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MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN 401k Plan overview

Plan NameMIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN
Plan identification number 001

MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

MIDWEST COMMUNITY BANCSHARES, INC. has sponsored the creation of one or more 401k plans.

Company Name:MIDWEST COMMUNITY BANCSHARES, INC.
Employer identification number (EIN):364148677
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01MITZI MOORE
0012016-01-01MITZI MOORE
0012015-01-01MITZI MOORE
0012014-01-01MITZI MOORE2015-07-08
0012013-01-01RAYMOND A. ALTMIX, ROBERT L. KINCHE2014-05-07
0012012-01-01RAYMOND A. ALTMIX, ROBERT L. KINCHE2013-03-11
0012011-01-01RAYMOND A. ALTMIX, ROBERT L. KINCHE2012-05-03
0012010-01-01MITZI MOORE2011-05-11 MITZI MOORE2011-05-11

Plan Statistics for MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN

401k plan membership statisitcs for MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN

Measure Date Value
2022: MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01179
Total number of active participants reported on line 7a of the Form 55002022-01-01137
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0137
Total of all active and inactive participants2022-01-01174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01174
Number of participants with account balances2022-01-01160
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-015
2021: MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01165
Total number of active participants reported on line 7a of the Form 55002021-01-01119
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0125
Total of all active and inactive participants2021-01-01144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01144
Number of participants with account balances2021-01-01135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01156
Total number of active participants reported on line 7a of the Form 55002020-01-01131
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0130
Total of all active and inactive participants2020-01-01161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01161
Number of participants with account balances2020-01-01152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01153
Total number of active participants reported on line 7a of the Form 55002019-01-01132
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0120
Total of all active and inactive participants2019-01-01152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01152
Number of participants with account balances2019-01-01143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01154
Total number of active participants reported on line 7a of the Form 55002018-01-01122
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0122
Total of all active and inactive participants2018-01-01144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01144
Number of participants with account balances2018-01-01136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01157
Total number of active participants reported on line 7a of the Form 55002017-01-01130
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0121
Total of all active and inactive participants2017-01-01151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01151
Number of participants with account balances2017-01-01138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01166
Total number of active participants reported on line 7a of the Form 55002016-01-01145
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0111
Total of all active and inactive participants2016-01-01156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01156
Number of participants with account balances2016-01-01135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01172
Total number of active participants reported on line 7a of the Form 55002015-01-01143
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0121
Total of all active and inactive participants2015-01-01164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01164
Number of participants with account balances2015-01-01146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-012

