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FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 401k Plan overview

Plan NameFIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN
Plan identification number 503

FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Other welfare benefit cover

401k Sponsoring company profile

FIRST KEYSTONE COMMUNITY BANK has sponsored the creation of one or more 401k plans.

Company Name:FIRST KEYSTONE COMMUNITY BANK
Employer identification number (EIN):240525403
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-01-01
5032021-01-01
5032020-01-01
5032019-01-01
5032018-01-01
5032017-01-01ELAINE WOODLAND
5032016-01-01MATTHEW PROSSEDA
5032015-01-01MATTHEW PROSSEDA
5032014-01-01MATTHEW PROSSEDA
5032013-01-01MATTHEW PROSSEDA
5032012-01-01MATTHEW PROSSEDA
5032011-01-01MATTHEW PROSSEDA
5032009-01-01J. GERALD BAZEWICZ

Plan Statistics for FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN

401k plan membership statisitcs for FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN

Measure Date Value
2022: FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01150
Total number of active participants reported on line 7a of the Form 55002022-01-01138
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01139
2021: FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01147
Total number of active participants reported on line 7a of the Form 55002021-01-01148
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-011
Total of all active and inactive participants2021-01-01150
2020: FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01142
Total number of active participants reported on line 7a of the Form 55002020-01-01147
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01147
2019: FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01140
Total number of active participants reported on line 7a of the Form 55002019-01-01142
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01142
2018: FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01127
Total number of active participants reported on line 7a of the Form 55002018-01-01140
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01140
2017: FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01127
Total number of active participants reported on line 7a of the Form 55002017-01-01127
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01127
2016: FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01129
Total number of active participants reported on line 7a of the Form 55002016-01-01125
Number of retired or separated participants receiving benefits2016-01-012
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01127
2015: FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01132
Total number of active participants reported on line 7a of the Form 55002015-01-01126
Number of retired or separated participants receiving benefits2015-01-013
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01129
2014: FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01122
Total number of active participants reported on line 7a of the Form 55002014-01-01128
Number of retired or separated participants receiving benefits2014-01-014
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01132
2013: FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01125
Total number of active participants reported on line 7a of the Form 55002013-01-01118
Number of retired or separated participants receiving benefits2013-01-014
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01122
2012: FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01117
Total number of active participants reported on line 7a of the Form 55002012-01-01119
Number of retired or separated participants receiving benefits2012-01-016
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01125
2011: FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01112
Total number of active participants reported on line 7a of the Form 55002011-01-01113
Number of retired or separated participants receiving benefits2011-01-014
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01117
2009: FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01110
Total number of active participants reported on line 7a of the Form 55002009-01-01100
Number of retired or separated participants receiving benefits2009-01-0117
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01117

