401k Plan data: VISTA BANK HEALTH AND WELFARE PLAN plan

VISTA BANK HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	VISTA BANK HEALTH AND WELFARE PLAN
Plan identification number	501

VISTA BANK HEALTH AND WELFARE PLAN 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 Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

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

Company Name: VISTA BANK

Employer identification number (EIN): 750548850

NAIC Classification: 522110
NAIC Description: Commercial Banking

Additional information about VISTA BANK

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1929-03-27

Company Identification Number: 0000115001

Legal Registered Office Address: 901 MAIN ST

RALLS
United States of America (USA)
79357

More information about VISTA BANK

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VISTA BANK HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01 JOY HOLLY 2024-06-27
501 2022-12-01 JOY HOLLY 2023-06-28
501 2021-12-01 JOY HOLLY 2023-06-13
501 2020-12-01 JOY HOLLY 2022-05-23
501 2019-12-01 JOY HOLLY 2021-05-17
501 2018-12-01 JOY HOLLY 2020-04-17
501 2017-12-01 JOY HOLLY 2019-05-22

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2023-01-01	JOY HOLLY	2024-06-27
501	2022-12-01	JOY HOLLY	2023-06-28
501	2021-12-01	JOY HOLLY	2023-06-13
501	2020-12-01	JOY HOLLY	2022-05-23
501	2019-12-01	JOY HOLLY	2021-05-17
501	2018-12-01	JOY HOLLY	2020-04-17
501	2017-12-01	JOY HOLLY	2019-05-22

Plan Statistics for VISTA BANK HEALTH AND WELFARE PLAN

401k plan membership statisitcs for VISTA BANK HEALTH AND WELFARE PLAN

Measure Date Value
2023: VISTA BANK HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 155
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 213
Number of retired or separated participants receiving benefits 2023-01-01 4
Number of other retired or separated participants entitled to future benefits 2023-01-01 6
Total of all active and inactive participants 2023-01-01 223
Number of employers contributing to the scheme 2023-01-01 1
2022: VISTA BANK HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year 2022-12-01 155
Total number of active participants reported on line 7a of the Form 5500 2022-12-01 155
Number of retired or separated participants receiving benefits 2022-12-01 0
Number of other retired or separated participants entitled to future benefits 2022-12-01 0
Total of all active and inactive participants 2022-12-01 155
Number of employers contributing to the scheme 2022-12-01 0
2021: VISTA BANK HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year 2021-12-01 139
Total number of active participants reported on line 7a of the Form 5500 2021-12-01 155
Number of retired or separated participants receiving benefits 2021-12-01 0
Number of other retired or separated participants entitled to future benefits 2021-12-01 0
Total of all active and inactive participants 2021-12-01 155
Number of employers contributing to the scheme 2021-12-01 0
2020: VISTA BANK HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year 2020-12-01 153
Total number of active participants reported on line 7a of the Form 5500 2020-12-01 139
Number of retired or separated participants receiving benefits 2020-12-01 2
Number of other retired or separated participants entitled to future benefits 2020-12-01 1
Total of all active and inactive participants 2020-12-01 142
Number of employers contributing to the scheme 2020-12-01 0
2019: VISTA BANK HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year 2019-12-01 151
Total number of active participants reported on line 7a of the Form 5500 2019-12-01 153
Number of retired or separated participants receiving benefits 2019-12-01 0
Number of other retired or separated participants entitled to future benefits 2019-12-01 0
Total of all active and inactive participants 2019-12-01 153
Number of employers contributing to the scheme 2019-12-01 0
2018: VISTA BANK HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year 2018-12-01 133
Total number of active participants reported on line 7a of the Form 5500 2018-12-01 152
Number of retired or separated participants receiving benefits 2018-12-01 2
Number of other retired or separated participants entitled to future benefits 2018-12-01 0
Total of all active and inactive participants 2018-12-01 154
Number of employers contributing to the scheme 2018-12-01 0
2017: VISTA BANK HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-12-01 114
Total number of active participants reported on line 7a of the Form 5500 2017-12-01 130
Number of retired or separated participants receiving benefits 2017-12-01 0
Number of other retired or separated participants entitled to future benefits 2017-12-01 0
Total of all active and inactive participants 2017-12-01 130
Number of employers contributing to the scheme 2017-12-01 0

