401k Plan data: SOUTHERN FIRST BANCSHARES, INC. plan

SOUTHERN FIRST BANCSHARES, INC. 401k Plan overview

Plan Name	SOUTHERN FIRST BANCSHARES, INC.
Plan identification number	501

SOUTHERN FIRST BANCSHARES, INC. Benefits

401k Plan Type	Welfare 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

401k Sponsoring company profile

SOUTHERN FIRST BANCSHARES, INC. has sponsored the creation of one or more 401k plans.

Company Name: SOUTHERN FIRST BANCSHARES, INC.

Employer identification number (EIN): 582459561

NAIC Classification: 522110
NAIC Description: Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOUTHERN FIRST BANCSHARES, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2014-11-01 SHARISE MUNDT
501 2013-11-01 SHARISE MUNDT
501 2012-11-01
501 2011-11-01 SHARISE MUNDT
501 2011-10-01 SHARISE MUNDT
501 2009-11-01 SHARISE MUNDT
501 2009-11-01 SHARISE MUNDT

Plan Statistics for SOUTHERN FIRST BANCSHARES, INC.

401k plan membership statisitcs for SOUTHERN FIRST BANCSHARES, INC.

Measure Date Value
2014: SOUTHERN FIRST BANCSHARES, INC. 2014 401k membership
Total participants, beginning-of-year 2014-11-01 134
Total number of active participants reported on line 7a of the Form 5500 2014-11-01 139
Number of retired or separated participants receiving benefits 2014-11-01 1
Number of other retired or separated participants entitled to future benefits 2014-11-01 2
Total of all active and inactive participants 2014-11-01 142
2013: SOUTHERN FIRST BANCSHARES, INC. 2013 401k membership
Total participants, beginning-of-year 2013-11-01 135
Total number of active participants reported on line 7a of the Form 5500 2013-11-01 131
Number of retired or separated participants receiving benefits 2013-11-01 1
Number of other retired or separated participants entitled to future benefits 2013-11-01 2
Total of all active and inactive participants 2013-11-01 134
2012: SOUTHERN FIRST BANCSHARES, INC. 2012 401k membership
Total participants, beginning-of-year 2012-11-01 120
Total number of active participants reported on line 7a of the Form 5500 2012-11-01 137
Total of all active and inactive participants 2012-11-01 137
Total participants 2012-11-01 137
2011: SOUTHERN FIRST BANCSHARES, INC. 2011 401k membership
Total participants, beginning-of-year 2011-11-01 120
Total of all active and inactive participants 2011-11-01 0
Total participants 2011-11-01 0
Total participants, beginning-of-year 2011-10-01 0
Total of all active and inactive participants 2011-10-01 0
Total participants 2011-10-01 0
2009: SOUTHERN FIRST BANCSHARES, INC. 2009 401k membership
Total participants, beginning-of-year 2009-11-01 103
Total number of active participants reported on line 7a of the Form 5500 2009-11-01 103
Total of all active and inactive participants 2009-11-01 103
Total participants 2009-11-01 103

Measure	Date	Value
2014: SOUTHERN FIRST BANCSHARES, INC. 2014 401k membership
Total participants, beginning-of-year	2014-11-01	134
Total number of active participants reported on line 7a of the Form 5500	2014-11-01	139
Number of retired or separated participants receiving benefits	2014-11-01	1
Number of other retired or separated participants entitled to future benefits	2014-11-01	2
Total of all active and inactive participants	2014-11-01	142
2013: SOUTHERN FIRST BANCSHARES, INC. 2013 401k membership
Total participants, beginning-of-year	2013-11-01	135
Total number of active participants reported on line 7a of the Form 5500	2013-11-01	131
Number of retired or separated participants receiving benefits	2013-11-01	1
Number of other retired or separated participants entitled to future benefits	2013-11-01	2
Total of all active and inactive participants	2013-11-01	134
2012: SOUTHERN FIRST BANCSHARES, INC. 2012 401k membership
Total participants, beginning-of-year	2012-11-01	120
Total number of active participants reported on line 7a of the Form 5500	2012-11-01	137
Total of all active and inactive participants	2012-11-01	137
Total participants	2012-11-01	137
2011: SOUTHERN FIRST BANCSHARES, INC. 2011 401k membership
Total participants, beginning-of-year	2011-11-01	120
Total of all active and inactive participants	2011-11-01	0
Total participants	2011-11-01	0
Total participants, beginning-of-year	2011-10-01	0
Total of all active and inactive participants	2011-10-01	0
Total participants	2011-10-01	0
2009: SOUTHERN FIRST BANCSHARES, INC. 2009 401k membership
Total participants, beginning-of-year	2009-11-01	103
Total number of active participants reported on line 7a of the Form 5500	2009-11-01	103
Total of all active and inactive participants	2009-11-01	103
Total participants	2009-11-01	103

