401k Plan data: OXFORD BANK & TRUST HEALTH INSURANCE PLAN plan

OXFORD BANK & TRUST HEALTH INSURANCE PLAN 401k Plan overview

Plan Name	OXFORD BANK & TRUST HEALTH INSURANCE PLAN
Plan identification number	503

OXFORD BANK & TRUST HEALTH INSURANCE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

OXFORD BANK & TRUST has sponsored the creation of one or more 401k plans.

Company Name: OXFORD BANK & TRUST

Employer identification number (EIN): 360706170

NAIC Classification: 522110
NAIC Description: Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OXFORD BANK & TRUST HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2012-08-01 DEBORAH DICOLA
503 2011-08-01 DEBORA DICOLA
503 2009-08-01 DEBORA DICOLA
503 2008-08-01 DEBORA DICOLA

Plan id#	Filing Submission Date	Name of Administrator
503	2012-08-01	DEBORAH DICOLA
503	2011-08-01	DEBORA DICOLA
503	2009-08-01	DEBORA DICOLA
503	2008-08-01	DEBORA DICOLA

Plan Statistics for OXFORD BANK & TRUST HEALTH INSURANCE PLAN

401k plan membership statisitcs for OXFORD BANK & TRUST HEALTH INSURANCE PLAN

Measure Date Value
2012: OXFORD BANK & TRUST HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-08-01 86
Total number of active participants reported on line 7a of the Form 5500 2012-08-01 82
Number of retired or separated participants receiving benefits 2012-08-01 1
Number of other retired or separated participants entitled to future benefits 2012-08-01 0
Total of all active and inactive participants 2012-08-01 83
2011: OXFORD BANK & TRUST HEALTH INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-08-01 91
Total number of active participants reported on line 7a of the Form 5500 2011-08-01 85
Number of retired or separated participants receiving benefits 2011-08-01 1
Number of other retired or separated participants entitled to future benefits 2011-08-01 0
Total of all active and inactive participants 2011-08-01 86
2009: OXFORD BANK & TRUST HEALTH INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-08-01 102
Total number of active participants reported on line 7a of the Form 5500 2009-08-01 95
Number of retired or separated participants receiving benefits 2009-08-01 1
Number of other retired or separated participants entitled to future benefits 2009-08-01 0
Total of all active and inactive participants 2009-08-01 96
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-08-01 0
Total participants 2009-08-01 96
2008: OXFORD BANK & TRUST HEALTH INSURANCE PLAN 2008 401k membership
Total participants, beginning-of-year 2008-08-01 112
Total number of active participants reported on line 7a of the Form 5500 2008-08-01 101
Number of retired or separated participants receiving benefits 2008-08-01 1
Number of other retired or separated participants entitled to future benefits 2008-08-01 0
Total of all active and inactive participants 2008-08-01 102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2008-08-01 0
Total participants 2008-08-01 102
Number of participants with account balances 2008-08-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2008-08-01 0

Measure	Date	Value
2012: OXFORD BANK & TRUST HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-08-01	86
Total number of active participants reported on line 7a of the Form 5500	2012-08-01	82
Number of retired or separated participants receiving benefits	2012-08-01	1
Number of other retired or separated participants entitled to future benefits	2012-08-01	0
Total of all active and inactive participants	2012-08-01	83
2011: OXFORD BANK & TRUST HEALTH INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-08-01	91
Total number of active participants reported on line 7a of the Form 5500	2011-08-01	85
Number of retired or separated participants receiving benefits	2011-08-01	1
Number of other retired or separated participants entitled to future benefits	2011-08-01	0
Total of all active and inactive participants	2011-08-01	86
2009: OXFORD BANK & TRUST HEALTH INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-08-01	102
Total number of active participants reported on line 7a of the Form 5500	2009-08-01	95
Number of retired or separated participants receiving benefits	2009-08-01	1
Number of other retired or separated participants entitled to future benefits	2009-08-01	0
Total of all active and inactive participants	2009-08-01	96
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-08-01	0
Total participants	2009-08-01	96
2008: OXFORD BANK & TRUST HEALTH INSURANCE PLAN 2008 401k membership
Total participants, beginning-of-year	2008-08-01	112
Total number of active participants reported on line 7a of the Form 5500	2008-08-01	101
Number of retired or separated participants receiving benefits	2008-08-01	1
Number of other retired or separated participants entitled to future benefits	2008-08-01	0
Total of all active and inactive participants	2008-08-01	102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2008-08-01	0
Total participants	2008-08-01	102
Number of participants with account balances	2008-08-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2008-08-01	0

Financial Data on OXFORD BANK & TRUST HEALTH INSURANCE PLAN

Measure	Date	Value
2011 : OXFORD BANK & TRUST HEALTH INSURANCE PLAN 2011 401k financial data
Total income from all sources	2011-07-31	$852,938
Expenses. Total of all expenses incurred	2011-07-31	$852,938
Value of fidelity bond covering the plan	2011-07-31	$5,000,000
Total contributions received or receivable from participants	2011-07-31	$341,804
Expenses. Other expenses not covered elsewhere	2011-07-31	$852,938
Net income (gross income less expenses)	2011-07-31	$0
Total contributions received or receivable from employer(s)	2011-07-31	$511,134

Form 5500 Responses for OXFORD BANK & TRUST HEALTH INSURANCE PLAN

2012: OXFORD BANK & TRUST HEALTH INSURANCE PLAN 2012 form 5500 responses
2012-08-01	Type of plan entity	Single employer plan
2012-08-01	Submission has been amended	No
2012-08-01	This submission is the final filing	No
2012-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-08-01	Plan is a collectively bargained plan	No
2012-08-01	Plan funding arrangement – Insurance	Yes
2012-08-01	Plan benefit arrangement – Insurance	Yes
2011: OXFORD BANK & TRUST HEALTH INSURANCE PLAN 2011 form 5500 responses
2011-08-01	Type of plan entity	Single employer plan
2011-08-01	Submission has been amended	No
2011-08-01	This submission is the final filing	No
2011-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-08-01	Plan is a collectively bargained plan	No
2011-08-01	Plan funding arrangement – Insurance	Yes
2011-08-01	Plan benefit arrangement – Insurance	Yes
2009: OXFORD BANK & TRUST HEALTH INSURANCE PLAN 2009 form 5500 responses
2009-08-01	Type of plan entity	Single employer plan
2009-08-01	Submission has been amended	No
2009-08-01	This submission is the final filing	No
2009-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-08-01	Plan is a collectively bargained plan	No
2009-08-01	Plan funding arrangement – Insurance	Yes
2009-08-01	Plan benefit arrangement – Insurance	Yes
2008: OXFORD BANK & TRUST HEALTH INSURANCE PLAN 2008 form 5500 responses
2008-08-01	Type of plan entity	Single employer plan
2008-08-01	Submission has been amended	No
2008-08-01	This submission is the final filing	No
2008-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-08-01	Plan is a collectively bargained plan	No
2008-08-01	Plan funding arrangement – Insurance	Yes
2008-08-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	OXFORD BANK & TRUST
Employer identification number (EIN):	360706170
NAIC Classification:	522110
NAIC Description:	Commercial Banking