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THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 401k Plan overview

Plan NameTHE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST
Plan identification number 502

THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Other welfare benefit cover

401k Sponsoring company profile

THE FIRST NATIONAL BANK AND TRUST COMPANY has sponsored the creation of one or more 401k plans.

Company Name:THE FIRST NATIONAL BANK AND TRUST COMPANY
Employer identification number (EIN):730241540
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022023-01-01
5022022-01-01
5022021-01-01
5022020-01-01
5022019-01-01
5022018-01-01
5022017-01-01ROB KIMBROUGH ROB KIMBROUGH2018-10-08
5022016-01-01ROB KIMBROUGH ROB KIMBROUGH2017-10-04
5022016-01-01 ROB KIMBROUGH2017-10-04
5022015-01-01ROB KIMBROUGH ROB KIMBROUGH2016-10-12
5022014-01-01
5022013-01-01
5022012-01-01JARED SCOTT
5022011-01-01ROB KIMBROUGH
5022009-01-01TODD PEFFERMAN
5022009-01-01TODD PEFFERMAN

Plan Statistics for THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST

401k plan membership statisitcs for THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST

Measure Date Value
2023: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2023 401k membership
Total participants, beginning-of-year2023-01-0134
Total number of active participants reported on line 7a of the Form 55002023-01-0135
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-0135
2022: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2022 401k membership
Total participants, beginning-of-year2022-01-0133
Total number of active participants reported on line 7a of the Form 55002022-01-0134
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0134
2021: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2021 401k membership
Total participants, beginning-of-year2021-01-0133
Total number of active participants reported on line 7a of the Form 55002021-01-0132
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 participants2021-01-0132
2020: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2020 401k membership
Total participants, beginning-of-year2020-01-0132
Total number of active participants reported on line 7a of the Form 55002020-01-0134
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0134
2019: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2019 401k membership
Total participants, beginning-of-year2019-01-0126
Total number of active participants reported on line 7a of the Form 55002019-01-0132
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0132
2018: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2018 401k membership
Total participants, beginning-of-year2018-01-0130
Total number of active participants reported on line 7a of the Form 55002018-01-0129
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0129
2017: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2017 401k membership
Total participants, beginning-of-year2017-01-0132
Total number of active participants reported on line 7a of the Form 55002017-01-0130
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0130
2016: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2016 401k membership
Total participants, beginning-of-year2016-01-0133
Total number of active participants reported on line 7a of the Form 55002016-01-0132
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0132
2015: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2015 401k membership
Total participants, beginning-of-year2015-01-0135
Total number of active participants reported on line 7a of the Form 55002015-01-0131
Number of retired or separated participants receiving benefits2015-01-011
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-0132
2014: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2014 401k membership
Total participants, beginning-of-year2014-01-0135
Total number of active participants reported on line 7a of the Form 55002014-01-0135
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0135
2013: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2013 401k membership
Total participants, beginning-of-year2013-01-0138
Total number of active participants reported on line 7a of the Form 55002013-01-0137
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-0137
2012: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-0136
Total number of active participants reported on line 7a of the Form 55002012-01-0138
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-0138
2011: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-0137
Total number of active participants reported on line 7a of the Form 55002011-01-0136
Total of all active and inactive participants2011-01-0136
Total participants2011-01-0136
2009: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-0137
Total number of active participants reported on line 7a of the Form 55002009-01-0138
Total of all active and inactive participants2009-01-0138
Total participants2009-01-0138

