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FIRST NATIONAL BANK OF WATERLOO MEDICAL PLAN 401k Plan overview

Plan NameFIRST NATIONAL BANK OF WATERLOO MEDICAL PLAN
Plan identification number 501

FIRST NATIONAL BANK OF WATERLOO MEDICAL PLAN Benefits

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

FIRST NATIONAL BANK OF WATERLOO has sponsored the creation of one or more 401k plans.

Company Name:FIRST NATIONAL BANK OF WATERLOO
Employer identification number (EIN):370573575
NAIC Classification:522120
NAIC Description:Savings Institutions

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIRST NATIONAL BANK OF WATERLOO MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01DEANNA ROESSLER2024-07-01
5012022-01-01DEANNA ROESSLER2023-05-10
5012021-01-01DEANNA ROESSLER2022-08-22

Plan Statistics for FIRST NATIONAL BANK OF WATERLOO MEDICAL PLAN

401k plan membership statisitcs for FIRST NATIONAL BANK OF WATERLOO MEDICAL PLAN

Measure Date Value
2023: FIRST NATIONAL BANK OF WATERLOO MEDICAL PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01106
Total number of active participants reported on line 7a of the Form 55002023-01-0185
Number of retired or separated participants receiving benefits2023-01-011
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-0186
Number of employers contributing to the scheme2023-01-010
2022: FIRST NATIONAL BANK OF WATERLOO MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01106
Total number of active participants reported on line 7a of the Form 55002022-01-01106
Number of retired or separated participants receiving benefits2022-01-015
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01111
Number of employers contributing to the scheme2022-01-010
2021: FIRST NATIONAL BANK OF WATERLOO MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01105
Total number of active participants reported on line 7a of the Form 55002021-01-01106
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01106
Number of employers contributing to the scheme2021-01-010

Form 5500 Responses for FIRST NATIONAL BANK OF WATERLOO MEDICAL PLAN

2023: FIRST NATIONAL BANK OF WATERLOO MEDICAL PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: FIRST NATIONAL BANK OF WATERLOO MEDICAL PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: FIRST NATIONAL BANK OF WATERLOO MEDICAL PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01First time form 5500 has been submittedYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 )
Policy contract number175959
Policy instance 1
Insurance contract or identification number175959
Number of Individuals Covered177
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $48,999
Total amount of fees paid to insurance companyUSD $134
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,506,724
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 )
Policy contract number175959
Policy instance 1
Insurance contract or identification number175959
Number of Individuals Covered239
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $46,630
Total amount of fees paid to insurance companyUSD $5,000
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,694,507
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,630
Amount paid for insurance broker fees5000
Additional information about fees paid to insurance broker2022 Q1 GROW WITH US NEW BUSINESS INCENTIVE RISK
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number920335
Policy instance 1
Insurance contract or identification number920335
Number of Individuals Covered251
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 $48,395
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,491,842
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees44755
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3

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