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FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 401k Plan overview

Plan NameFARMERS & MERCHANTS STATE BANK SAVINGS PLAN
Plan identification number 002

FARMERS & MERCHANTS STATE BANK SAVINGS 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

FARMERS & MERCHANTS STATE BANK has sponsored the creation of one or more 401k plans.

Company Name:FARMERS & MERCHANTS STATE BANK
Employer identification number (EIN):390273610
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FARMERS & MERCHANTS STATE BANK SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01
0022021-01-01
0022020-01-01
0022019-01-01
0022018-01-01WILLIAM HOGAN
0022017-01-01WILLIAM HOGAN
0022016-01-01WILLIAM HOGAN
0022015-01-01WILLIAM HOGAN
0022014-01-01WILLIAM HOGAN2015-06-13 WILLIAM HOGAN2015-06-13
0022013-01-01WILLIAM HOGAN2014-07-15 WILLIAM HOGAN2014-07-15
0022012-01-01WILLIAM HOGAN2013-07-10 WILLIAM HOGAN2013-07-10
0022011-01-01WILLIAM HOGAN2012-03-28 WILLIAM HOGAN2012-03-28
0022010-01-01WILLIAM HOGAN2011-02-10 WILLIAM HOGAN2011-02-10

Plan Statistics for FARMERS & MERCHANTS STATE BANK SAVINGS PLAN

401k plan membership statisitcs for FARMERS & MERCHANTS STATE BANK SAVINGS PLAN

Measure Date Value
2022: FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0142
Total number of active participants reported on line 7a of the Form 55002022-01-0128
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0112
Total of all active and inactive participants2022-01-0140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0140
Number of participants with account balances2022-01-0140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-016
2021: FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0142
Total number of active participants reported on line 7a of the Form 55002021-01-0135
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-017
Total of all active and inactive participants2021-01-0142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0142
Number of participants with account balances2021-01-0141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0142
Total number of active participants reported on line 7a of the Form 55002020-01-0134
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-017
Total of all active and inactive participants2020-01-0142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0142
Number of participants with account balances2020-01-0141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0143
Total number of active participants reported on line 7a of the Form 55002019-01-0134
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-018
Total of all active and inactive participants2019-01-0142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0142
Number of participants with account balances2019-01-0141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-012
2018: FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0141
Total number of active participants reported on line 7a of the Form 55002018-01-0132
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0111
Total of all active and inactive participants2018-01-0143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0143
Number of participants with account balances2018-01-0143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-012
2017: FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0140
Total number of active participants reported on line 7a of the Form 55002017-01-0132
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-019
Total of all active and inactive participants2017-01-0141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0141
Number of participants with account balances2017-01-0141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0142
Total number of active participants reported on line 7a of the Form 55002016-01-0135
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-015
Total of all active and inactive participants2016-01-0140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0140
Number of participants with account balances2016-01-0140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-011
2015: FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0144
Total number of active participants reported on line 7a of the Form 55002015-01-0135
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-017
Total of all active and inactive participants2015-01-0142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0142
Number of participants with account balances2015-01-0142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-011