Financial Data on THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST

Measure Date Value
2023 : THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2023 401k financial data
Total plan liabilities at beginning of year2023-12-31$36,790
Total income from all sources2023-12-31$476,543
Expenses. Total of all expenses incurred2023-12-31$375,690
Benefits paid (including direct rollovers)2023-12-31$367,593
Total plan assets at end of year2023-12-31$64,063
Value of fidelity bond covering the plan2023-12-31$4,000,000
Total contributions received or receivable from participants2023-12-31$18,600
Expenses. Other expenses not covered elsewhere2023-12-31$30
Other income received2023-12-31$6,112
Net income (gross income less expenses)2023-12-31$100,853
Net plan assets at end of year (total assets less liabilities)2023-12-31$64,063
Net plan assets at beginning of year (total assets less liabilities)2023-12-31$-36,790
Total contributions received or receivable from employer(s)2023-12-31$451,831
Expenses. Administrative service providers (salaries,fees and commissions)2023-12-31$8,067
2022 : THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2022 401k financial data
Total plan liabilities at end of year2022-12-31$36,790
Total plan liabilities at beginning of year2022-12-31$7,030
Total income from all sources2022-12-31$460,673
Expenses. Total of all expenses incurred2022-12-31$490,433
Benefits paid (including direct rollovers)2022-12-31$482,222
Value of fidelity bond covering the plan2022-12-31$4,000,000
Total contributions received or receivable from participants2022-12-31$18,360
Expenses. Other expenses not covered elsewhere2022-12-31$66
Other income received2022-12-31$4,787
Net income (gross income less expenses)2022-12-31$-29,760
Net plan assets at end of year (total assets less liabilities)2022-12-31$-36,790
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$-7,030
Total contributions received or receivable from employer(s)2022-12-31$437,526
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$8,145
2021 : THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2021 401k financial data
Total plan liabilities at end of year2021-12-31$7,030
Total income from all sources2021-12-31$356,438
Expenses. Total of all expenses incurred2021-12-31$485,136
Benefits paid (including direct rollovers)2021-12-31$477,076
Total plan assets at beginning of year2021-12-31$121,668
Value of fidelity bond covering the plan2021-12-31$4,000,000
Total contributions received or receivable from participants2021-12-31$18,540
Expenses. Other expenses not covered elsewhere2021-12-31$48
Other income received2021-12-31$3,921
Net income (gross income less expenses)2021-12-31$-128,698
Net plan assets at end of year (total assets less liabilities)2021-12-31$-7,030
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$121,668
Total contributions received or receivable from employer(s)2021-12-31$333,977
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$8,012
2020 : THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2020 401k financial data
Total income from all sources2020-12-31$342,910
Expenses. Total of all expenses incurred2020-12-31$349,350
Benefits paid (including direct rollovers)2020-12-31$340,973
Total plan assets at end of year2020-12-31$121,668
Total plan assets at beginning of year2020-12-31$128,108
Value of fidelity bond covering the plan2020-12-31$4,000,000
Total contributions received or receivable from participants2020-12-31$23,700
Expenses. Other expenses not covered elsewhere2020-12-31$30
Other income received2020-12-31$12,636
Net income (gross income less expenses)2020-12-31$-6,440
Net plan assets at end of year (total assets less liabilities)2020-12-31$121,668
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$128,108
Total contributions received or receivable from employer(s)2020-12-31$306,574
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$8,347
2019 : THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2019 401k financial data
Total income from all sources2019-12-31$377,702
Expenses. Total of all expenses incurred2019-12-31$424,613
Benefits paid (including direct rollovers)2019-12-31$417,023
Total plan assets at end of year2019-12-31$128,108
Total plan assets at beginning of year2019-12-31$175,019
Value of fidelity bond covering the plan2019-12-31$4,000,000
Total contributions received or receivable from participants2019-12-31$21,000
Expenses. Other expenses not covered elsewhere2019-12-31$71
Other income received2019-12-31$6,833
Net income (gross income less expenses)2019-12-31$-46,911
Net plan assets at end of year (total assets less liabilities)2019-12-31$128,108
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$175,019
Total contributions received or receivable from employer(s)2019-12-31$349,869
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$7,519
2018 : THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2018 401k financial data
Total income from all sources2018-12-31$518,345
Expenses. Total of all expenses incurred2018-12-31$412,600
Benefits paid (including direct rollovers)2018-12-31$404,852
Total plan assets at end of year2018-12-31$175,019
Total plan assets at beginning of year2018-12-31$69,274
Value of fidelity bond covering the plan2018-12-31$4,000,000
Total contributions received or receivable from participants2018-12-31$26,220
Expenses. Other expenses not covered elsewhere2018-12-31$42
Other income received2018-12-31$30,685
Net income (gross income less expenses)2018-12-31$105,745
Net plan assets at end of year (total assets less liabilities)2018-12-31$175,019
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$69,274
Total contributions received or receivable from employer(s)2018-12-31$461,440
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$7,706
2017 : THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2017 401k financial data
Total income from all sources2017-12-31$973,525
Expenses. Total of all expenses incurred2017-12-31$914,391
Benefits paid (including direct rollovers)2017-12-31$906,586
Total plan assets at end of year2017-12-31$69,274
Total plan assets at beginning of year2017-12-31$10,140
Value of fidelity bond covering the plan2017-12-31$4,000,000
Total contributions received or receivable from participants2017-12-31$29,760
Expenses. Other expenses not covered elsewhere2017-12-31$60
Other income received2017-12-31$2,794
Net income (gross income less expenses)2017-12-31$59,134
Net plan assets at end of year (total assets less liabilities)2017-12-31$69,274
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$10,140
