401k Plan data: FLEXIBLE SPENDING PLAN plan

FLEXIBLE SPENDING PLAN 401k Plan overview

Plan Name	FLEXIBLE SPENDING PLAN
Plan identification number	501

FLEXIBLE SPENDING PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

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

Company Name: FIRST PALMETTO BANK

Employer identification number (EIN): 570921408

NAIC Classification: 522120
NAIC Description: Savings Institutions

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FLEXIBLE SPENDING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2021-10-01
501 2020-10-01
501 2019-10-01
501 2018-10-01
501 2017-10-01
501 2016-10-01 VIRGINIA LOCKE VIRGINIA LOCKE 2018-04-25
501 2015-10-01 VIRGINIA LOCKE VIRGINIA LOCKE 2017-04-28
501 2014-10-01 VIRGINIA LOCKE VIRGINIA LOCKE 2016-07-14
501 2013-10-01 VIRGINIA LOCKE VIRGINIA LOCKE 2015-04-30
501 2012-10-01 VIRGINIA LOCKE VIRGINIA LOCKE 2014-07-11
501 2011-10-01 VIRGINIA LOCKE VIRGINIA LOCKE 2013-07-10
501 2009-10-01 VIRGINIA LOCKE VIRGINIA LOCKE 2011-05-04

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2021-10-01
501	2020-10-01
501	2019-10-01
501	2018-10-01
501	2017-10-01
501	2016-10-01	VIRGINIA LOCKE	VIRGINIA LOCKE	2018-04-25
501	2015-10-01	VIRGINIA LOCKE	VIRGINIA LOCKE	2017-04-28
501	2014-10-01	VIRGINIA LOCKE	VIRGINIA LOCKE	2016-07-14
501	2013-10-01	VIRGINIA LOCKE	VIRGINIA LOCKE	2015-04-30
501	2012-10-01	VIRGINIA LOCKE	VIRGINIA LOCKE	2014-07-11
501	2011-10-01	VIRGINIA LOCKE	VIRGINIA LOCKE	2013-07-10
501	2009-10-01	VIRGINIA LOCKE	VIRGINIA LOCKE	2011-05-04

Plan Statistics for FLEXIBLE SPENDING PLAN

401k plan membership statisitcs for FLEXIBLE SPENDING PLAN

Measure Date Value
2021: FLEXIBLE SPENDING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-10-01 234
Total number of active participants reported on line 7a of the Form 5500 2021-10-01 190
Number of retired or separated participants receiving benefits 2021-10-01 0
Number of other retired or separated participants entitled to future benefits 2021-10-01 0
Total of all active and inactive participants 2021-10-01 190
2020: FLEXIBLE SPENDING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-10-01 188
Total number of active participants reported on line 7a of the Form 5500 2020-10-01 234
Number of retired or separated participants receiving benefits 2020-10-01 0
Number of other retired or separated participants entitled to future benefits 2020-10-01 0
Total of all active and inactive participants 2020-10-01 234
2019: FLEXIBLE SPENDING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-10-01 146
Total number of active participants reported on line 7a of the Form 5500 2019-10-01 188
Number of retired or separated participants receiving benefits 2019-10-01 0
Number of other retired or separated participants entitled to future benefits 2019-10-01 0
Total of all active and inactive participants 2019-10-01 188
2018: FLEXIBLE SPENDING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-10-01 147
Total number of active participants reported on line 7a of the Form 5500 2018-10-01 146
Number of retired or separated participants receiving benefits 2018-10-01 0
Number of other retired or separated participants entitled to future benefits 2018-10-01 0
Total of all active and inactive participants 2018-10-01 146
2017: FLEXIBLE SPENDING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-10-01 145
Total number of active participants reported on line 7a of the Form 5500 2017-10-01 147
Number of retired or separated participants receiving benefits 2017-10-01 0
Number of other retired or separated participants entitled to future benefits 2017-10-01 0
Total of all active and inactive participants 2017-10-01 147
2016: FLEXIBLE SPENDING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-10-01 142
Total number of active participants reported on line 7a of the Form 5500 2016-10-01 145
Number of retired or separated participants receiving benefits 2016-10-01 0
Number of other retired or separated participants entitled to future benefits 2016-10-01 0
Total of all active and inactive participants 2016-10-01 145
2015: FLEXIBLE SPENDING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-10-01 141
Total number of active participants reported on line 7a of the Form 5500 2015-10-01 142
Number of retired or separated participants receiving benefits 2015-10-01 0
Number of other retired or separated participants entitled to future benefits 2015-10-01 0
Total of all active and inactive participants 2015-10-01 142
2014: FLEXIBLE SPENDING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-10-01 131
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 141
Number of retired or separated participants receiving benefits 2014-10-01 0
Number of other retired or separated participants entitled to future benefits 2014-10-01 0
Total of all active and inactive participants 2014-10-01 141
2013: FLEXIBLE SPENDING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-10-01 131
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 131
Total of all active and inactive participants 2013-10-01 131
2012: FLEXIBLE SPENDING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-10-01 128
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 131
Total of all active and inactive participants 2012-10-01 131
2011: FLEXIBLE SPENDING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-10-01 135
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 128
Total of all active and inactive participants 2011-10-01 128
2009: FLEXIBLE SPENDING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-10-01 138
Total number of active participants reported on line 7a of the Form 5500 2009-10-01 133
Total of all active and inactive participants 2009-10-01 133

