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| Plan Name | MERCHANTS BANCORP GROUP DENTAL AND VISION INSURANCE PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | MERCHANTS BANCORP |
| Employer identification number (EIN): | 205747400 |
| NAIC Classification: | 522110 |
| NAIC Description: | Commercial Banking |
Additional information about MERCHANTS BANCORP
| Jurisdiction of Incorporation: | Oregon Secretary of State Corporations Division |
| Incorporation Date: | 2000-03-09 |
| Company Identification Number: | 74112088 |
| Legal Registered Office Address: |
9 SE 3RD AVE STE 100 PORTLAND United States of America (USA) 97214 |
More information about MERCHANTS BANCORP
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2017-01-01 | NICOLAS BAUMANN | NICOLAS BAUMANN | 2018-06-07 | |
| 502 | 2017-01-01 |
| Measure | Date | Value |
|---|---|---|
| 2017: MERCHANTS BANCORP GROUP DENTAL AND VISION INSURANCE PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-01-01 | 115 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 154 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 3 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 157 |
| 2017: MERCHANTS BANCORP GROUP DENTAL AND VISION INSURANCE PLAN 2017 form 5500 responses | ||
|---|---|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | First time form 5500 has been submitted | Yes |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) | |||||||||||||||||||||||||||||
| Policy contract number | 637956 | ||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||
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| HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 ) | |||||||||||||||||||||||||||||
| Policy contract number | 637956 | ||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||
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