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FIRST CHOICE BANK MEDICAL AND DENTAL INSURANCE PLAN 401k Plan overview

Plan NameFIRST CHOICE BANK MEDICAL AND DENTAL INSURANCE PLAN
Plan identification number 501

FIRST CHOICE BANK MEDICAL AND DENTAL INSURANCE 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
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

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

Company Name:FIRST CHOICE BANK
Employer identification number (EIN):142008612
NAIC Classification:522110
NAIC Description:Commercial Banking

Additional information about FIRST CHOICE BANK

Jurisdiction of Incorporation: California Department of State
Incorporation Date:
Company Identification Number: C2725324

More information about FIRST CHOICE BANK

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIRST CHOICE BANK MEDICAL AND DENTAL INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012015-05-01PATRICIA OLSEN
5012014-05-01HOWARD N HALL
5012013-05-01DAVID LAUER
5012012-05-01DAVID LAUER
5012011-05-01DAVID LAUER

Plan Statistics for FIRST CHOICE BANK MEDICAL AND DENTAL INSURANCE PLAN

401k plan membership statisitcs for FIRST CHOICE BANK MEDICAL AND DENTAL INSURANCE PLAN

Measure Date Value
2015: FIRST CHOICE BANK MEDICAL AND DENTAL INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-05-01636
Total number of active participants reported on line 7a of the Form 55002015-05-01304
Number of retired or separated participants receiving benefits2015-05-0110
Number of other retired or separated participants entitled to future benefits2015-05-010
Total of all active and inactive participants2015-05-01314
2014: FIRST CHOICE BANK MEDICAL AND DENTAL INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-05-01280
Total number of active participants reported on line 7a of the Form 55002014-05-01629
Number of retired or separated participants receiving benefits2014-05-017
Number of other retired or separated participants entitled to future benefits2014-05-010
Total of all active and inactive participants2014-05-01636
2013: FIRST CHOICE BANK MEDICAL AND DENTAL INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-05-01313
Total number of active participants reported on line 7a of the Form 55002013-05-01280
Total of all active and inactive participants2013-05-01280
2012: FIRST CHOICE BANK MEDICAL AND DENTAL INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-05-01270
Total number of active participants reported on line 7a of the Form 55002012-05-01313
Total of all active and inactive participants2012-05-01313
2011: FIRST CHOICE BANK MEDICAL AND DENTAL INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-05-0147
Total number of active participants reported on line 7a of the Form 55002011-05-01270
Total of all active and inactive participants2011-05-01270