Total contributions received or receivable from employer(s)2017-12-31$940,971
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$7,745
2016 : THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2016 401k financial data
Total income from all sources2016-12-31$504,140
Expenses. Total of all expenses incurred2016-12-31$503,209
Benefits paid (including direct rollovers)2016-12-31$494,597
Total plan assets at end of year2016-12-31$10,140
Total plan assets at beginning of year2016-12-31$9,209
Value of fidelity bond covering the plan2016-12-31$4,000,000
Total contributions received or receivable from participants2016-12-31$35,240
Other income received2016-12-31$5,176
Net income (gross income less expenses)2016-12-31$931
Net plan assets at end of year (total assets less liabilities)2016-12-31$10,140
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$9,209
Total contributions received or receivable from employer(s)2016-12-31$463,724
Value of corrective distributions2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$8,612
2015 : THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2015 401k financial data
Total income from all sources2015-12-31$448,578
Expenses. Total of all expenses incurred2015-12-31$510,925
Benefits paid (including direct rollovers)2015-12-31$502,592
Total plan assets at end of year2015-12-31$9,209
Total plan assets at beginning of year2015-12-31$71,556
Value of fidelity bond covering the plan2015-12-31$4,000,000
Total contributions received or receivable from participants2015-12-31$31,260
Other income received2015-12-31$32,794
Net income (gross income less expenses)2015-12-31$-62,347
Net plan assets at end of year (total assets less liabilities)2015-12-31$9,209
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$71,556
Total contributions received or receivable from employer(s)2015-12-31$384,524
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$8,333
2014 : THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2014 401k financial data
Total income from all sources2014-12-31$376,011
Expenses. Total of all expenses incurred2014-12-31$464,233
Benefits paid (including direct rollovers)2014-12-31$455,606
Total plan assets at end of year2014-12-31$71,556
Total plan assets at beginning of year2014-12-31$159,778
Value of fidelity bond covering the plan2014-12-31$4,000,000
Total contributions received or receivable from participants2014-12-31$33,120
Expenses. Other expenses not covered elsewhere2014-12-31$76
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$52,972
Net income (gross income less expenses)2014-12-31$-88,222
Net plan assets at end of year (total assets less liabilities)2014-12-31$71,556
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$159,778
Total contributions received or receivable from employer(s)2014-12-31$289,919
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$8,551
2013 : THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2013 401k financial data
Total income from all sources2013-12-31$367,381
Expenses. Total of all expenses incurred2013-12-31$342,174
Benefits paid (including direct rollovers)2013-12-31$333,590
Total plan assets at end of year2013-12-31$159,778
Total plan assets at beginning of year2013-12-31$134,571
Value of fidelity bond covering the plan2013-12-31$4,000,000
Total contributions received or receivable from participants2013-12-31$28,140
Expenses. Other expenses not covered elsewhere2013-12-31$8,584
Other income received2013-12-31$8,357
Net income (gross income less expenses)2013-12-31$25,207
Net plan assets at end of year (total assets less liabilities)2013-12-31$159,778
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$134,571
Total contributions received or receivable from employer(s)2013-12-31$330,884
2012 : THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2012 401k financial data
Total income from all sources2012-12-31$417,138
Expenses. Total of all expenses incurred2012-12-31$324,883
Benefits paid (including direct rollovers)2012-12-31$315,900
Total plan assets at end of year2012-12-31$134,571
Total plan assets at beginning of year2012-12-31$42,316
Value of fidelity bond covering the plan2012-12-31$4,000,000
Total contributions received or receivable from participants2012-12-31$26,100
Expenses. Other expenses not covered elsewhere2012-12-31$8,983
Other income received2012-12-31$55,407
Net income (gross income less expenses)2012-12-31$92,255
Net plan assets at end of year (total assets less liabilities)2012-12-31$134,571
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$42,316
Total contributions received or receivable from employer(s)2012-12-31$335,631
2011 : THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2011 401k financial data
Total income from all sources2011-12-31$356,129
Expenses. Total of all expenses incurred2011-12-31$360,135
Benefits paid (including direct rollovers)2011-12-31$351,655
Total plan assets at end of year2011-12-31$42,316
Total plan assets at beginning of year2011-12-31$46,322
Value of fidelity bond covering the plan2011-12-31$4,000,000
Total contributions received or receivable from participants2011-12-31$25,200
Expenses. Other expenses not covered elsewhere2011-12-31$8,480
Contributions received from other sources (not participants or employers)2011-12-31$0
Net income (gross income less expenses)2011-12-31$-4,006
Net plan assets at end of year (total assets less liabilities)2011-12-31$42,316
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$46,322
Total contributions received or receivable from employer(s)2011-12-31$330,929
2010 : THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2010 401k financial data
Total plan liabilities at beginning of year2010-12-31$1,235
Total income from all sources2010-12-31$411,279
Expenses. Total of all expenses incurred2010-12-31$363,722
Benefits paid (including direct rollovers)2010-12-31$355,089
Total plan assets at end of year2010-12-31$46,322
Total plan assets at beginning of year2010-12-31$0
Value of fidelity bond covering the plan2010-12-31$4,000,000
Total contributions received or receivable from participants2010-12-31$25,140
Expenses. Other expenses not covered elsewhere2010-12-31$8,633
Contributions received from other sources (not participants or employers)2010-12-31$57,390
Net income (gross income less expenses)2010-12-31$47,557
Net plan assets at end of year (total assets less liabilities)2010-12-31$46,322
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$-1,235
Total contributions received or receivable from employer(s)2010-12-31$328,749