Measure	Date	Value
2023: VISTA BANK HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	155
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	213
Number of retired or separated participants receiving benefits	2023-01-01	4
Number of other retired or separated participants entitled to future benefits	2023-01-01	6
Total of all active and inactive participants	2023-01-01	223
Number of employers contributing to the scheme	2023-01-01	1
2022: VISTA BANK HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year	2022-12-01	155
Total number of active participants reported on line 7a of the Form 5500	2022-12-01	155
Number of retired or separated participants receiving benefits	2022-12-01	0
Number of other retired or separated participants entitled to future benefits	2022-12-01	0
Total of all active and inactive participants	2022-12-01	155
Number of employers contributing to the scheme	2022-12-01	0
2021: VISTA BANK HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-12-01	139
Total number of active participants reported on line 7a of the Form 5500	2021-12-01	155
Number of retired or separated participants receiving benefits	2021-12-01	0
Number of other retired or separated participants entitled to future benefits	2021-12-01	0
Total of all active and inactive participants	2021-12-01	155
Number of employers contributing to the scheme	2021-12-01	0
2020: VISTA BANK HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-12-01	153
Total number of active participants reported on line 7a of the Form 5500	2020-12-01	139
Number of retired or separated participants receiving benefits	2020-12-01	2
Number of other retired or separated participants entitled to future benefits	2020-12-01	1
Total of all active and inactive participants	2020-12-01	142
Number of employers contributing to the scheme	2020-12-01	0
2019: VISTA BANK HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-12-01	151
Total number of active participants reported on line 7a of the Form 5500	2019-12-01	153
Number of retired or separated participants receiving benefits	2019-12-01	0
Number of other retired or separated participants entitled to future benefits	2019-12-01	0
Total of all active and inactive participants	2019-12-01	153
Number of employers contributing to the scheme	2019-12-01	0
2018: VISTA BANK HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-12-01	133
Total number of active participants reported on line 7a of the Form 5500	2018-12-01	152
Number of retired or separated participants receiving benefits	2018-12-01	2
Number of other retired or separated participants entitled to future benefits	2018-12-01	0
Total of all active and inactive participants	2018-12-01	154
Number of employers contributing to the scheme	2018-12-01	0
2017: VISTA BANK HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-12-01	114
Total number of active participants reported on line 7a of the Form 5500	2017-12-01	130
Number of retired or separated participants receiving benefits	2017-12-01	0
Number of other retired or separated participants entitled to future benefits	2017-12-01	0
Total of all active and inactive participants	2017-12-01	130
Number of employers contributing to the scheme	2017-12-01	0

Form 5500 Responses for VISTA BANK HEALTH AND WELFARE PLAN

2023: VISTA BANK HEALTH AND WELFARE PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2022: VISTA BANK HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-12-01	Type of plan entity	Single employer plan
2022-12-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2022-12-01	Plan funding arrangement – Insurance	Yes
2022-12-01	Plan benefit arrangement – Insurance	Yes
2021: VISTA BANK HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-12-01	Type of plan entity	Single employer plan
2021-12-01	Plan funding arrangement – Insurance	Yes
2021-12-01	Plan benefit arrangement – Insurance	Yes
2020: VISTA BANK HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-12-01	Type of plan entity	Single employer plan
2020-12-01	Plan funding arrangement – Insurance	Yes
2020-12-01	Plan benefit arrangement – Insurance	Yes
2019: VISTA BANK HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-12-01	Type of plan entity	Single employer plan
2019-12-01	Plan funding arrangement – Insurance	Yes
2019-12-01	Plan benefit arrangement – Insurance	Yes
2018: VISTA BANK HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-12-01	Type of plan entity	Single employer plan
2018-12-01	Plan funding arrangement – Insurance	Yes
2018-12-01	Plan benefit arrangement – Insurance	Yes
2017: VISTA BANK HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-12-01	Type of plan entity	Single employer plan
2017-12-01	First time form 5500 has been submitted	Yes
2017-12-01	Plan funding arrangement – Insurance	Yes
2017-12-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )

Policy contract number

F025125

Policy instance

Insurance contract or identification number	F025125
Number of Individuals Covered	215
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $14,462
Total amount of fees paid to insurance company	USD $834
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $142,122
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

JRN77

Policy instance

Insurance contract or identification number	JRN77
Number of Individuals Covered	52
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $6,017
Total amount of fees paid to insurance company	USD $24
Other welfare benefits provided	ACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER
Welfare Benefit Premiums Paid to Carrier	USD $42,374
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

8346

Policy instance

Insurance contract or identification number	8346
Number of Individuals Covered	374
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $78,180
Total amount of fees paid to insurance company	USD $1,307
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,079,252
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

8346

Policy instance

Insurance contract or identification number	8346
Number of Individuals Covered	275
Insurance policy start date	2022-12-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $5,318
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $138,359
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

JRN77

Policy instance

Insurance contract or identification number	JRN77
Number of Individuals Covered	46
Insurance policy start date	2022-12-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $228
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER
Welfare Benefit Premiums Paid to Carrier	USD $3,233
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )

Policy contract number

F025125

Policy instance

Insurance contract or identification number	F025125
Number of Individuals Covered	150
Insurance policy start date	2022-12-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $1,186
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $8,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )

Policy contract number

F025125

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

JRN77

Policy instance

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

8346

Policy instance

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )

Policy contract number

F025125

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

JRN77

Policy instance

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

8346

Policy instance

RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61700 )

Policy contract number

4884

Policy instance

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )

Policy contract number

F025125

Policy instance

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

8346

Policy instance

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM609421

Policy instance

RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61700 )

Policy contract number

4884

Policy instance

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

8346

Policy instance

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

8346

Policy instance

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

160849

Policy instance

Potentially related plans

VISTA BANK TEXAS PROFIT SHARING PLAN [EIN = 741676486]

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Company Name:	VISTA BANK
Employer identification number (EIN):	750548850
NAIC Classification:	522110
NAIC Description:	Commercial Banking

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1929-03-27
Company Identification Number:	0000115001
Legal Registered Office Address:	901 MAIN ST RALLS United States of America (USA) 79357