Measure	Date	Value
2021: FLEXIBLE SPENDING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-10-01	234
Total number of active participants reported on line 7a of the Form 5500	2021-10-01	190
Number of retired or separated participants receiving benefits	2021-10-01	0
Number of other retired or separated participants entitled to future benefits	2021-10-01	0
Total of all active and inactive participants	2021-10-01	190
2020: FLEXIBLE SPENDING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-10-01	188
Total number of active participants reported on line 7a of the Form 5500	2020-10-01	234
Number of retired or separated participants receiving benefits	2020-10-01	0
Number of other retired or separated participants entitled to future benefits	2020-10-01	0
Total of all active and inactive participants	2020-10-01	234
2019: FLEXIBLE SPENDING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-10-01	146
Total number of active participants reported on line 7a of the Form 5500	2019-10-01	188
Number of retired or separated participants receiving benefits	2019-10-01	0
Number of other retired or separated participants entitled to future benefits	2019-10-01	0
Total of all active and inactive participants	2019-10-01	188
2018: FLEXIBLE SPENDING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-10-01	147
Total number of active participants reported on line 7a of the Form 5500	2018-10-01	146
Number of retired or separated participants receiving benefits	2018-10-01	0
Number of other retired or separated participants entitled to future benefits	2018-10-01	0
Total of all active and inactive participants	2018-10-01	146
2017: FLEXIBLE SPENDING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-10-01	145
Total number of active participants reported on line 7a of the Form 5500	2017-10-01	147
Number of retired or separated participants receiving benefits	2017-10-01	0
Number of other retired or separated participants entitled to future benefits	2017-10-01	0
Total of all active and inactive participants	2017-10-01	147
2016: FLEXIBLE SPENDING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-10-01	142
Total number of active participants reported on line 7a of the Form 5500	2016-10-01	145
Number of retired or separated participants receiving benefits	2016-10-01	0
Number of other retired or separated participants entitled to future benefits	2016-10-01	0
Total of all active and inactive participants	2016-10-01	145
2015: FLEXIBLE SPENDING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-10-01	141
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	142
Number of retired or separated participants receiving benefits	2015-10-01	0
Number of other retired or separated participants entitled to future benefits	2015-10-01	0
Total of all active and inactive participants	2015-10-01	142
2014: FLEXIBLE SPENDING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-10-01	131
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	141
Number of retired or separated participants receiving benefits	2014-10-01	0
Number of other retired or separated participants entitled to future benefits	2014-10-01	0
Total of all active and inactive participants	2014-10-01	141
2013: FLEXIBLE SPENDING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-10-01	131
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	131
Total of all active and inactive participants	2013-10-01	131
2012: FLEXIBLE SPENDING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-10-01	128
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	131
Total of all active and inactive participants	2012-10-01	131
2011: FLEXIBLE SPENDING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-10-01	135
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	128
Total of all active and inactive participants	2011-10-01	128
2009: FLEXIBLE SPENDING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-10-01	138
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	133
Total of all active and inactive participants	2009-10-01	133

