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TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 401k Plan overview

Plan NameTRI CITY BANKSHARES CORPORATION CAFETERIA PLAN
Plan identification number 501

TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN Benefits

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

401k Sponsoring company profile

TRI CITY BANKSHARES CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:TRI CITY BANKSHARES CORPORATION
Employer identification number (EIN):391158740
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01SUSAN LEMKE SUSAN LEMKE2019-07-24
5012017-01-01SUSAN LEMKE SUSAN LEMKE2018-07-30
5012016-01-01JO ANNE MEYER JO ANNE MEYER2017-07-31
5012015-01-01JO ANNE MEYER JO ANNE MEYER2016-07-29
5012014-01-01JO ANNE MEYER JO ANNE MEYER2015-07-28
5012013-01-01JO ANNE MEYER JO ANNE MEYER2014-07-30
5012012-01-01GEORGE MIKOLAJCZAK
5012011-01-01GEORGE MIKOLAJCZAK
5012010-01-01GEORGE MIKOLAJCZAK
5012009-01-01GEORGE MIKOLAJCZAK

Plan Statistics for TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN

401k plan membership statisitcs for TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN

Measure Date Value
2023: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01229
Total number of active participants reported on line 7a of the Form 55002023-01-01248
Number of retired or separated participants receiving benefits2023-01-014
Total of all active and inactive participants2023-01-01252
Total participants2023-01-01252
2022: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01259
Total number of active participants reported on line 7a of the Form 55002022-01-01251
Number of retired or separated participants receiving benefits2022-01-015
Total of all active and inactive participants2022-01-01256
Total participants2022-01-01256
2021: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01285
Total number of active participants reported on line 7a of the Form 55002021-01-01257
Number of retired or separated participants receiving benefits2021-01-019
Total of all active and inactive participants2021-01-01266
Total participants2021-01-01266
2020: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01292
Total number of active participants reported on line 7a of the Form 55002020-01-01286
Number of retired or separated participants receiving benefits2020-01-019
Total of all active and inactive participants2020-01-01295
Total participants2020-01-01295
2019: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01267
Total number of active participants reported on line 7a of the Form 55002019-01-01285
Number of retired or separated participants receiving benefits2019-01-017
Total of all active and inactive participants2019-01-01292
Total participants2019-01-01292
2018: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01269
Total number of active participants reported on line 7a of the Form 55002018-01-01267
Number of retired or separated participants receiving benefits2018-01-010
Total of all active and inactive participants2018-01-01267
Total participants2018-01-01267
2017: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01287
Total number of active participants reported on line 7a of the Form 55002017-01-01293
Number of retired or separated participants receiving benefits2017-01-014
Total of all active and inactive participants2017-01-01297
Total participants2017-01-01297
2016: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01301
Total number of active participants reported on line 7a of the Form 55002016-01-01295
Number of retired or separated participants receiving benefits2016-01-017
Total of all active and inactive participants2016-01-01302
Total participants2016-01-01302
2015: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01297
Total number of active participants reported on line 7a of the Form 55002015-01-01299
Number of retired or separated participants receiving benefits2015-01-012
Total of all active and inactive participants2015-01-01301
Total participants2015-01-01301
2014: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01297
Total number of active participants reported on line 7a of the Form 55002014-01-01307
Number of retired or separated participants receiving benefits2014-01-012
Total of all active and inactive participants2014-01-01309
Total participants2014-01-01309
2013: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01366
Total number of active participants reported on line 7a of the Form 55002013-01-01360
Number of retired or separated participants receiving benefits2013-01-013
Total of all active and inactive participants2013-01-01363
Total participants2013-01-01363
2012: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01371
Total number of active participants reported on line 7a of the Form 55002012-01-01366
Total of all active and inactive participants2012-01-01366
Total participants2012-01-01366
2011: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01376
Total number of active participants reported on line 7a of the Form 55002011-01-01371
Total of all active and inactive participants2011-01-01371
Total participants2011-01-01371
2010: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01312
Total number of active participants reported on line 7a of the Form 55002010-01-01376
Total of all active and inactive participants2010-01-01376
Total participants2010-01-01376
2009: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01232
Total number of active participants reported on line 7a of the Form 55002009-01-01312
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01312
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01312

Form 5500 Responses for TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN

2023: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: TRI CITY BANKSHARES CORPORATION CAFETERIA 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 – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01First time form 5500 has been submittedYes
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 – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: TRI CITY BANKSHARES CORPORATION CAFETERIA 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 – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: TRI CITY BANKSHARES CORPORATION CAFETERIA 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 – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: TRI CITY BANKSHARES CORPORATION CAFETERIA 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 – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: TRI CITY BANKSHARES CORPORATION CAFETERIA 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 – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: TRI CITY BANKSHARES CORPORATION CAFETERIA 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 – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: TRI CITY BANKSHARES CORPORATION CAFETERIA 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 – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: TRI CITY BANKSHARES CORPORATION CAFETERIA PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract numberW81224
Policy instance 2
Insurance contract or identification numberW81224
Number of Individuals Covered83
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of fees paid to insurance companyUSD $7,523
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $7,523
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPCARE HEALTH SERVICES INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95693 )
Policy contract numberW81224
Policy instance 3
Insurance contract or identification numberW81224
Number of Individuals Covered83
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of fees paid to insurance companyUSD $34,230
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
Welfare Benefit Premiums Paid to CarrierUSD $34,230
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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