Financial Data on FARMERS & MERCHANTS STATE BANK SAVINGS PLAN

Measure Date Value
2022 : FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2022 401k financial data
Transfers to/from the plan2022-12-31$0
Total plan liabilities at end of year2022-12-31$0
Total plan liabilities at beginning of year2022-12-31$0
Total income from all sources2022-12-31$-949,011
Expenses. Total of all expenses incurred2022-12-31$1,034,820
Benefits paid (including direct rollovers)2022-12-31$1,034,595
Total plan assets at end of year2022-12-31$5,720,582
Total plan assets at beginning of year2022-12-31$7,704,413
Value of fidelity bond covering the plan2022-12-31$2,800,000
Assets. Value of tangible personal property2022-12-31$0
Total contributions received or receivable from participants2022-12-31$173,612
Assets. Value of loans (other than to participants)2022-12-31$0
Expenses. Other expenses not covered elsewhere2022-12-31$0
Contributions received from other sources (not participants or employers)2022-12-31$0
Other income received2022-12-31$-1,301,445
Noncash contributions received2022-12-31$0
Net income (gross income less expenses)2022-12-31$-1,983,831
Net plan assets at end of year (total assets less liabilities)2022-12-31$5,720,582
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$7,704,413
Assets. Value of participant loans2022-12-31$0
Assets. Value of assets in partnership/joint-venture interests2022-12-31$0
Assets. Value of real-estate (other than employer real property)2022-12-31$0
Assets. Value of employer securities2022-12-31$0
Assets. Value of employer real property2022-12-31$0
Total contributions received or receivable from employer(s)2022-12-31$178,822
Value of certain deemed distributions of participant loans2022-12-31$0
Value of corrective distributions2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$225
2021 : FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2021 401k financial data
Transfers to/from the plan2021-12-31$0
Total plan liabilities at end of year2021-12-31$0
Total plan liabilities at beginning of year2021-12-31$0
Total income from all sources2021-12-31$1,516,065
Expenses. Total of all expenses incurred2021-12-31$359,945
Benefits paid (including direct rollovers)2021-12-31$359,696
Total plan assets at end of year2021-12-31$7,704,413
Total plan assets at beginning of year2021-12-31$6,548,293
Value of fidelity bond covering the plan2021-12-31$2,800,000
Assets. Value of tangible personal property2021-12-31$0
Total contributions received or receivable from participants2021-12-31$171,396
Assets. Value of loans (other than to participants)2021-12-31$0
Expenses. Other expenses not covered elsewhere2021-12-31$0
Contributions received from other sources (not participants or employers)2021-12-31$0
Other income received2021-12-31$1,141,009
Noncash contributions received2021-12-31$0
Net income (gross income less expenses)2021-12-31$1,156,120
Net plan assets at end of year (total assets less liabilities)2021-12-31$7,704,413
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$6,548,293
Assets. Value of participant loans2021-12-31$0
Assets. Value of assets in partnership/joint-venture interests2021-12-31$0
Assets. Value of real-estate (other than employer real property)2021-12-31$0
Assets. Value of employer securities2021-12-31$0
Assets. Value of employer real property2021-12-31$0
Total contributions received or receivable from employer(s)2021-12-31$203,660
Value of certain deemed distributions of participant loans2021-12-31$0
Value of corrective distributions2021-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$249
2020 : FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2020 401k financial data
Transfers to/from the plan2020-12-31$0
Total plan liabilities at end of year2020-12-31$0
Total plan liabilities at beginning of year2020-12-31$0
Total income from all sources2020-12-31$1,270,930
Expenses. Total of all expenses incurred2020-12-31$490,691
Benefits paid (including direct rollovers)2020-12-31$490,616
Total plan assets at end of year2020-12-31$6,548,293
Total plan assets at beginning of year2020-12-31$5,768,054
Value of fidelity bond covering the plan2020-12-31$2,800,000
Assets. Value of tangible personal property2020-12-31$0
Total contributions received or receivable from participants2020-12-31$165,557
Assets. Value of loans (other than to participants)2020-12-31$0
Expenses. Other expenses not covered elsewhere2020-12-31$0
Contributions received from other sources (not participants or employers)2020-12-31$377
Other income received2020-12-31$951,572
Noncash contributions received2020-12-31$0
Net income (gross income less expenses)2020-12-31$780,239
Net plan assets at end of year (total assets less liabilities)2020-12-31$6,548,293
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$5,768,054
Assets. Value of participant loans2020-12-31$0
Assets. Value of assets in partnership/joint-venture interests2020-12-31$0
Assets. Value of real-estate (other than employer real property)2020-12-31$0
Assets. Value of employer securities2020-12-31$0
Assets. Value of employer real property2020-12-31$0
Total contributions received or receivable from employer(s)2020-12-31$153,424
Value of certain deemed distributions of participant loans2020-12-31$0
Value of corrective distributions2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$75
2019 : FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2019 401k financial data
Transfers to/from the plan2019-12-31$0
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$1,458,974
Expenses. Total of all expenses incurred2019-12-31$274,416
Benefits paid (including direct rollovers)2019-12-31$274,391
Total plan assets at end of year2019-12-31$5,768,054
Total plan assets at beginning of year2019-12-31$4,583,496
Value of fidelity bond covering the plan2019-12-31$2,800,000
Total contributions received or receivable from participants2019-12-31$155,732
Expenses. Other expenses not covered elsewhere2019-12-31$0
Contributions received from other sources (not participants or employers)2019-12-31$13,942
Other income received2019-12-31$1,132,000
Noncash contributions received2019-12-31$0
Net income (gross income less expenses)2019-12-31$1,184,558
Net plan assets at end of year (total assets less liabilities)2019-12-31$5,768,054
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$4,583,496
Total contributions received or receivable from employer(s)2019-12-31$157,300
Value of certain deemed distributions of participant loans2019-12-31$0
Value of corrective distributions2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$25
2018 : FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2018 401k financial data
Transfers to/from the plan2018-12-31$0
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$18,267
Expenses. Total of all expenses incurred2018-12-31$23,559
Benefits paid (including direct rollovers)2018-12-31$23,559
Total plan assets at end of year2018-12-31$4,583,496
Total plan assets at beginning of year2018-12-31$4,588,788
Value of fidelity bond covering the plan2018-12-31$2,800,000
Total contributions received or receivable from participants2018-12-31$149,987
Expenses. Other expenses not covered elsewhere2018-12-31$0
Contributions received from other sources (not participants or employers)2018-12-31$1,487
Other income received2018-12-31$-286,068
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$-5,292
Net plan assets at end of year (total assets less liabilities)2018-12-31$4,583,496
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$4,588,788
Total contributions received or receivable from employer(s)2018-12-31$152,861
Value of certain deemed distributions of participant loans2018-12-31$0
Value of corrective distributions2018-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$0
2017 : FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2017 401k financial data
Transfers to/from the plan2017-12-31$0
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$1,024,175
Expenses. Total of all expenses incurred2017-12-31$129,702
Benefits paid (including direct rollovers)2017-12-31$129,677
Total plan assets at end of year2017-12-31$4,588,788
Total plan assets at beginning of year2017-12-31$3,694,315
Value of fidelity bond covering the plan2017-12-31$2,800,000
Total contributions received or receivable from participants2017-12-31$128,146
Expenses. Other expenses not covered elsewhere2017-12-31$0
Contributions received from other sources (not participants or employers)2017-12-31$16,263
Other income received2017-12-31$733,360
Noncash contributions received2017-12-31$0
Net income (gross income less expenses)2017-12-31$894,473
Net plan assets at end of year (total assets less liabilities)2017-12-31$4,588,788
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$3,694,315
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022017-12-31$0
Total contributions received or receivable from employer(s)2017-12-31$146,406
Value of certain deemed distributions of participant loans2017-12-31$0
Value of corrective distributions2017-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$25
2016 : FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2016 401k financial data
Transfers to/from the plan2016-12-31$0
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$574,273
Expenses. Total of all expenses incurred2016-12-31$364,203
Benefits paid (including direct rollovers)2016-12-31$364,203
Total plan assets at end of year2016-12-31$3,694,315
Total plan assets at beginning of year2016-12-31$3,484,245
Value of fidelity bond covering the plan2016-12-31$2,275,000
Total contributions received or receivable from participants2016-12-31$120,074
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$311,504
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$210,070
Net plan assets at end of year (total assets less liabilities)2016-12-31$3,694,315
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$3,484,245
Total contributions received or receivable from employer(s)2016-12-31$142,695
Value of certain deemed distributions of participant loans2016-12-31$0
Value of corrective distributions2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$0
2015 : FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2015 401k financial data
Transfers to/from the plan2015-12-31$0
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$307,339
Expenses. Total of all expenses incurred2015-12-31$151,059
Benefits paid (including direct rollovers)2015-12-31$149,254
Total plan assets at end of year2015-12-31$3,484,245
Total plan assets at beginning of year2015-12-31$3,327,965
Value of fidelity bond covering the plan2015-12-31$2,275,000
Total contributions received or receivable from participants2015-12-31$117,095
Expenses. Other expenses not covered elsewhere2015-12-31$0
Contributions received from other sources (not participants or employers)2015-12-31$25,033
Other income received2015-12-31$3,006
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$156,280
Net plan assets at end of year (total assets less liabilities)2015-12-31$3,484,245
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$3,327,965
Total contributions received or receivable from employer(s)2015-12-31$162,205
Value of certain deemed distributions of participant loans2015-12-31$0
Value of corrective distributions2015-12-31$1,805
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$0