Form 5500 Responses for FLEXIBLE SPENDING PLAN

2021: FLEXIBLE SPENDING PLAN 2021 form 5500 responses
2021-10-01	Type of plan entity	Single employer plan
2021-10-01	Plan funding arrangement – Insurance	Yes
2021-10-01	Plan benefit arrangement – Insurance	Yes
2020: FLEXIBLE SPENDING PLAN 2020 form 5500 responses
2020-10-01	Type of plan entity	Single employer plan
2020-10-01	Plan funding arrangement – Insurance	Yes
2020-10-01	Plan benefit arrangement – Insurance	Yes
2019: FLEXIBLE SPENDING PLAN 2019 form 5500 responses
2019-10-01	Type of plan entity	Single employer plan
2019-10-01	Plan funding arrangement – Insurance	Yes
2019-10-01	Plan benefit arrangement – Insurance	Yes
2018: FLEXIBLE SPENDING PLAN 2018 form 5500 responses
2018-10-01	Type of plan entity	Single employer plan
2018-10-01	Plan funding arrangement – Insurance	Yes
2018-10-01	Plan benefit arrangement – Insurance	Yes
2017: FLEXIBLE SPENDING PLAN 2017 form 5500 responses
2017-10-01	Type of plan entity	Single employer plan
2017-10-01	Plan funding arrangement – Insurance	Yes
2017-10-01	Plan benefit arrangement – Insurance	Yes
2016: FLEXIBLE SPENDING PLAN 2016 form 5500 responses
2016-10-01	Type of plan entity	Single employer plan
2016-10-01	Plan funding arrangement – Insurance	Yes
2016-10-01	Plan benefit arrangement – Insurance	Yes
2015: FLEXIBLE SPENDING PLAN 2015 form 5500 responses
2015-10-01	Type of plan entity	Single employer plan
2015-10-01	Plan funding arrangement – Insurance	Yes
2015-10-01	Plan benefit arrangement – Insurance	Yes
2014: FLEXIBLE SPENDING PLAN 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2013: FLEXIBLE SPENDING PLAN 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Plan funding arrangement – Insurance	Yes
2013-10-01	Plan benefit arrangement – Insurance	Yes
2012: FLEXIBLE SPENDING PLAN 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	Plan funding arrangement – Insurance	Yes
2012-10-01	Plan benefit arrangement – Insurance	Yes
2011: FLEXIBLE SPENDING PLAN 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	Plan funding arrangement – Insurance	Yes
2011-10-01	Plan benefit arrangement – Insurance	Yes
2009: FLEXIBLE SPENDING PLAN 2009 form 5500 responses
2009-10-01	Type of plan entity	Single employer plan
2009-10-01	Plan funding arrangement – Insurance	Yes
2009-10-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GVTL0C2FR

Policy instance

Insurance contract or identification number	GVTL0C2FR
Number of Individuals Covered	72
Insurance policy start date	2022-02-01
Insurance policy end date	2023-02-01
Total amount of commissions paid to insurance broker	USD $2,337
Total amount of fees paid to insurance company	USD $623
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,579
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,337
Additional information about fees paid to insurance broker	AGENT OR BROKER OF RECORD
Insurance broker organization code?	3
Amount paid for insurance broker fees	623

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

926784

Policy instance

Insurance contract or identification number	926784
Number of Individuals Covered	190
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $38,647
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $966,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $38,647
Additional information about fees paid to insurance broker	AGENT OR BROKER OF RECORD
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLTD0C2FR