Financial Data on FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN

Measure Date Value
2022 : FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$68,459
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$278,990
Total income from all sources (including contributions)2022-12-31$2,565,854
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$2,617,710
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$1,730,871
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,564,436
Value of total assets at end of year2022-12-31$338,609
Value of total assets at beginning of year2022-12-31$600,996
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$886,839
Total interest from all sources2022-12-31$1,418
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
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 bond2022-12-31No
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$507,216
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$207,432
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$233,255
Administrative expenses (other) incurred2022-12-31$820,836
Liabilities. Value of operating payables at end of year2022-12-31$0
Liabilities. Value of operating payables at beginning of year2022-12-31$309
Total non interest bearing cash at end of year2022-12-31$0
Total non interest bearing cash at beginning of year2022-12-31$16,361
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-51,856
Value of net assets at end of year (total assets less liabilities)2022-12-31$270,150
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$322,006
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
Investment advisory and management fees2022-12-31$56,782
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$131,177
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$584,635
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$584,635
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$1,418
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$1,730,871
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$2,057,220
Contract administrator fees2022-12-31$9,221
Liabilities. Value of benefit claims payable at end of year2022-12-31$68,459
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$45,426
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 name2022-12-31YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2022-12-31251589048
2021 : FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$278,990
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$85,206
Total income from all sources (including contributions)2021-12-31$2,517,943
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$2,195,937
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,365,497
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$2,517,366
Value of total assets at end of year2021-12-31$600,996
Value of total assets at beginning of year2021-12-31$85,206
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$830,440
Total interest from all sources2021-12-31$577
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
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 bond2021-12-31No
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$467,780
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$233,255
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$84,920
Administrative expenses (other) incurred2021-12-31$753,157
Liabilities. Value of operating payables at end of year2021-12-31$309
Liabilities. Value of operating payables at beginning of year2021-12-31$286
Total non interest bearing cash at end of year2021-12-31$16,361
Total non interest bearing cash at beginning of year2021-12-31$69,590
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$322,006
Value of net assets at end of year (total assets less liabilities)2021-12-31$322,006
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$0
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
Investment advisory and management fees2021-12-31$51,924
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$584,635
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$15,616
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$15,616
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$577
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$1,365,497
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$2,049,586
Contract administrator fees2021-12-31$25,359
Liabilities. Value of benefit claims payable at end of year2021-12-31$45,426
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$0
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 name2021-12-31YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2021-12-31251589048
2020 : FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$85,206
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$18,475
Total income from all sources (including contributions)2020-12-31$2,170,286
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$2,701,103
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,900,902
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$2,164,231
Value of total assets at end of year2020-12-31$85,206
Value of total assets at beginning of year2020-12-31$549,292
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$800,201
Total interest from all sources2020-12-31$6,055
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
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 bond2020-12-31No
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$462,290
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$84,920
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$0
Administrative expenses (other) incurred2020-12-31$719,961
Liabilities. Value of operating payables at end of year2020-12-31$286
Liabilities. Value of operating payables at beginning of year2020-12-31$660
Total non interest bearing cash at end of year2020-12-31$69,590
Total non interest bearing cash at beginning of year2020-12-31$2,639
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-530,817
Value of net assets at end of year (total assets less liabilities)2020-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$530,817
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
Investment advisory and management fees2020-12-31$51,991
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$15,616
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$546,653
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$546,653
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$6,055
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$1,900,902
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$1,701,941
Contract administrator fees2020-12-31$28,249
Liabilities. Value of benefit claims payable at end of year2020-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$17,815
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 name2020-12-31YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2020-12-31251589048
2019 : FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$18,475
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$169,408
Total income from all sources (including contributions)2019-12-31$1,914,949
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$2,085,307
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,362,342
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,903,265
Value of total assets at end of year2019-12-31$549,292
Value of total assets at beginning of year2019-12-31$870,583
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$722,965
Total interest from all sources2019-12-31$11,684
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
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 bond2019-12-31No
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$427,237
Administrative expenses (other) incurred2019-12-31$635,688
Liabilities. Value of operating payables at end of year2019-12-31$660
Liabilities. Value of operating payables at beginning of year2019-12-31$151,759
Total non interest bearing cash at end of year2019-12-31$2,639
Total non interest bearing cash at beginning of year2019-12-31$61,646
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$-170,358
Value of net assets at end of year (total assets less liabilities)2019-12-31$530,817
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$701,175
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
Investment advisory and management fees2019-12-31$48,095
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$546,653
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$808,937
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$808,937
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$11,684
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$1,362,342
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$1,476,028
Contract administrator fees2019-12-31$39,182
Liabilities. Value of benefit claims payable at end of year2019-12-31$17,815
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$17,649
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 name2019-12-31YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2019-12-31251589048
2018 : FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$169,408
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$225,127
Total income from all sources (including contributions)2018-12-31$1,766,311
