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AMERICAN CHARTERED BANK HEALTH INSURANCE 401k Plan overview

Plan NameAMERICAN CHARTERED BANK HEALTH INSURANCE
Plan identification number 501

AMERICAN CHARTERED BANK HEALTH INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

AMERICAN CHARTERED BANK has sponsored the creation of one or more 401k plans.

Company Name:AMERICAN CHARTERED BANK
Employer identification number (EIN):363513864
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMERICAN CHARTERED BANK HEALTH INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012015-01-01MARK MOISE
5012014-01-01MARK MOISE
5012013-01-01MARK MOISE
5012012-01-01MARK MOISE
5012011-01-01MARK MOISE
5012010-01-01MARK MOISE
5012009-01-01MARK MOISE

Plan Statistics for AMERICAN CHARTERED BANK HEALTH INSURANCE

401k plan membership statisitcs for AMERICAN CHARTERED BANK HEALTH INSURANCE

Measure Date Value
2015: AMERICAN CHARTERED BANK HEALTH INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-01-01579
Total number of active participants reported on line 7a of the Form 55002015-01-01570
Total of all active and inactive participants2015-01-01570
Total participants2015-01-01570
2014: AMERICAN CHARTERED BANK HEALTH INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-01-01576
Total number of active participants reported on line 7a of the Form 55002014-01-01579
Number of retired or separated participants receiving benefits2014-01-010
Total of all active and inactive participants2014-01-01579
Total participants2014-01-01579
2013: AMERICAN CHARTERED BANK HEALTH INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-01-01645
Total number of active participants reported on line 7a of the Form 55002013-01-01576
Total of all active and inactive participants2013-01-01576
Total participants2013-01-01576
2012: AMERICAN CHARTERED BANK HEALTH INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-01-01666
Total number of active participants reported on line 7a of the Form 55002012-01-01645
Total of all active and inactive participants2012-01-01645
Total participants2012-01-01645
2011: AMERICAN CHARTERED BANK HEALTH INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-01-01667
Total number of active participants reported on line 7a of the Form 55002011-01-01666
Total of all active and inactive participants2011-01-01666
Total participants2011-01-01666
2010: AMERICAN CHARTERED BANK HEALTH INSURANCE 2010 401k membership
Total participants, beginning-of-year2010-01-01676
Total number of active participants reported on line 7a of the Form 55002010-01-01667
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01667
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01667
2009: AMERICAN CHARTERED BANK HEALTH INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-01-01661
Total number of active participants reported on line 7a of the Form 55002009-01-01676
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01676
Total participants2009-01-01676

Form 5500 Responses for AMERICAN CHARTERED BANK HEALTH INSURANCE

2015: AMERICAN CHARTERED BANK HEALTH INSURANCE 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 benefit arrangement – InsuranceYes
2014: AMERICAN CHARTERED BANK HEALTH INSURANCE 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 benefit arrangement – InsuranceYes
2013: AMERICAN CHARTERED BANK HEALTH INSURANCE 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 benefit arrangement – InsuranceYes
2012: AMERICAN CHARTERED BANK HEALTH INSURANCE 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 benefit arrangement – InsuranceYes
2011: AMERICAN CHARTERED BANK HEALTH INSURANCE 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 benefit arrangement – InsuranceYes
2010: AMERICAN CHARTERED BANK HEALTH INSURANCE 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: AMERICAN CHARTERED BANK HEALTH INSURANCE 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 benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number10342
Policy instance 1
Insurance contract or identification number10342
Number of Individuals Covered570
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $106,772
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $188,089
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $106,772
Insurance broker organization code?3
Insurance broker nameDS&P INSURANCE SERVICES INC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number10342
Policy instance 1
Insurance contract or identification number10342
Number of Individuals Covered579
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $96,757
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $175,173
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $96,757
Insurance broker organization code?3
Insurance broker nameDSP INSURANCE SERVICES INC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number10342
Policy instance 1
Insurance contract or identification number10342
Number of Individuals Covered576
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $71,891
Total amount of fees paid to insurance companyUSD $1,427
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $158,762
Commission paid to Insurance BrokerUSD $71,891
Amount paid for insurance broker fees1427
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameDSP INSURANCE SERVICES INC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number10342
Policy instance 1
Insurance contract or identification number10342
Number of Individuals Covered645
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $110,141
Total amount of fees paid to insurance companyUSD $1,444
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $177,287
Commission paid to Insurance BrokerUSD $110,141
Amount paid for insurance broker fees1444
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameDS&P INSURANCE SERVICES INC.
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number10342
Policy instance 1
Insurance contract or identification number10342
Number of Individuals Covered666
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $68,807
Total amount of fees paid to insurance companyUSD $2,366
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $165,900
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number10342
Policy instance 1
Insurance contract or identification number10342
Number of Individuals Covered667
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $69,622
Total amount of fees paid to insurance companyUSD $2,446
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $151,294
Commission paid to Insurance BrokerUSD $69,622
Amount paid for insurance broker fees2446
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameDS&P INSURANCE SERVICES INC

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