Form 5500 Responses for THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST

2023: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 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 – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 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 – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
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 – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 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 – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 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: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 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: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 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 – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedYes
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: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 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 – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 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 – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 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 – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 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 – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: THE FIRST NATIONAL BANK AND TRUST COMPANY OF MIAMI EMPLOYEES BENEFICIARY ASSOCIATION TRUST 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BVYY
Policy instance 2
Insurance contract or identification numberGLUG0BVYY
Number of Individuals Covered35
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $162
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedA D & D
Welfare Benefit Premiums Paid to CarrierUSD $1,552
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberSL20000019-221
Policy instance 1
Insurance contract or identification numberSL20000019-221
Number of Individuals Covered33
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $13,581
Total amount of fees paid to insurance companyUSD $8,067
Welfare Benefit Premiums Paid to CarrierUSD $135,812
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BVYY
Policy instance 2
Insurance contract or identification numberGLUG0BVYY
Number of Individuals Covered34
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $153
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedA D & D
Welfare Benefit Premiums Paid to CarrierUSD $1,568
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $153
Insurance broker organization code?3
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberSL20000019-221
Policy instance 1
Insurance contract or identification numberSL20000019-221
Number of Individuals Covered34
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $13,117
Total amount of fees paid to insurance companyUSD $8,145
Welfare Benefit Premiums Paid to CarrierUSD $131,173
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,117
Amount paid for insurance broker fees6628
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BVYY
Policy instance 1
Insurance contract or identification numberGLUG0BVYY
Number of Individuals Covered30
Insurance policy start date2021-04-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $115
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedA D & D
Welfare Benefit Premiums Paid to CarrierUSD $1,146
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $115
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number234515
Policy instance 2
Insurance contract or identification number234515
Number of Individuals Covered34
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $26
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedA D & D
Welfare Benefit Premiums Paid to CarrierUSD $214
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13
Insurance broker organization code?3
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberSL20000019-211
Policy instance 3
Insurance contract or identification numberSL20000019-211
Number of Individuals Covered32
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $12,044
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $132,907
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,044
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number234515
Policy instance 2
Insurance contract or identification number234515
Number of Individuals Covered34
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $209
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,532
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $209
Insurance broker organization code?3
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberSL20000019-191
Policy instance 1
Insurance contract or identification numberSL20000019-191
Number of Individuals Covered61
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $14,018
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $126,167
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,018
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number234515
Policy instance 2
Insurance contract or identification number234515
Number of Individuals Covered32
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $162
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,090
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $162
Insurance broker organization code?3
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberSL20000019-171
Policy instance 1
Insurance contract or identification numberSL20000019-171
Number of Individuals Covered33
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $12,210
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $109,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,210
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number234515
Policy instance 2
Insurance contract or identification number234515
Number of Individuals Covered142
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $142
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $142
Insurance broker organization code?3
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberSL20000019-171
Policy instance 1
Insurance contract or identification numberSL20000019-171
Number of Individuals Covered29
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $11,868
Total amount of fees paid to insurance companyUSD $7,706
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $106,802
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,868
Amount paid for insurance broker fees6394
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES UTILIZATION REVIEW FEES
Insurance broker organization code?5
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberSL20000019-141
Policy instance 2
Insurance contract or identification numberSL20000019-141
Number of Individuals Covered30
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Total amount of commissions paid to insurance brokerUSD $17,813