Form 5500 Responses for FARMERS & MERCHANTS STATE BANK SAVINGS PLAN

2022: FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01This submission is the final filingNo
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: FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01This submission is the final filingNo
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: FARMERS & MERCHANTS STATE BANK SAVINGS PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01This submission is the final filingNo
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: FARMERS & MERCHANTS STATE BANK SAVINGS 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: FARMERS & MERCHANTS STATE BANK SAVINGS 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: FARMERS & MERCHANTS STATE BANK SAVINGS 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
2017-01-01Plan 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: FARMERS & MERCHANTS STATE BANK SAVINGS 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: FARMERS & MERCHANTS STATE BANK SAVINGS 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 – TrustYes
2015-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-063437
Policy instance 1
Insurance contract or identification numberGA-063437
Number of Individuals Covered2
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-063437
Policy instance 1
Insurance contract or identification numberGA-063437
Number of Individuals Covered2
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-063437
Policy instance 1
Insurance contract or identification numberGA-063437
Number of Individuals Covered3
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-063437
Policy instance 1
Insurance contract or identification numberGA-063437
Number of Individuals Covered2
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
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-063437
Policy instance 1
Insurance contract or identification numberGA-063437
Number of Individuals Covered4
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
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-063437
Policy instance 1
Insurance contract or identification numberGA-063437
Number of Individuals Covered3
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 $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?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

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