Form 5500 Responses for SOUTHERN FIRST BANCSHARES, INC.

2014: SOUTHERN FIRST BANCSHARES, INC. 2014 form 5500 responses
2014-11-01	Type of plan entity	Single employer plan
2014-11-01	Submission has been amended	No
2014-11-01	This submission is the final filing	No
2014-11-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-11-01	Plan is a collectively bargained plan	No
2014-11-01	Plan funding arrangement – Insurance	Yes
2014-11-01	Plan benefit arrangement – Insurance	Yes
2013: SOUTHERN FIRST BANCSHARES, INC. 2013 form 5500 responses
2013-11-01	Type of plan entity	Single employer plan
2013-11-01	Submission has been amended	No
2013-11-01	This submission is the final filing	No
2013-11-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-11-01	Plan is a collectively bargained plan	No
2013-11-01	Plan funding arrangement – Insurance	Yes
2013-11-01	Plan benefit arrangement – Insurance	Yes
2012: SOUTHERN FIRST BANCSHARES, INC. 2012 form 5500 responses
2012-11-01	Type of plan entity	Single employer plan
2012-11-01	Submission has been amended	Yes
2012-11-01	Plan funding arrangement – Insurance	Yes
2012-11-01	Plan benefit arrangement – Insurance	Yes
2011: SOUTHERN FIRST BANCSHARES, INC. 2011 form 5500 responses
2011-11-01	Type of plan entity	Single employer plan
2011-11-01	Plan funding arrangement – Insurance	Yes
2011-11-01	Plan benefit arrangement – Insurance	Yes
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2011-10-01	Plan funding arrangement – Insurance	Yes
2011-10-01	Plan benefit arrangement – Insurance	Yes
2009: SOUTHERN FIRST BANCSHARES, INC. 2009 form 5500 responses
2009-11-01	Type of plan entity	Single employer plan
2009-11-01	Submission has been amended	Yes
2009-11-01	Plan funding arrangement – Insurance	Yes
2009-11-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

858351G

Policy instance

Insurance contract or identification number	858351G
Number of Individuals Covered	163
Insurance policy start date	2014-11-01
Insurance policy end date	2015-10-31
Total amount of commissions paid to insurance broker	USD $8,719
Total amount of fees paid to insurance company	USD $813
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ADD
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 Carrier	USD $94,565
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,719
Amount paid for insurance broker fees	813
Additional information about fees paid to insurance broker	BONUS PAID
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES INC

PHYSICIANS EYECARE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

00252

Policy instance

Insurance contract or identification number	00252
Number of Individuals Covered	244
Insurance policy start date	2014-11-01
Insurance policy end date	2015-10-31
Total amount of commissions paid to insurance broker	USD $1,882
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $18,818
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,882
Insurance broker organization code?	3
Insurance broker name	NFP EMPLOYEE BENEFITS

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

232626

Policy instance

Insurance contract or identification number	232626
Number of Individuals Covered	130
Insurance policy start date	2014-11-01
Insurance policy end date	2015-10-31
Total amount of commissions paid to insurance broker	USD $3,122
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $68,587
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,122
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES (SE) INC

KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 )

Policy contract number

890097

Policy instance

Insurance contract or identification number	890097
Number of Individuals Covered	156
Insurance policy start date	2014-11-01
Insurance policy end date	2015-10-31
Total amount of commissions paid to insurance broker	USD $1,296
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	SUPPLEMENTAL CRITICAL ILLNESS
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 Carrier	USD $24,725
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,286
Insurance broker organization code?	3
Insurance broker name	CORPORATE BENEFITS INC.

BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )

Policy contract number

25-34435-00

Policy instance

Insurance contract or identification number	25-34435-00
Number of Individuals Covered	140
Insurance policy start date	2014-11-01
Insurance policy end date	2015-10-31
Total amount of commissions paid to insurance broker	USD $53,790
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $1,807,025
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $53,790
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES INCORPORATED

KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 )

Policy contract number

K100311

Policy instance

Insurance contract or identification number	K100311
Number of Individuals Covered	153
Insurance policy start date	2013-11-01
Insurance policy end date	2014-10-31
Total amount of commissions paid to insurance broker	USD $2,854
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	CRITICAL ILLNESS
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 Carrier	USD $28,537
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,854
Insurance broker organization code?	3
Insurance broker name	CORPORATE BENEFITS INC.

BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )

Policy contract number

25-34435-00

Policy instance

Insurance contract or identification number	25-34435-00
Number of Individuals Covered	131
Insurance policy start date	2013-11-01
Insurance policy end date	2014-10-31
Total amount of commissions paid to insurance broker	USD $45,747
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $1,533,200
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $45,747
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES INCORPORATED

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

858351G

Policy instance

Insurance contract or identification number	858351G
Number of Individuals Covered	154
Insurance policy start date	2013-11-01
Insurance policy end date	2014-10-31
Total amount of commissions paid to insurance broker	USD $11,141
Total amount of fees paid to insurance company	USD $937
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ADD
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 Carrier	USD $101,715
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,141
Amount paid for insurance broker fees	937
Additional information about fees paid to insurance broker	BONUS PAID
Insurance broker organization code?	3
Insurance broker name	CORPORATE BENEFITS, INC

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30008029

Policy instance

Insurance contract or identification number	30008029
Number of Individuals Covered	100
Insurance policy start date	2013-10-01
Insurance policy end date	2014-10-31
Total amount of commissions paid to insurance broker	USD $1,022
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $15,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $577
Insurance broker organization code?	3
Insurance broker name	CORPORATE BENEFITS, INC.

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

232626

Policy instance

Insurance contract or identification number	232626
Number of Individuals Covered	123
Insurance policy start date	2013-11-01
Insurance policy end date	2014-10-31
Total amount of commissions paid to insurance broker	USD $2,994
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $62,187
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,969
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES (NC) INC.

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

858351G

Policy instance

Insurance contract or identification number	858351G
Number of Individuals Covered	135
Insurance policy start date	2012-11-01
Insurance policy end date	2013-10-31
Total amount of commissions paid to insurance broker	USD $8,879
Total amount of fees paid to insurance company	USD $761
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ADD
Welfare Benefit Premiums Paid to Carrier	USD $71,184

BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )

Policy contract number

05-34435-00, 01

Policy instance

Insurance contract or identification number	05-34435-00, 01
Number of Individuals Covered	137
Insurance policy start date	2012-11-01
Insurance policy end date	2013-10-31
Total amount of commissions paid to insurance broker	USD $29,827
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,177,244
Commission paid to Insurance Broker	USD $29,827
Insurance broker organization code?	3
Insurance broker name	COORPORATE BENEFITS, INC.

BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )

Policy contract number

05-34435-00, 01

Policy instance

Insurance contract or identification number	05-34435-00, 01
Number of Individuals Covered	137
Insurance policy start date	2012-11-01
Insurance policy end date	2013-10-31
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	0 ADD
Welfare Benefit Premiums Paid to Carrier	USD $16,336

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

858351G

Policy instance

Insurance contract or identification number	858351G
Number of Individuals Covered	135
Insurance policy start date	2012-11-01
Insurance policy end date	2013-10-31
Total amount of commissions paid to insurance broker	USD $8,879
Total amount of fees paid to insurance company	USD $761
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ADD
Welfare Benefit Premiums Paid to Carrier	USD $71,184
Commission paid to Insurance Broker	USD $8,879
Amount paid for insurance broker fees	761
Additional information about fees paid to insurance broker	BONUS PAID
Insurance broker organization code?	3
Insurance broker name	CORPORATE BENEFITS, INC.