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$1,849,280
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$1,161,820
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,753,231
Value of total assets at end of year2018-12-31$870,583
Value of total assets at beginning of year2018-12-31$1,009,271
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$687,460
Total interest from all sources2018-12-31$13,080
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
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 bond2018-12-31No
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$422,346
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$157,731
Administrative expenses (other) incurred2018-12-31$594,498
Liabilities. Value of operating payables at end of year2018-12-31$151,759
Liabilities. Value of operating payables at beginning of year2018-12-31$0
Total non interest bearing cash at end of year2018-12-31$61,646
Total non interest bearing cash at beginning of year2018-12-31$104,300
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-82,969
Value of net assets at end of year (total assets less liabilities)2018-12-31$701,175
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$784,144
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
Investment advisory and management fees2018-12-31$46,580
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$808,937
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$904,971
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$904,971
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$13,080
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$1,161,820
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$1,330,885
Contract administrator fees2018-12-31$46,382
Liabilities. Value of benefit claims payable at end of year2018-12-31$17,649
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$67,396
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 name2018-12-31YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2018-12-31251589048
2017 : FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$225,127
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$216,327
Total income from all sources (including contributions)2017-12-31$1,959,415
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$1,831,082
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$1,173,956
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$1,953,616
Value of total assets at end of year2017-12-31$1,009,271
Value of total assets at beginning of year2017-12-31$872,138
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$657,126
Total interest from all sources2017-12-31$5,799
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
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$416,220
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$157,731
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$199,902
Administrative expenses (other) incurred2017-12-31$545,521
Total non interest bearing cash at end of year2017-12-31$104,300
Total non interest bearing cash at beginning of year2017-12-31$53,706
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$128,333
Value of net assets at end of year (total assets less liabilities)2017-12-31$784,144
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$655,811
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
Investment advisory and management fees2017-12-31$44,012
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$904,971
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$818,432
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$818,432
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$5,799
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$1,173,956
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$1,537,396
Contract administrator fees2017-12-31$67,593
Liabilities. Value of benefit claims payable at end of year2017-12-31$67,396
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$16,425
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 name2017-12-31YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2017-12-31251589048
2016 : FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$216,327
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$165,057
Total income from all sources (including contributions)2016-12-31$2,004,759
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$1,606,924
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$1,029,197
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$2,003,149
Value of total assets at end of year2016-12-31$872,138
Value of total assets at beginning of year2016-12-31$423,033
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$577,727
Total interest from all sources2016-12-31$1,610
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
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$421,547
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$199,902
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$164,835
Administrative expenses (other) incurred2016-12-31$464,363
Total non interest bearing cash at end of year2016-12-31$53,706
Total non interest bearing cash at beginning of year2016-12-31$47,365
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$397,835
Value of net assets at end of year (total assets less liabilities)2016-12-31$655,811
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$257,976
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
Investment advisory and management fees2016-12-31$42,705
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$818,432
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$375,668
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$375,668
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$1,610
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$1,029,197
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$1,581,602
Contract administrator fees2016-12-31$70,659
Liabilities. Value of benefit claims payable at end of year2016-12-31$16,425
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$222
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 name2016-12-31YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2016-12-31251589048
2015 : FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$165,057
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$162,233
Total income from all sources (including contributions)2015-12-31$1,828,066
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$1,879,768
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$1,368,917
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,826,898
Value of total assets at end of year2015-12-31$423,033
Value of total assets at beginning of year2015-12-31$471,911
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$510,851
Total interest from all sources2015-12-31$1,168
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
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$365,051
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$164,835
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$158,810
Administrative expenses (other) incurred2015-12-31$393,796
Total non interest bearing cash at end of year2015-12-31$47,365
Total non interest bearing cash at beginning of year2015-12-31$46,771
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-51,702
Value of net assets at end of year (total assets less liabilities)2015-12-31$257,976
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$309,678
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
Investment advisory and management fees2015-12-31$45,017
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$375,668
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$425,140
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$425,140
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$1,168
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$1,368,917
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$1,461,847
Contract administrator fees2015-12-31$72,038
Liabilities. Value of benefit claims payable at end of year2015-12-31$222
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$3,423
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 name2015-12-31YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2015-12-31251589048
2014 : FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$162,233
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$174,091
Total income from all sources (including contributions)2014-12-31$1,805,024
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$1,746,759
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$1,273,823
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$1,803,793
Value of total assets at end of year2014-12-31$471,911
Value of total assets at beginning of year2014-12-31$425,504
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$472,936
Total interest from all sources2014-12-31$1,231
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
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$368,437
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$158,810
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$144,754
Administrative expenses (other) incurred2014-12-31$355,066
Total non interest bearing cash at end of year2014-12-31$46,771
Total non interest bearing cash at beginning of year2014-12-31$38,627
