401k Plan data: TBK BANK SSB DENTAL PLAN plan

TBK BANK SSB DENTAL PLAN 401k Plan overview

Plan Name	TBK BANK SSB DENTAL PLAN
Plan identification number	506

TBK BANK SSB DENTAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Dental

401k Sponsoring company profile

TBK BANK, SSB has sponsored the creation of one or more 401k plans.

Company Name: TBK BANK, SSB

Employer identification number (EIN): 751745500

NAIC Classification: 522110
NAIC Description: Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TBK BANK SSB DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
506 2016-01-01 PEGGY BREHMER-HULL
506 2015-10-01 PEGGY BREHMER-HULL

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
506	2016-01-01	PEGGY BREHMER-HULL
506	2015-10-01	PEGGY BREHMER-HULL

Plan Statistics for TBK BANK SSB DENTAL PLAN

401k plan membership statisitcs for TBK BANK SSB DENTAL PLAN

Measure Date Value
2016: TBK BANK SSB DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 184
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 178
Number of retired or separated participants receiving benefits 2016-01-01 4
Total of all active and inactive participants 2016-01-01 182
Total participants 2016-01-01 182
2015: TBK BANK SSB DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year 2015-10-01 386
Total number of active participants reported on line 7a of the Form 5500 2015-10-01 397
Total of all active and inactive participants 2015-10-01 397
Total participants 2015-10-01 397

Measure	Date	Value
2016: TBK BANK SSB DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	184
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	178
Number of retired or separated participants receiving benefits	2016-01-01	4
Total of all active and inactive participants	2016-01-01	182
Total participants	2016-01-01	182
2015: TBK BANK SSB DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year	2015-10-01	386
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	397
Total of all active and inactive participants	2015-10-01	397
Total participants	2015-10-01	397

Form 5500 Responses for TBK BANK SSB DENTAL PLAN

2016: TBK BANK SSB DENTAL PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: TBK BANK SSB DENTAL PLAN 2015 form 5500 responses
2015-10-01	Type of plan entity	Single employer plan
2015-10-01	First time form 5500 has been submitted	Yes
2015-10-01	Submission has been amended	No
2015-10-01	This submission is the final filing	No
2015-10-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-10-01	Plan is a collectively bargained plan	No
2015-10-01	Plan funding arrangement – Insurance	Yes
2015-10-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

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

Policy contract number

KM05914927

Policy instance

Insurance contract or identification number	KM05914927
Number of Individuals Covered	386
Insurance policy start date	2015-01-01
Insurance policy end date	2015-09-30
Total amount of commissions paid to insurance broker	USD $20,694
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 $39,274
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $20,694
Insurance broker organization code?	3
Insurance broker name	LB BENEFITS INC

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Company Name:	TBK BANK, SSB
Employer identification number (EIN):	751745500
NAIC Classification:	522110
NAIC Description:	Commercial Banking