Form 5500 Responses for FIRST CHOICE BANK MEDICAL AND DENTAL INSURANCE PLAN

2015: FIRST CHOICE BANK MEDICAL AND DENTAL INSURANCE PLAN 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan benefit arrangement – InsuranceYes
2014: FIRST CHOICE BANK MEDICAL AND DENTAL INSURANCE PLAN 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Submission has been amendedNo
2014-05-01This submission is the final filingNo
2014-05-01This return/report is a short plan year return/report (less than 12 months)No
2014-05-01Plan is a collectively bargained planNo
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan benefit arrangement – InsuranceYes
2013: FIRST CHOICE BANK MEDICAL AND DENTAL INSURANCE PLAN 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan benefit arrangement – InsuranceYes
2012: FIRST CHOICE BANK MEDICAL AND DENTAL INSURANCE PLAN 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Submission has been amendedYes
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan benefit arrangement – InsuranceYes
2011: FIRST CHOICE BANK MEDICAL AND DENTAL INSURANCE PLAN 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01First time form 5500 has been submittedYes
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3337314
Policy instance 1
Insurance contract or identification number3337314
Number of Individuals Covered633
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $137,104
Total amount of fees paid to insurance companyUSD $6,838
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 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 $748,933
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $116,528
Insurance broker organization code?3
Amount paid for insurance broker fees6838
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
Insurance broker nameUSI INSURANCE SERVICES, LLC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0264556
Policy instance 3
Insurance contract or identification numberR0264556
Number of Individuals Covered105
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $5,875
Total amount of fees paid to insurance companyUSD $107
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 BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $44,523
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,875
Amount paid for insurance broker fees107
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameNOTTINGHAM AGENCY, INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number467225
Policy instance 2
Insurance contract or identification number467225
Number of Individuals Covered304
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $26,313
Total amount of fees paid to insurance companyUSD $8,457
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 BenefitYes
Vision Insurance Welfare BenefitYes
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 $344,104
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,313
Amount paid for insurance broker fees8457
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameEMERSON REID LLC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0264556
Policy instance 3
Insurance contract or identification numberR0264556
Number of Individuals Covered82
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $4,488
Total amount of fees paid to insurance companyUSD $181
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 BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $31,203
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,488
Amount paid for insurance broker fees181
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameNOTTINGHAM AGENCY, INC.
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3337314
Policy instance 1
Insurance contract or identification number3337314
Number of Individuals Covered629
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $123,728
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 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 $692,543
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $105,151
Insurance broker organization code?3
Insurance broker nameEMERSON REID AND COMPANY, INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number467225
Policy instance 2
Insurance contract or identification number467225
Number of Individuals Covered319
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $25,001
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 BenefitYes
Vision Insurance Welfare BenefitYes
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 $322,423
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,001
Insurance broker organization code?3
Insurance broker nameEMERSON REID AND COMPANY, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR026556
Policy instance 3
Insurance contract or identification numberR026556
Number of Individuals Covered66
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $2,908
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,908
Insurance broker nameNOTTINGHAM AGENCY INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00467225
Policy instance 2
Insurance contract or identification number00467225
Number of Individuals Covered280
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $25,429
Total amount of fees paid to insurance companyUSD $7,890
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,338
Amount paid for insurance broker fees7890
Insurance broker nameNRL WEALTH CREATION
IOA RE/US FIRE INSURANCE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number69463
Policy instance 1
Insurance contract or identification number69463
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $47,916
Total amount of fees paid to insurance companyUSD $74,111
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,916
Amount paid for insurance broker fees74111
Insurance broker nameBROKERAGE CONCEPTS
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3337314
Policy instance 4
Insurance contract or identification number3337314
Number of Individuals Covered524
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $77,155
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $65,569
Insurance broker nameEMERSON REID AND COMPANY
IOA RE/US FIRE INSURANCE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number69463
Policy instance 1
Insurance contract or identification number69463
Number of Individuals Covered270
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $189,108
Total amount of fees paid to insurance companyUSD $271,071
Welfare Benefit Premiums Paid to CarrierUSD $418,155
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $189,108
Amount paid for insurance broker fees271071
Insurance broker nameBROKERAGE CONCEPTS
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00467225
Policy instance 2
Insurance contract or identification number00467225
Number of Individuals Covered313
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $21,480
Total amount of fees paid to insurance companyUSD $7,638
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $268,091
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,322
Amount paid for insurance broker fees7638
Insurance broker nameNRL WEALTH CREATION
IOA RE/US FIRE INSURANCE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number69463
Policy instance 1
Insurance contract or identification number69463
Number of Individuals Covered270
Insurance policy start date2011-09-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $121,931
Total amount of fees paid to insurance companyUSD $191,137
Welfare Benefit Premiums Paid to CarrierUSD $215,379
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 78026 )
Policy contract numberFC1697
Policy instance 2
Insurance contract or identification numberFC1697
Number of Individuals Covered500
Insurance policy start date2011-05-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $32,002
Total amount of fees paid to insurance companyUSD $9,542
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $830,522
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00467225
Policy instance 3
Insurance contract or identification number00467225
Number of Individuals Covered241
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $17,273
Total amount of fees paid to insurance companyUSD $4,845
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $207,620
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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