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TM05986079

Policy instance

Insurance contract or identification number	TM05986079
Number of Individuals Covered	107
Insurance policy start date	2012-11-01
Insurance policy end date	2013-10-31
Total amount of commissions paid to insurance broker	USD $3,115
Total amount of fees paid to insurance company	USD $308
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $51,005
Commission paid to Insurance Broker	USD $2,748
Amount paid for insurance broker fees	308
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	NFP INS SERVICES, INC.

KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 )

Policy contract number

K100311

Policy instance

Insurance contract or identification number	K100311
Number of Individuals Covered	134
Insurance policy start date	2012-11-01
Insurance policy end date	2013-10-31
Other welfare benefits provided	CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $25,761

BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )

Policy contract number

05-34435-00, 01

Policy instance

Insurance contract or identification number	05-34435-00, 01
Number of Individuals Covered	137
Insurance policy start date	2012-11-01
Insurance policy end date	2013-10-31
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ADD
Welfare Benefit Premiums Paid to Carrier	USD $16,336

BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )

Policy contract number

05-34435-00/01

Policy instance

Insurance contract or identification number	05-34435-00/01
Number of Individuals Covered	120
Insurance policy start date	2011-11-01
Insurance policy end date	2012-10-31
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,402

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

858351G

Policy instance

Insurance contract or identification number	858351G
Number of Individuals Covered	120
Insurance policy start date	2011-11-01
Insurance policy end date	2012-10-31
Total amount of commissions paid to insurance broker	USD $9,148
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ADD
Welfare Benefit Premiums Paid to Carrier	USD $59,297

KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 )

Policy contract number

K100311

Policy instance

Insurance contract or identification number	K100311
Number of Individuals Covered	118
Insurance policy start date	2011-11-01
Insurance policy end date	2012-10-31
Total amount of commissions paid to insurance broker	USD $2,324
Other welfare benefits provided	CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $23,243

KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 )

Policy contract number

K100311

Policy instance

Insurance contract or identification number	K100311
Number of Individuals Covered	108
Insurance policy start date	2011-10-01
Insurance policy end date	2011-10-31
Total amount of commissions paid to insurance broker	USD $182
Other welfare benefits provided	CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $1,818

KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 )

Policy contract number

K100311

Policy instance

Insurance contract or identification number	K100311
Number of Individuals Covered	108
Insurance policy start date	2010-10-01
Insurance policy end date	2011-09-30
Total amount of commissions paid to insurance broker	USD $5,898
Other welfare benefits provided	CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $21,247

BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )

Policy contract number

05-34435-00/01

Policy instance

Insurance contract or identification number	05-34435-00/01
Number of Individuals Covered	107
Insurance policy start date	2010-11-01
Insurance policy end date	2011-10-31
Total amount of commissions paid to insurance broker	USD $1,981
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,144

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

858351G

Policy instance

Insurance contract or identification number	858351G
Number of Individuals Covered	109
Insurance policy start date	2010-11-01
Insurance policy end date	2011-10-31
Total amount of commissions paid to insurance broker	USD $7,433
Total amount of fees paid to insurance company	USD $1,157
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ADD
Welfare Benefit Premiums Paid to Carrier	USD $31,472

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Company Name:	SOUTHERN FIRST BANCSHARES, INC.
Employer identification number (EIN):	582459561
NAIC Classification:	522110
NAIC Description:	Commercial Banking

Plan id#	Filing Submission Date	Name of Administrator
501	2014-11-01	SHARISE MUNDT
501	2013-11-01	SHARISE MUNDT
501	2012-11-01
501	2011-11-01	SHARISE MUNDT
501	2011-10-01	SHARISE MUNDT
501	2009-11-01	SHARISE MUNDT
501	2009-11-01	SHARISE MUNDT