Total amount of fees paid to insurance companyUSD $9,746
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $101,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,813
Amount paid for insurance broker fees8445
Additional information about fees paid to insurance brokerADMINISTRATIVE AND UTILIZATION REVIEW FEES
Insurance broker organization code?5
Insurance broker namePREFERRED COMMUNITY CHOICE
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number234515
Policy instance 1
Insurance contract or identification number234515
Number of Individuals Covered30
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $155
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,142
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $155
Insurance broker organization code?3
Insurance broker nameBENEFIT MANAGEMENT, INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number234515
Policy instance 1
Insurance contract or identification number234515
Number of Individuals Covered31
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $183
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,225
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $183
Insurance broker organization code?3
Insurance broker nameBENEFIT MANAGEMENT, INC
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10120 )
Policy contract numberSL20000019-141
Policy instance 2
Insurance contract or identification numberSL20000019-141
Number of Individuals Covered31
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $18,264
Total amount of fees paid to insurance companyUSD $8,551
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $104,293
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,305
Amount paid for insurance broker fees7156
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES AND UTILIZATION REVIEW FEES
Insurance broker organization code?5
Insurance broker namePREFERRED COMMUNITY CHOICE
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberSL20000019-111
Policy instance 1
Insurance contract or identification numberSL20000019-111
Number of Individuals Covered35
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $17,060
Total amount of fees paid to insurance companyUSD $8,547
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $99,585
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,157
Amount paid for insurance broker fees7174
Additional information about fees paid to insurance brokerUTILIZATION REVIEW FEES ADMINISTRATIVE FEES
Insurance broker organization code?5
Insurance broker namePREFERRED COMMUNITY CHOICE
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF006740-0001
Policy instance 2
Insurance contract or identification numberF006740-0001
Number of Individuals Covered35
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $225
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,252
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $225
Insurance broker organization code?3
Insurance broker nameBENEFIT MANAGEMENT, INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF006740-0001
Policy instance 1
Insurance contract or identification numberF006740-0001
Number of Individuals Covered37
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $237
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 BenefitYes
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 $2,130
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $237
Insurance broker organization code?3
Insurance broker nameBENEFIT MANAGEMENT, INC
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberSL20000019-111
Policy instance 2
Insurance contract or identification numberSL20000019-111
Number of Individuals Covered37
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $13,105
Total amount of fees paid to insurance companyUSD $8,942
Are there contracts with allocated funds for individual policies?No
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 BenefitYes
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 $105,716
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,193
Amount paid for insurance broker fees7527
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES UTILIZATION REVIEW FEES
Insurance broker organization code?5
Insurance broker namePREFERRED COMMUNITY CHOICE
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF006740-0001
Policy instance 2
Insurance contract or identification numberF006740-0001
Number of Individuals Covered36
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $226
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $226
Insurance broker organization code?3
Insurance broker nameBENEFIT MANAGEMENT, INC
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberSL20000019-111
Policy instance 1
Insurance contract or identification numberSL20000019-111
Number of Individuals Covered36
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $16,812
Total amount of fees paid to insurance companyUSD $11,481
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $92,265
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,406
Amount paid for insurance broker fees7100
Additional information about fees paid to insurance brokerADMINISTRATION FEES AND UTILIZATION REVIEW FEES
Insurance broker organization code?5
Insurance broker nameEXCESS LOSS INSURANCE SERVICES, INC
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberSL20000019-111
Policy instance 2
Insurance contract or identification numberSL20000019-111
Number of Individuals Covered36
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $16,812
Total amount of fees paid to insurance companyUSD $11,481
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $92,265
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF006740-0001
Policy instance 1
Insurance contract or identification numberF006740-0001
Number of Individuals Covered36
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $226
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF006740-0001
Policy instance 1
Insurance contract or identification numberF006740-0001
Number of Individuals Covered37
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $238
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,375
Commission paid to Insurance BrokerUSD $238
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameBENEFIT MANAGEMENT INC
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberSL20000019-111
Policy instance 2
Insurance contract or identification numberSL20000019-111
Number of Individuals Covered37
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $13,152
Total amount of fees paid to insurance companyUSD $9,265
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $74,098
Commission paid to Insurance BrokerUSD $6,576
Amount paid for insurance broker fees5449
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES AND UTILIZATION REVIEW FEES
Insurance broker organization code?5
Insurance broker nameEXCESS LOSS INSURANCE SERVICES, INC

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