Policy instance

Insurance contract or identification number	GLTD0C2FR
Number of Individuals Covered	173
Insurance policy start date	2022-02-01
Insurance policy end date	2023-02-01
Total amount of commissions paid to insurance broker	USD $4,369
Total amount of fees paid to insurance company	USD $1,165
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $29,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,369
Additional information about fees paid to insurance broker	AGENT OR BROKER OF RECORD
Insurance broker organization code?	3
Amount paid for insurance broker fees	1165

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

B3704

Policy instance

Insurance contract or identification number	B3704
Number of Individuals Covered	5
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $284
Other welfare benefits provided	OTHER -CANCER
Welfare Benefit Premiums Paid to Carrier	USD $2,193
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $73
Insurance broker organization code?	3

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E9151432

Policy instance

Insurance contract or identification number	E9151432
Number of Individuals Covered	1
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $22
Other welfare benefits provided	OTHER
Welfare Benefit Premiums Paid to Carrier	USD $639
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14
Additional information about fees paid to insurance broker	AGENT OR BROKER OF RECORD
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0C2FR

Policy instance

Insurance contract or identification number	GLUG0C2FR
Number of Individuals Covered	173
Insurance policy start date	2022-02-01
Insurance policy end date	2023-02-01
Total amount of commissions paid to insurance broker	USD $3,462
Total amount of fees paid to insurance company	USD $923
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $23,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,462
Additional information about fees paid to insurance broker	AGENT OR BROKER OF RECORD
Insurance broker organization code?	3
Amount paid for insurance broker fees	923

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUC0C2FR

Policy instance

Insurance contract or identification number	GUC0C2FR
Number of Individuals Covered	29
Insurance policy start date	2022-02-01
Insurance policy end date	2023-02-01
Total amount of commissions paid to insurance broker	USD $1,975
Total amount of fees paid to insurance company	USD $527
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,165
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,975
Additional information about fees paid to insurance broker	AGENT OR BROKER OF RECORD
Insurance broker organization code?	3
Amount paid for insurance broker fees	527

PHYSICIANS EYECARE PLAN (National Association of Insurance Commissioners NAIC id number: 15447 )

Policy contract number

00605

Policy instance

Insurance contract or identification number	00605
Number of Individuals Covered	111
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $1,217
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $12,167
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,217
Additional information about fees paid to insurance broker	AGENT OR BROKER OF RECORD
Insurance broker organization code?	3

BLUECHOICE HEALTHPLAN (National Association of Insurance Commissioners NAIC id number: 95741 )

Policy contract number

0661

Policy instance

Insurance contract or identification number	0661
Number of Individuals Covered	123
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
Total amount of commissions paid to insurance broker	USD $41,145
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $41,145
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

165289

Policy instance

Insurance contract or identification number	165289
Number of Individuals Covered	124
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
Total amount of commissions paid to insurance broker	USD $5,458
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,957
Insurance broker organization code?	3

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

B3704

Policy instance

Insurance contract or identification number	B3704
Number of Individuals Covered	5
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
Total amount of commissions paid to insurance broker	USD $220
Other welfare benefits provided	OTHER -CANCER
Welfare Benefit Premiums Paid to Carrier	USD $1,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $59
Insurance broker organization code?	3

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E9151432

Policy instance

Insurance contract or identification number	E9151432
Number of Individuals Covered	1
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
Total amount of commissions paid to insurance broker	USD $22
Other welfare benefits provided	OTHER
Welfare Benefit Premiums Paid to Carrier	USD $590
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	INSURANCE

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

165289

Policy instance

Insurance contract or identification number	165289
Number of Individuals Covered	234
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
Total amount of commissions paid to insurance broker	USD $5,325
Total amount of fees paid to insurance company	USD $38
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,833
Insurance broker organization code?	3
Amount paid for insurance broker fees	38
Additional information about fees paid to insurance broker	ADMINISTRATION

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

165289

Policy instance

Insurance contract or identification number	165289
Number of Individuals Covered	170
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
Total amount of commissions paid to insurance broker	USD $4,452
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,395
Insurance broker organization code?	3

PHYSICIANS EYECARE PLAN (National Association of Insurance Commissioners NAIC id number: 15447 )

