Policy instance 3
Insurance contract or identification numberFLK960782
Number of Individuals Covered426
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,454
Total amount of fees paid to insurance companyUSD $583
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,454
Amount paid for insurance broker fees583
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AEMZ
Policy instance 2
Insurance contract or identification numberG000AEMZ
Number of Individuals Covered227
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $16,674
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $111,157
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,674
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AEMZ
Policy instance 1
Insurance contract or identification numberG000AEMZ
Number of Individuals Covered553
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $993
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,623
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $993
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AEMZ
Policy instance 3
Insurance contract or identification numberG000AEMZ
Number of Individuals Covered541
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,894
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,894
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
LIFEWISE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 94188 )
Policy contract numberMT-400064-9999
Policy instance 4
Insurance contract or identification numberMT-400064-9999
Number of Individuals Covered397
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $69,301
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $462,007
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $69,301
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AEMZ
Policy instance 2
Insurance contract or identification numberG000AEMZ
Number of Individuals Covered230
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $15,526
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $103,507
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,526
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AEMZ
Policy instance 3
Insurance contract or identification numberG000AEMZ
Number of Individuals Covered502
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,273
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,485
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,273
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-011676-000
Policy instance 4
Insurance contract or identification number16-011676-000
Number of Individuals Covered379
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $62,166
Total amount of fees paid to insurance companyUSD $5,290
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $414,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $62,166
Amount paid for insurance broker fees5290
Additional information about fees paid to insurance brokerGROUP VOLUME BONUS
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AEMZ
Policy instance 1
Insurance contract or identification numberG000AEMZ
Number of Individuals Covered522
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $918
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,122
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $918
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-011676-000
Policy instance 4
Insurance contract or identification number16-011676-000
Number of Individuals Covered346
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $49,480
Total amount of fees paid to insurance companyUSD $12,947
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $329,865
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 numberG000AEMZ
Policy instance 1
Insurance contract or identification numberG000AEMZ
Number of Individuals Covered467
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $958
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $5,578
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 numberG000AEMZ
Policy instance 2
Insurance contract or identification numberG000AEMZ
Number of Individuals Covered225
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $15,282
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $90,249
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 numberG000AEMZ
Policy instance 3
Insurance contract or identification numberG000AEMZ
Number of Individuals Covered446
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $5,250
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,037
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 numberG000AEMZ
Policy instance 1
Insurance contract or identification numberG000AEMZ
Number of Individuals Covered437
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $824
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $5,493
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $824
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AEMZ
Policy instance 2
Insurance contract or identification numberG000AEMZ
Number of Individuals Covered213
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $12,362
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $82,414
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,362
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AEMZ
Policy instance 4
Insurance contract or identification numberG000AEMZ
Number of Individuals Covered412
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,888
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,254
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,888
Insurance broker organization code?3
Insurance broker nameINTERMOUNTAIN UNDERWRITERS INC
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number299-6574
Policy instance 3
Insurance contract or identification number299-6574
Number of Individuals Covered318
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $50,065
Total amount of fees paid to insurance companyUSD $5,674
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $283,699
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,065
Insurance broker organization code?3
Amount paid for insurance broker fees5674
Additional information about fees paid to insurance brokerSERVICE ALLOWANCE PAYMENT
Insurance broker nameALLEGIANCE BENEFIT PLAN MANAGEMENT

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