Financial Data on MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN

Measure Date Value
2022 : MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total transfer of assets to this plan2022-12-31$1,608,770
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-1,485,718
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$817,066
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$789,922
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$772,735
Value of total assets at end of year2022-12-31$13,072,194
Value of total assets at beginning of year2022-12-31$13,766,208
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$27,144
Total interest from all sources2022-12-31$9,209
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$462,280
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$462,280
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$6,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$488,707
Participant contributions at end of year2022-12-31$38,156
Participant contributions at beginning of year2022-12-31$34,269
Participant contributions at end of year2022-12-31$50
Participant contributions at beginning of year2022-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$16,054
Administrative expenses (other) incurred2022-12-31$27,144
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-2,302,784
Value of net assets at end of year (total assets less liabilities)2022-12-31$13,072,194
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$13,766,208
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$12,269,774
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$13,172,091
Interest on participant loans2022-12-31$2,023
Interest earned on other investments2022-12-31$7,186
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$745,196
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$558,629
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-2,729,942
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$267,974
Employer contributions (assets) at end of year2022-12-31$19,018
Employer contributions (assets) at beginning of year2022-12-31$1,219
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$789,922
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31FORVIS, LLP
Accountancy firm EIN2022-12-31440160260
2021 : MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$2,604,065
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$1,183,170
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,154,361
Expenses. Certain deemed distributions of participant loans2021-12-31$1,927
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$661,825
Value of total assets at end of year2021-12-31$13,766,208
Value of total assets at beginning of year2021-12-31$12,345,313
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$26,882
Total interest from all sources2021-12-31$6,322
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$945,038
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$945,038
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$6,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$434,229
Participant contributions at end of year2021-12-31$34,269
Participant contributions at beginning of year2021-12-31$22,708
Participant contributions at end of year2021-12-31$0
Participant contributions at beginning of year2021-12-31$13,811
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$998
Other income not declared elsewhere2021-12-31$1,838
Administrative expenses (other) incurred2021-12-31$2,713
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$1,420,895
Value of net assets at end of year (total assets less liabilities)2021-12-31$13,766,208
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$12,345,313
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$22,970
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$13,172,091
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$11,936,934
Interest on participant loans2021-12-31$1,442
Interest earned on other investments2021-12-31$4,880
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$558,629
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$361,489
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$989,042
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$226,598
Employer contributions (assets) at end of year2021-12-31$1,219
Employer contributions (assets) at beginning of year2021-12-31$10,371
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,154,361
Contract administrator fees2021-12-31$1,199
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 name2021-12-31FORVIS, LLP
Accountancy firm EIN2021-12-31440160260
2020 : MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$2,287,684
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$615,118
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$592,661
Expenses. Certain deemed distributions of participant loans2020-12-31$1,838
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$652,910
Value of total assets at end of year2020-12-31$12,345,313
Value of total assets at beginning of year2020-12-31$10,672,747
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$20,619
Total interest from all sources2020-12-31$6,951
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$310,793
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$310,793
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$5,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$426,094
Participant contributions at end of year2020-12-31$22,708
Participant contributions at beginning of year2020-12-31$31,912
Participant contributions at end of year2020-12-31$13,811
Participant contributions at beginning of year2020-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$2,083
Other income not declared elsewhere2020-12-31$1,955
Administrative expenses (other) incurred2020-12-31$1,075
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$1,672,566
Value of net assets at end of year (total assets less liabilities)2020-12-31$12,345,313
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$10,672,747
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$18,698
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$11,936,934
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$10,162,317
Interest on participant loans2020-12-31$1,875
Interest earned on other investments2020-12-31$5,076
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$361,489
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$477,600
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$1,315,075
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$224,733
Employer contributions (assets) at end of year2020-12-31$10,371
Employer contributions (assets) at beginning of year2020-12-31$918
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$592,661
Contract administrator fees2020-12-31$846
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 name2020-12-31BKD, LLP
Accountancy firm EIN2020-12-31440160260
2019 : MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$2,555,665
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$1,207,763
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,187,640
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$643,790
Value of total assets at end of year2019-12-31$10,672,747
Value of total assets at beginning of year2019-12-31$9,324,845
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$20,123
Total interest from all sources2019-12-31$8,693
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$316,965
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$316,965
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$5,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$416,894
Participant contributions at end of year2019-12-31$31,912
Participant contributions at beginning of year2019-12-31$7,825
Administrative expenses (other) incurred2019-12-31$1,600
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$1,347,902
Value of net assets at end of year (total assets less liabilities)2019-12-31$10,672,747
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$9,324,845
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$10,162,317
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$8,854,318
Interest on participant loans2019-12-31$1,490
Interest earned on other investments2019-12-31$7,203
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$477,600
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$462,341
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$1,586,217
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$226,896
Employer contributions (assets) at end of year2019-12-31$918
Employer contributions (assets) at beginning of year2019-12-31$361
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$1,187,640
Contract administrator fees2019-12-31$18,523
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)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31BKD, LLP
Accountancy firm EIN2019-12-31440160260
2018 : MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$109,236
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$469,813
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$463,890
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$635,365
Value of total assets at end of year2018-12-31$9,324,845
Value of total assets at beginning of year2018-12-31$9,685,422
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$5,923
Total interest from all sources2018-12-31$799
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 bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$5,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$398,943
Participant contributions at end of year2018-12-31$7,825
Participant contributions at beginning of year2018-12-31$19,435
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$32
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$15,124
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-360,577
Value of net assets at end of year (total assets less liabilities)2018-12-31$9,324,845
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$9,685,422
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$5,923
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$8,854,318
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$9,663,884
Income. Interest from loans (other than to participants)2018-12-31$799
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$462,341
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-526,928
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$221,298
Employer contributions (assets) at end of year2018-12-31$361
Employer contributions (assets) at beginning of year2018-12-31$2,071
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$463,890
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
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)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31BKD, LLP
Accountancy firm EIN2018-12-31440160260
2017 : MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$1,970,900
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$217,147
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$214,077
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$616,288
Value of total assets at end of year2017-12-31$9,685,422
Value of total assets at beginning of year2017-12-31$7,931,669
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$3,070
Total interest from all sources2017-12-31$785
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$5,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$396,320
Participant contributions at end of year2017-12-31$19,435
Participant contributions at beginning of year2017-12-31$2,835
Participant contributions at end of year2017-12-31$32
Participant contributions at beginning of year2017-12-31$0
Other income not declared elsewhere2017-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$1,753,753
Value of net assets at end of year (total assets less liabilities)2017-12-31$9,685,422
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$7,931,669
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$3,070
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$9,663,884
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$0
Value of interest in pooled separate accounts at end of year2017-12-31$0
Value of interest in pooled separate accounts at beginning of year2017-12-31$7,925,602
Interest on participant loans2017-12-31$785
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$1,353,827
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$219,968
Employer contributions (assets) at end of year2017-12-31$2,071
Employer contributions (assets) at beginning of year2017-12-31$3,232
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$214,077
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
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)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31BKD, LLP
Accountancy firm EIN2017-12-31440160260
2016 : MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$1,214,353
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$429,182
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$425,904
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$643,156
Value of total assets at end of year2016-12-31$7,931,669
Value of total assets at beginning of year2016-12-31$7,146,498
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$3,278
Total interest from all sources2016-12-31$772
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$5,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$357,590
Participant contributions at end of year2016-12-31$2,835
Participant contributions at beginning of year2016-12-31$23,908
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$84,455
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$785,171
Value of net assets at end of year (total assets less liabilities)2016-12-31$7,931,669
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$7,146,498
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$3,278
Value of interest in pooled separate accounts at end of year2016-12-31$7,925,602
Value of interest in pooled separate accounts at beginning of year2016-12-31$7,120,499
Interest on participant loans2016-12-31$772
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$570,425
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$201,111
Employer contributions (assets) at end of year2016-12-31$3,232
Employer contributions (assets) at beginning of year2016-12-31$2,091
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$425,904
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
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)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31BKD, LLP
Accountancy firm EIN2016-12-31440160260
2015 : MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total transfer of assets to this plan2015-12-31$2,851,333
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$498,533
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$2,617,307
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$2,614,967
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$600,032
Value of total assets at end of year2015-12-31$7,146,498
Value of total assets at beginning of year2015-12-31$6,413,939
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$2,340
Total interest from all sources2015-12-31$1,683
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$375,762
Participant contributions at end of year2015-12-31$23,908
Participant contributions at beginning of year2015-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$3,602
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-2,118,774
Value of net assets at end of year (total assets less liabilities)2015-12-31$7,146,498
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$6,413,939
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$2,340
Value of interest in pooled separate accounts at end of year2015-12-31$7,120,499
Value of interest in pooled separate accounts at beginning of year2015-12-31$6,413,939
Interest on participant loans2015-12-31$1,683
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-103,182
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$220,668
Employer contributions (assets) at end of year2015-12-31$2,091
Employer contributions (assets) at beginning of year2015-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$2,614,967
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
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)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31BKD, LLP
Accountancy firm EIN2015-12-31440160260

