401k Plan data: H. L. HAYDEL MEMORIAL HOSPICE plan

H. L. HAYDEL MEMORIAL HOSPICE 401k Plan overview

Plan Name	H. L. HAYDEL MEMORIAL HOSPICE
Plan identification number	001

H. L. HAYDEL MEMORIAL HOSPICE Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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

THE AMERICAN NATIONAL BANK OF TEXAS has sponsored the creation of one or more 401k plans.

Company Name: THE AMERICAN NATIONAL BANK OF TEXAS

Employer identification number (EIN): 751747054

NAIC Classification: 522110
NAIC Description: Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan H. L. HAYDEL MEMORIAL HOSPICE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-01-01 DAVID HEAD 2016-09-06
001 2012-01-01 KATHY HOWE
001 2011-01-01 FRANCIS BOROWY

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2015-01-01	DAVID HEAD	2016-09-06
001	2012-01-01	KATHY HOWE
001	2011-01-01	FRANCIS BOROWY

Plan Statistics for H. L. HAYDEL MEMORIAL HOSPICE

401k plan membership statisitcs for H. L. HAYDEL MEMORIAL HOSPICE

Measure Date Value
2012: H. L. HAYDEL MEMORIAL HOSPICE 2012 401k membership
Total participants, beginning-of-year 2012-01-01 602
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
Total of all active and inactive participants 2012-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 0
Number of participants with account balances 2012-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: H. L. HAYDEL MEMORIAL HOSPICE 2011 401k membership
Total participants, beginning-of-year 2011-01-01 604
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 557
Number of retired or separated participants receiving benefits 2011-01-01 4
Number of other retired or separated participants entitled to future benefits 2011-01-01 41
Total of all active and inactive participants 2011-01-01 602
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 602
Number of participants with account balances 2011-01-01 408
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 21

Measure	Date	Value
2012: H. L. HAYDEL MEMORIAL HOSPICE 2012 401k membership
Total participants, beginning-of-year	2012-01-01	602
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
Total of all active and inactive participants	2012-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	0
Number of participants with account balances	2012-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: H. L. HAYDEL MEMORIAL HOSPICE 2011 401k membership
Total participants, beginning-of-year	2011-01-01	604
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	557
Number of retired or separated participants receiving benefits	2011-01-01	4
Number of other retired or separated participants entitled to future benefits	2011-01-01	41
Total of all active and inactive participants	2011-01-01	602
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	602
Number of participants with account balances	2011-01-01	408
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	21

Financial Data on H. L. HAYDEL MEMORIAL HOSPICE

Measure	Date	Value
2012 : H. L. HAYDEL MEMORIAL HOSPICE 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total transfer of assets from this plan	2012-12-31	$6,812,800
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$0
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$0
Value of total assets at end of year	2012-12-31	$0
Value of total assets at beginning of year	2012-12-31	$6,812,800
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$0
Total interest from all sources	2012-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Participant contributions at beginning of year	2012-12-31	$293,496
Participant contributions at beginning of year	2012-12-31	$7
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$0
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$6,812,800
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$6,073,108
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$307,646
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Employer contributions (assets) at end of year	2012-12-31	$0
Employer contributions (assets) at beginning of year	2012-12-31	$138,543
Did the plan have assets held for investment	2012-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	SANFORD, BAUMEISTER & FRAZIER, LLP
Accountancy firm EIN	2012-12-31	208131297
2011 : H. L. HAYDEL MEMORIAL HOSPICE 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets to this plan	2011-12-31	$2,362,355
Total transfer of assets from this plan	2011-12-31	$487,481
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$1,360,548
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$529,397
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$445,408
Value of total corrective distributions	2011-12-31	$3,580
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,565,946
Value of total assets at end of year	2011-12-31	$6,812,800
Value of total assets at beginning of year	2011-12-31	$4,106,775
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$80,409
Total interest from all sources	2011-12-31	$9,958
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Administrative expenses professional fees incurred	2011-12-31	$15,122
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$908,059
Participant contributions at end of year	2011-12-31	$293,496
Participant contributions at beginning of year	2011-12-31	$118,293
Participant contributions at end of year	2011-12-31	$7
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$45,456
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$831,151
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$6,812,800
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$4,106,775
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Investment advisory and management fees	2011-12-31	$58,161
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$3,344,317
Value of interest in pooled separate accounts at end of year	2011-12-31	$6,073,108
Interest on participant loans	2011-12-31	$9,958
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$644,165
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$644,165
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$307,646
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-215,356
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$612,431
Employer contributions (assets) at end of year	2011-12-31	$138,543
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$445,408
Contract administrator fees	2011-12-31	$7,126
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	SANFORD, BAUMEISTER & FRAZIER, PLLC
Accountancy firm EIN	2011-12-31	208131297
2010 : H. L. HAYDEL MEMORIAL HOSPICE 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total transfer of assets to this plan	2010-12-31	$1,506,751
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$862,745
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$73,256
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$43,652
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$761,005
Value of total assets at end of year	2010-12-31	$4,106,775
Value of total assets at beginning of year	2010-12-31	$1,810,535
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$29,604
Total interest from all sources	2010-12-31	$974
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$41,689
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$41,689
Administrative expenses professional fees incurred	2010-12-31	$22,021
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$461,453
Participant contributions at end of year	2010-12-31	$118,293
Participant contributions at beginning of year	2010-12-31	$7,755
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$48,162
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$789,489
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$4,106,775
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,810,535
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Investment advisory and management fees	2010-12-31	$6,212
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$3,344,317
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$1,700,916
Interest on participant loans	2010-12-31	$974
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$644,165
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$101,864
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$101,864
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$59,077
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$251,390
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$43,652
Contract administrator fees	2010-12-31	$1,371
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	SANFORD, BAUMEISTER & FRAZIER, PLLC
Accountancy firm EIN	2010-12-31	208131297

Form 5500 Responses for H. L. HAYDEL MEMORIAL HOSPICE

2012: H. L. HAYDEL MEMORIAL HOSPICE 2012 form 5500 responses
2012-01-01	Type of plan entity	Mulitple employer plan
2012-01-01	Submission has been amended	Yes
2012-01-01	This submission is the final filing	Yes
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: H. L. HAYDEL MEMORIAL HOSPICE 2011 form 5500 responses
2011-01-01	Type of plan entity	Mulitple employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

932319

Policy instance

Insurance contract or identification number	932319
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
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
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

932264-000

Policy instance

Insurance contract or identification number	932264-000
Number of Individuals Covered	408
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,985
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
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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Company Name:	THE AMERICAN NATIONAL BANK OF TEXAS
Employer identification number (EIN):	751747054
NAIC Classification:	522110
NAIC Description:	Commercial Banking