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FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameFIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN
Plan identification number 001

FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

FIRST STATE BANK OF BEECHER CITY has sponsored the creation of one or more 401k plans.

Company Name:FIRST STATE BANK OF BEECHER CITY
Employer identification number (EIN):370274995
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01JOHN STEPHENS2023-07-26
0012021-01-01JOHN STEPHENS2022-10-14
0012020-01-01JOHN STEPHENS2021-07-15
0012019-01-01JOHN STEPHENS2020-10-11 JOHN STEPHENS2020-10-11
0012018-01-01JOHN STEPHENS2019-07-25 JOHN STEPHENS2019-07-25
0012017-01-01JOHN STEPHENS2018-07-26 JOHN STEPHENS2018-07-26
0012016-01-01JOHN STEPHENS2017-07-24
0012015-01-01JOHN STEPHENS2016-07-18 JOHN STEPHENS2016-07-18
0012014-01-01JOHN STEPHENS
0012013-01-01JOHN STEPHENS JOHN STEPHENS2014-07-30
0012012-01-01JOHN STEPHENS JOHN STEPHENS2013-07-24
0012011-01-01JOHN STEPHENS
0012010-01-01JOHN STEPHENS JOHN STEPHENS2011-07-14
0012009-01-01JOHN STEPHENS

Plan Statistics for FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN

Measure Date Value
2014: FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0116
Total number of active participants reported on line 7a of the Form 55002014-01-0115
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-011
Total of all active and inactive participants2014-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0116
Number of participants with account balances2014-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0116
Total number of active participants reported on line 7a of the Form 55002013-01-0115
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-011
Total of all active and inactive participants2013-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0116
Number of participants with account balances2013-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0115
Total number of active participants reported on line 7a of the Form 55002012-01-0115
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-011
Total of all active and inactive participants2012-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0116
Number of participants with account balances2012-01-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0114
Total number of active participants reported on line 7a of the Form 55002011-01-0115
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0115
Number of participants with account balances2011-01-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0114
Total number of active participants reported on line 7a of the Form 55002010-01-0114
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0114
Number of participants with account balances2010-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0116
Total number of active participants reported on line 7a of the Form 55002009-01-0114
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-011
Total of all active and inactive participants2009-01-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0115
Number of participants with account balances2009-01-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN

Measure Date Value
2014 : FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total income from all sources2014-12-31$232,495
Expenses. Total of all expenses incurred2014-12-31$90,000
Benefits paid (including direct rollovers)2014-12-31$90,000
Total plan assets at end of year2014-12-31$1,901,269
Total plan assets at beginning of year2014-12-31$1,758,774
Value of fidelity bond covering the plan2014-12-31$1,000,000
Total contributions received or receivable from participants2014-12-31$81,112
Expenses. Other expenses not covered elsewhere2014-12-31$0
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$114,484
Net income (gross income less expenses)2014-12-31$142,495
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,901,269
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,758,774
Assets. Value of participant loans2014-12-31$0
Total contributions received or receivable from employer(s)2014-12-31$36,899
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Funding deficiency by the employer to the plan for this plan year2014-12-31$0
Minimum employer required contribution for this plan year2014-12-31$0
Amount contributed by the employer to the plan for this plan year2014-12-31$0
2013 : FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total income from all sources2013-12-31$502,060
Expenses. Total of all expenses incurred2013-12-31$0
Benefits paid (including direct rollovers)2013-12-31$0
Total plan assets at end of year2013-12-31$1,758,775
Total plan assets at beginning of year2013-12-31$1,256,715
Value of fidelity bond covering the plan2013-12-31$1,000,000
Total contributions received or receivable from participants2013-12-31$80,379
Expenses. Other expenses not covered elsewhere2013-12-31$0
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$386,782
Net income (gross income less expenses)2013-12-31$502,060
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,758,775
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,256,715
Assets. Value of participant loans2013-12-31$0
Total contributions received or receivable from employer(s)2013-12-31$34,899
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
2012 : FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$260,662
Expenses. Total of all expenses incurred2012-12-31$0
Benefits paid (including direct rollovers)2012-12-31$0
Total plan assets at end of year2012-12-31$1,256,715
Total plan assets at beginning of year2012-12-31$996,053
Value of fidelity bond covering the plan2012-12-31$1,000,000
Total contributions received or receivable from participants2012-12-31$77,213
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$148,911
Net income (gross income less expenses)2012-12-31$260,662
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,256,715
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$996,053
Assets. Value of participant loans2012-12-31$0
Total contributions received or receivable from employer(s)2012-12-31$34,538
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
2011 : FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$36,611
Expenses. Total of all expenses incurred2011-12-31$5,059
Benefits paid (including direct rollovers)2011-12-31$5,059
Total plan assets at end of year2011-12-31$996,053
Total plan assets at beginning of year2011-12-31$964,501
Value of fidelity bond covering the plan2011-12-31$1,000,000
Total contributions received or receivable from participants2011-12-31$62,932
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$326
Other income received2011-12-31$-55,439
Net income (gross income less expenses)2011-12-31$31,552
Net plan assets at end of year (total assets less liabilities)2011-12-31$996,053
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$964,501
Assets. Value of participant loans2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$28,792
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
2010 : FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total income from all sources2010-12-31$197,300
Expenses. Total of all expenses incurred2010-12-31$26,678
Benefits paid (including direct rollovers)2010-12-31$26,678
Total plan assets at end of year2010-12-31$964,502
Total plan assets at beginning of year2010-12-31$793,880
Value of fidelity bond covering the plan2010-12-31$1,000,000
Total contributions received or receivable from participants2010-12-31$59,701
Expenses. Other expenses not covered elsewhere2010-12-31$0
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$110,428
Net income (gross income less expenses)2010-12-31$170,622
Net plan assets at end of year (total assets less liabilities)2010-12-31$964,502
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$793,880
Assets. Value of participant loans2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$27,171
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$0
Amount contributed by the employer to the plan for this plan year2010-12-31$0
2009 : FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year2009-12-31$0
Minimum employer required contribution for this plan year2009-12-31$0
Amount contributed by the employer to the plan for this plan year2009-12-31$0

Form 5500 Responses for FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING PLAN

2014: FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING 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 – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING 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 – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING 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 – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING 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 – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING 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 – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: FIRST STATE BANK OF BEECHER CITY 401(K) PROFIT SHARING 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 – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-018792
Policy instance 1
Insurance contract or identification numberGA-018792
Number of Individuals Covered16
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $6,279
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,279
Insurance broker organization code?3
Insurance broker nameEDWARD D JONES & CO L P.
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-018792
Policy instance 1
Insurance contract or identification numberGA-018792
Number of Individuals Covered16
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,853
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,853
Insurance broker organization code?3
Insurance broker nameEDWARD D JONES & CO
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-018792
Policy instance 1
Insurance contract or identification numberGA-018792
Number of Individuals Covered15
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,776
Total amount of fees paid to insurance companyUSD $1,083
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,776
Insurance broker organization code?3
Amount paid for insurance broker fees1083
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameEDWARD D JONES & CO
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-018792
Policy instance 1
Insurance contract or identification numberGA-018792
Number of Individuals Covered15
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,438
Total amount of fees paid to insurance companyUSD $817
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-018792
Policy instance 1
Insurance contract or identification numberGA-018792
Number of Individuals Covered14
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,828
Total amount of fees paid to insurance companyUSD $2,674
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,828
Insurance broker organization code?3
Amount paid for insurance broker fees2674
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameEDWARD D JONES & CO

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