Form 5500 Responses for MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) PLAN

2022: MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) 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 – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) 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: MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) 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: MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) 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: MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) 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: MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) 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: MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) 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: MIDWEST COMMUNITY BANCSHARES, INC. SAFE HARBOR 401(K) 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

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number504324-01
Policy instance 1
Insurance contract or identification number504324-01
Number of Individuals Covered70
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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?Yes
Health Insurance Welfare BenefitNo
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number504324-01
Policy instance 1
Insurance contract or identification number504324-01
Number of Individuals Covered47
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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?Yes
Health Insurance Welfare BenefitNo
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number504324-01
Policy instance 1
Insurance contract or identification number504324-01
Number of Individuals Covered52
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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?Yes
Health Insurance Welfare BenefitNo
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number504324-01
Policy instance 1
Insurance contract or identification number504324-01
Number of Individuals Covered52
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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?Yes
Health Insurance Welfare BenefitNo
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberGA-829681
Policy instance 1
Insurance contract or identification numberGA-829681
Number of Individuals Covered0
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,445
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2445
Additional information about fees paid to insurance brokerADMINISTRATIVE ALLOWANCE
Insurance broker organization code?5
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number504324-01
Policy instance 2
Insurance contract or identification number504324-01
Number of Individuals Covered55
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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?Yes
Health Insurance Welfare BenefitNo
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberGA-829681
Policy instance 1
Insurance contract or identification numberGA-829681
Number of Individuals Covered137
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $5,414
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees5414
Additional information about fees paid to insurance brokerADMINISTRATIVE ALLOWANCE
Insurance broker organization code?5
Insurance broker nameBENEFIT PLANS PLUS, LLC
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberGA-829681
Policy instance 1
Insurance contract or identification numberGA-829681
Number of Individuals Covered146
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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