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ANDROSCOGGIN BANK GROUP BENEFIT PLAN 401k Plan overview

Plan NameANDROSCOGGIN BANK GROUP BENEFIT PLAN
Plan identification number 502

ANDROSCOGGIN BANK GROUP BENEFIT PLAN Benefits

401k Plan TypeWelfare 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
  • 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

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

Company Name:ANDROSCOGGIN BANK
Employer identification number (EIN):010020240
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ANDROSCOGGIN BANK GROUP BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022017-07-01
5022016-07-01
5022015-07-01
5022014-07-01
5022013-07-01MICHAEL LETOURNEAU MICHAEL LETOURNEAU2015-01-30
5022012-07-01MICHAEL LETOURNEAU MICHAEL LETOURNEAU2015-01-22
5022011-07-01DAVID PEASE DAVID PEASE2012-11-29
5022009-07-01DAVID PEASE DAVID PEASE2011-01-24

Plan Statistics for ANDROSCOGGIN BANK GROUP BENEFIT PLAN

401k plan membership statisitcs for ANDROSCOGGIN BANK GROUP BENEFIT PLAN

Measure Date Value
2017
Total participants, beginning-of-year2017-07-01184
Total number of active participants reported on line 7a of the Form 55002017-07-01185
Number of retired or separated participants receiving benefits2017-07-019
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-01194
2016
Total participants, beginning-of-year2016-07-01302
Total number of active participants reported on line 7a of the Form 55002016-07-01314
Number of retired or separated participants receiving benefits2016-07-0120
Number of other retired or separated participants entitled to future benefits2016-07-0120
Total of all active and inactive participants2016-07-01354
2015
Total participants, beginning-of-year2015-07-01289
Total number of active participants reported on line 7a of the Form 55002015-07-01302
Number of retired or separated participants receiving benefits2015-07-015
Number of other retired or separated participants entitled to future benefits2015-07-014
Total of all active and inactive participants2015-07-01311
2014
Total participants, beginning-of-year2014-07-01280
Total number of active participants reported on line 7a of the Form 55002014-07-01282
Number of retired or separated participants receiving benefits2014-07-017
Total of all active and inactive participants2014-07-01289
2013
Total participants, beginning-of-year2013-07-01158
Total number of active participants reported on line 7a of the Form 55002013-07-01158
Total of all active and inactive participants2013-07-01158
2012
Total participants, beginning-of-year2012-07-01157
Total number of active participants reported on line 7a of the Form 55002012-07-01158
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-01158
2011
Total participants, beginning-of-year2011-07-01171
Total number of active participants reported on line 7a of the Form 55002011-07-01149
Number of retired or separated participants receiving benefits2011-07-018
Total of all active and inactive participants2011-07-01157
2009
Total participants, beginning-of-year2009-07-01178
Total number of active participants reported on line 7a of the Form 55002009-07-01187
Number of retired or separated participants receiving benefits2009-07-0111
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01198

Form 5500 Responses

2017
2017-07-01Type of plan entitySingle employer plan
2017-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – General assets of the sponsorYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedYes
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – General assets of the sponsorYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2009
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0619960
Policy instance 1
Insurance contract or identification number0619960
Number of Individuals Covered343
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $42,356
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,328,067
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30026008
Policy instance 2
Insurance contract or identification number30026008
Number of Individuals Covered122
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,005
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00005878
Policy instance 3
Insurance contract or identification numberAL00005878
Number of Individuals Covered188
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $17,246
Total amount of fees paid to insurance companyUSD $7,437
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $141,077
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: 60054 )
Policy contract number0619960
Policy instance 1
Insurance contract or identification number0619960
Number of Individuals Covered329
Insurance policy start date2017-07-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $16,633
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $654,149
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,633
Insurance broker organization code?3
Insurance broker nameHOLDEN AGENCY
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30026008
Policy instance 2
Insurance contract or identification number30026008
Number of Individuals Covered112
Insurance policy start date2017-07-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $623
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $623
Insurance broker organization code?3
Insurance broker nameHOLDEN AGENCY
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00005878
Policy instance 3
Insurance contract or identification numberAL00005878
Number of Individuals Covered185
Insurance policy start date2017-07-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $9,361
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,150
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,361
Insurance broker organization code?3
Insurance broker nameHOLDEN AGENCY

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