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WAUKESHA STATE BANK HEALTH PLAN 401k Plan overview

Plan NameWAUKESHA STATE BANK HEALTH PLAN
Plan identification number 511

WAUKESHA STATE BANK HEALTH PLAN Benefits

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

401k Sponsoring company profile

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

Company Name:WAUKESHA STATE BANK
Employer identification number (EIN):390764270
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WAUKESHA STATE BANK HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5112020-01-01
5112020-01-01
5112019-01-01
5112018-01-01JULIE MCCORMICK
5112017-01-01JULIE MCCORMICK
5112016-01-01EMILY HEPBURN
5112015-01-01EMILY HEPBURN EMILY HEPBURN2016-07-29

Plan Statistics for WAUKESHA STATE BANK HEALTH PLAN

401k plan membership statisitcs for WAUKESHA STATE BANK HEALTH PLAN

Measure Date Value
2020: WAUKESHA STATE BANK HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01187
Total number of active participants reported on line 7a of the Form 55002020-01-01187
Number of retired or separated participants receiving benefits2020-01-012
Total of all active and inactive participants2020-01-01189
Total participants2020-01-01189
2019: WAUKESHA STATE BANK HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01176
Total number of active participants reported on line 7a of the Form 55002019-01-01173
Number of retired or separated participants receiving benefits2019-01-016
Total of all active and inactive participants2019-01-01179
Total participants2019-01-01179
2018: WAUKESHA STATE BANK HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01163
Total number of active participants reported on line 7a of the Form 55002018-01-01163
Number of retired or separated participants receiving benefits2018-01-018
Total of all active and inactive participants2018-01-01171
2017: WAUKESHA STATE BANK HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01171
Total number of active participants reported on line 7a of the Form 55002017-01-01154
Number of retired or separated participants receiving benefits2017-01-018
Total of all active and inactive participants2017-01-01162
2016: WAUKESHA STATE BANK HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01284
Total number of active participants reported on line 7a of the Form 55002016-01-01303
Number of retired or separated participants receiving benefits2016-01-012
Total of all active and inactive participants2016-01-01305
2015: WAUKESHA STATE BANK HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01166
Total number of active participants reported on line 7a of the Form 55002015-01-01153
Number of retired or separated participants receiving benefits2015-01-018
Total of all active and inactive participants2015-01-01161

Form 5500 Responses for WAUKESHA STATE BANK HEALTH PLAN

2020: WAUKESHA STATE BANK HEALTH PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: WAUKESHA STATE BANK HEALTH PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: WAUKESHA STATE BANK HEALTH PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: WAUKESHA STATE BANK HEALTH PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: WAUKESHA STATE BANK HEALTH PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: WAUKESHA STATE BANK HEALTH PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number821376
Policy instance 1
Insurance contract or identification number821376
Number of Individuals Covered184
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,470,645
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number821376
Policy instance 1
Insurance contract or identification number821376
Number of Individuals Covered181
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,178,721
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPCARE HEALTH SERVICES INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 95693 )
Policy contract number00252995
Policy instance 1
Insurance contract or identification number00252995
Number of Individuals Covered320
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,888
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,833,394
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,888
Insurance broker organization code?3
HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 95342 )
Policy contract number738917
Policy instance 1
Insurance contract or identification number738917
Number of Individuals Covered165
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,783,413
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 95342 )
Policy contract number738917
Policy instance 1
Insurance contract or identification number738917
Number of Individuals Covered162
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $6,280
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,731,719
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees6280
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameM3 INSURANCE SOLUTIONS

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