Form 5500 · Employee benefit plan · FRANKLIN, WV
PENDLETON COMMUNITY BANK
The filing calls this plan PENDLETON COMMUNITY BANK EMPLOYEE BENEFIT PLAN.
PENDLETON COMMUNITY BANK of FRANKLIN, WV insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is LAYMAN DIENER & BORNTRAGER INS. Coverage is written through PRINCIPAL LIFE INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in May.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 55-0251555 · plan 502 · plan year 2025, filed Dec 18, 2025
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
Also declared: death benefits.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 3 insured contracts covering health, dental, vision, life and disability; the largest, with PRINCIPAL LIFE INSURANCE COMPANY, covers 178 people.
Reported premium across the insured contracts is $151,237, with $13,628 in disclosed broker commissions — about 9% of premium.
The most recent policy period ended in May, and the plan year ends May 31. Group contracts typically renew on that annual cycle.
LAYMAN DIENER & BORNTRAGER INS is the broker of record on all 3 contracts.
Two carriers split the book: PRINCIPAL LIFE INSURANCE COMPANY and UNITED OF OMAHA LIFE INSURANCE COMPANY.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| PRINCIPAL LIFE INSURANCE COMPANY | Health, Dental, Vision, Life | 178 | Jun 1, 2025 | $88,613 | $7,105 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life, Disability | 134 | Jun 1, 2025 | $40,025 | $3,513 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 134 | Jun 1, 2025 | $22,599 | $3,010 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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