Policy contract number

00605

Policy instance

Insurance contract or identification number	00605
Number of Individuals Covered	92
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
Total amount of commissions paid to insurance broker	USD $911
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,102
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $470
Insurance broker organization code?	3

PHYSICIANS EYECARE PLAN (National Association of Insurance Commissioners NAIC id number: 15447 )

Policy contract number

00605

Policy instance

Insurance contract or identification number	00605
Number of Individuals Covered	69
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $632
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,317
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $632
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

165289

Policy instance

Insurance contract or identification number	165289
Number of Individuals Covered	151
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $4,058
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,058
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

165289

Policy instance

Insurance contract or identification number	165289
Number of Individuals Covered	188
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $3,593
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,593
Insurance broker organization code?	3

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E9151432

Policy instance

Insurance contract or identification number	E9151432
Number of Individuals Covered	1
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $26
Other welfare benefits provided	OTHER
Welfare Benefit Premiums Paid to Carrier	USD $590
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $17
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	INSURANCE

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

B3704

Policy instance

Insurance contract or identification number	B3704
Number of Individuals Covered	6
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $374
Other welfare benefits provided	OTHER -CANCER
Welfare Benefit Premiums Paid to Carrier	USD $2,852
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $137
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

165289

Policy instance

Insurance contract or identification number	165289
Number of Individuals Covered	104
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $5,516
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,516
Insurance broker organization code?	3

BLUECHOICE HEALTHPLAN (National Association of Insurance Commissioners NAIC id number: 95741 )

Policy contract number

0661

Policy instance

Insurance contract or identification number	0661
Number of Individuals Covered	105
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $27,252
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $27,252
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

165289

Policy instance

Insurance contract or identification number	165289
Number of Individuals Covered	96
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $3,946
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,946
Insurance broker organization code?	3

BLUECHOICE HEALTHPLAN (National Association of Insurance Commissioners NAIC id number: 95741 )

Policy contract number

0661

Policy instance

Insurance contract or identification number	0661
Number of Individuals Covered	99
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $22,976
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,976
Insurance broker organization code?	3

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

B3704

Policy instance

Insurance contract or identification number	B3704
Number of Individuals Covered	8
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $433
Other welfare benefits provided	OTHER -CANCER
Welfare Benefit Premiums Paid to Carrier	USD $3,308
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $184
Insurance broker organization code?	3

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E9151432

Policy instance

Insurance contract or identification number	E9151432
Number of Individuals Covered	1
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $26
Other welfare benefits provided	OTHER
Welfare Benefit Premiums Paid to Carrier	USD $590
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	INSURANCE

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

165289

Policy instance

Insurance contract or identification number	165289
Number of Individuals Covered	146
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $2,549
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,549
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

165289

Policy instance

Insurance contract or identification number	165289
Number of Individuals Covered	146
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $3,393
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,393
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

000000702842

Policy instance

Insurance contract or identification number	000000702842
Number of Individuals Covered	147
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $4,069
Welfare Benefit Premiums Paid to Carrier	USD $37,766
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E9151432

Policy instance

Insurance contract or identification number	E9151432
Number of Individuals Covered	1
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $40
Other welfare benefits provided	OTHER
Welfare Benefit Premiums Paid to Carrier	USD $590
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

B3704

Policy instance

Insurance contract or identification number	B3704
Number of Individuals Covered	9
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $445
Other welfare benefits provided	OTHER -CANCER
Welfare Benefit Premiums Paid to Carrier	USD $3,507
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5487603

Policy instance

Insurance contract or identification number	5487603
Number of Individuals Covered	98
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $4,505
Total amount of fees paid to insurance company	USD $2,825
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $45,086
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUECHOICE HEALTHPLAN (National Association of Insurance Commissioners NAIC id number: 95741 )

Policy contract number

0661

Policy instance

Insurance contract or identification number	0661
Number of Individuals Covered	103
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $17,317
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	FIRST PALMETTO BANK
Employer identification number (EIN):	570921408
NAIC Classification:	522120
NAIC Description:	Savings Institutions