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$58,265
Value of net assets at end of year (total assets less liabilities)2014-12-31$309,678
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$251,413
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
Investment advisory and management fees2014-12-31$44,449
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$425,140
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$386,877
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$386,877
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$1,231
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$1,273,823
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$1,435,356
Contract administrator fees2014-12-31$73,421
Liabilities. Value of benefit claims payable at end of year2014-12-31$3,423
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$29,337
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 name2014-12-31YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2014-12-31251589048
2013 : FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$174,091
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$183,835
Total income from all sources (including contributions)2013-12-31$2,473,847
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$2,493,799
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$2,077,183
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$1,585,853
Value of total assets at end of year2013-12-31$425,504
Value of total assets at beginning of year2013-12-31$455,200
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$416,616
Total interest from all sources2013-12-31$905
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
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$330,214
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$144,754
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$132,258
Other income not declared elsewhere2013-12-31$887,089
Administrative expenses (other) incurred2013-12-31$305,026
Total non interest bearing cash at end of year2013-12-31$38,627
Total non interest bearing cash at beginning of year2013-12-31$41,382
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-19,952
Value of net assets at end of year (total assets less liabilities)2013-12-31$251,413
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$271,365
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
Investment advisory and management fees2013-12-31$41,050
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$386,877
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$413,818
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$413,818
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$905
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$2,077,183
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$1,255,639
Contract administrator fees2013-12-31$70,540
Liabilities. Value of benefit claims payable at end of year2013-12-31$29,337
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$51,577
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 name2013-12-31YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2013-12-31251589048
2012 : FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$183,835
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$189,222
Total income from all sources (including contributions)2012-12-31$2,240,826
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$1,854,308
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$1,492,307
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$1,635,437
Value of total assets at end of year2012-12-31$455,200
Value of total assets at beginning of year2012-12-31$74,069
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$362,001
Total interest from all sources2012-12-31$955
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
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$276,120
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$132,258
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$180,160
Other income not declared elsewhere2012-12-31$604,434
Administrative expenses (other) incurred2012-12-31$256,240
Liabilities. Value of operating payables at end of year2012-12-31$0
Liabilities. Value of operating payables at beginning of year2012-12-31$3,640
Total non interest bearing cash at end of year2012-12-31$41,382
Total non interest bearing cash at beginning of year2012-12-31$35,007
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$386,518
Value of net assets at end of year (total assets less liabilities)2012-12-31$271,365
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$-115,153
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
Investment advisory and management fees2012-12-31$38,598
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$413,818
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$39,062
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$39,062
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$955
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$1,492,307
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$1,359,317
Contract administrator fees2012-12-31$67,163
Liabilities. Value of benefit claims payable at end of year2012-12-31$51,577
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$5,422
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 name2012-12-31YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2012-12-31251589048
2011 : FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$189,222
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$1,544,360
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$1,795,435
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$1,479,750
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$1,289,646
Value of total assets at end of year2011-12-31$74,069
Value of total assets at beginning of year2011-12-31$135,922
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$315,685
Total interest from all sources2011-12-31$1,502
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
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$270,467
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$180,160
Other income not declared elsewhere2011-12-31$253,212
Administrative expenses (other) incurred2011-12-31$218,961
Liabilities. Value of operating payables at end of year2011-12-31$3,640
Total non interest bearing cash at end of year2011-12-31$35,007
Total non interest bearing cash at beginning of year2011-12-31$1,001
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-251,075
Value of net assets at end of year (total assets less liabilities)2011-12-31$-115,153
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$135,922
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
Investment advisory and management fees2011-12-31$35,728
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$39,062
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$134,921
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$134,921
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$1,502
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$1,479,750
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$1,019,179
Contract administrator fees2011-12-31$60,996
Liabilities. Value of benefit claims payable at end of year2011-12-31$5,422
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 name2011-12-31YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2011-12-31251589048
2010 : FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$29,357
Total income from all sources (including contributions)2010-12-31$1,589,746
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$1,485,237
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$1,396,087
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$1,152,210
Value of total assets at end of year2010-12-31$135,922
Value of total assets at beginning of year2010-12-31$60,770
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$89,150
Total interest from all sources2010-12-31$1,420
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
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$1,555,810
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$213,361
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$29,357
Other income not declared elsewhere2010-12-31$436,116
Total non interest bearing cash at end of year2010-12-31$1,001
Total non interest bearing cash at beginning of year2010-12-31$25,319
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$104,509
Value of net assets at end of year (total assets less liabilities)2010-12-31$135,922
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$31,413
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
Investment advisory and management fees2010-12-31$33,375
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$134,921
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$35,451
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$35,451
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$1,420
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$1,396,087
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$938,849
Contract administrator fees2010-12-31$55,775
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 name2010-12-31YOUNG, OAKES, BROWN & CO., PC
Accountancy firm EIN2010-12-31251589048

Form 5500 Responses for FIRST KEYSTONE COMMUNITY BANK GROUP INSURANCE PLAN

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

Insurance Providers Used on plan

VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number2810
Policy instance 2
Insurance contract or identification number2810
Number of Individuals Covered148
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $924
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $924
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5968601
Policy instance 1
Insurance contract or identification number5968601
Number of Individuals Covered71
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $8,504
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $66,226
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,626
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5968601
Policy instance 1
Insurance contract or identification number5968601
Number of Individuals Covered118
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $7,936
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $58,585
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,335
Insurance broker organization code?3
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number2810
Policy instance 2
Insurance contract or identification number2810
Number of Individuals Covered147
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $913
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $913
Insurance broker organization code?3
(National Association of Insurance Commissioners NAIC id number: )
Policy contract number531929
Policy instance 1
Insurance contract or identification number531929
Number of Individuals Covered109
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,640
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $60,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,640
Insurance broker organization code?3
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number2810
Policy instance 2
Insurance contract or identification number2810
Number of Individuals Covered142
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $914
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $914
Insurance broker organization code?3
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number531929
Policy instance 1
Insurance contract or identification number531929
Number of Individuals Covered98
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,106
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $55,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,106
Insurance broker organization code?3
Insurance broker nameL.R. WEBBER ASSOCIATES, INC.
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number2810
Policy instance 2
Insurance contract or identification number2810
Number of Individuals Covered127
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $742
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $742
Insurance broker organization code?3
Insurance broker nameL.R. WEBBER ASSOCIATES, INC.
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number531929
Policy instance 1
Insurance contract or identification number531929
Number of Individuals Covered90
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,858
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $53,896
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,858
Insurance broker organization code?3
Insurance broker nameL.R. WEBBER ASSOCIATES, INC.
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number2810
Policy instance 2
Insurance contract or identification number2810
Number of Individuals Covered126
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $735
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $735
Insurance broker organization code?3
Insurance broker nameL.R. WEBBER ASSOCIATES, INC.
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number531929
Policy instance 1
Insurance contract or identification number531929
Number of Individuals Covered98
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,625
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $61,242
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,625
Insurance broker organization code?3
Insurance broker nameL.R. WEBBER ASSOCIATES, INC.
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number2810
Policy instance 2
Insurance contract or identification number2810
Number of Individuals Covered132
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $757
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $757
Insurance broker organization code?3
Insurance broker nameL.R. WEBBER ASSOCIATES, INC.
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number2810
Policy instance 2
Insurance contract or identification number2810
Number of Individuals Covered123
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $690
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $690
Insurance broker organization code?3
Insurance broker nameL.R. WEBBER ASSOCIATES, INC.
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number531929
Policy instance 1
Insurance contract or identification number531929
Number of Individuals Covered86
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,624
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $42,819
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,624
Insurance broker organization code?3
Insurance broker nameL.R. WEBBER ASSOCIATES, INC.
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number531929
Policy instance 1
Insurance contract or identification number531929
Number of Individuals Covered86
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,806
Total amount of fees paid to insurance companyUSD $205
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $41,574
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,806
Amount paid for insurance broker fees205
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameL.R. WEBBER ASSOCIATES, INC.
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number2810
Policy instance 2
Insurance contract or identification number2810
Number of Individuals Covered124
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $675
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $675
Insurance broker organization code?3
Insurance broker nameL.R. WEBBER ASSOCIATES, INC.
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number2810
Policy instance 2
Insurance contract or identification number2810
Number of Individuals Covered117
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $627
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number531929
Policy instance 1
Insurance contract or identification number531929
Number of Individuals Covered76
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,370
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $30,908
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number2810
Policy instance 2
Insurance contract or identification number2810
Number of Individuals Covered102
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $565
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $565
Insurance broker organization code?3
Insurance broker nameL.R. WEBBER ASSOCIATES, INC.
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number531929
Policy instance 1
Insurance contract or identification number531929
Number of Individuals Covered41
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,599
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $24,082
Commission paid to Insurance BrokerUSD $2,599
Insurance broker organization code?3
Insurance broker nameL.R. WEBBER ASSOCIATES, INC.

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