Form 5500 · Employee benefit plan · SANTA ROSA, CA
SUMMIT STATE BANK
SUMMIT STATE BANK of SANTA ROSA, CA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is ACRISURE WEST INS SERVICES. Coverage is written through CIGNA HEALTH AND LIFE INSURANCE COMPANY and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 94-2878925 · plan 501 · as of Jul 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Commission |
|---|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health | 52 | December | $69,155 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | Dental | 100 | December | $12,952 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 104 | December | $12,104 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 106 | December | $2,241 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 104 | December | $1,438 |
| VISION SERVICE PLAN | Vision | 95 | December | $0 |
Questions
Who is SUMMIT STATE BANK's benefits broker?
Per its most recent Form 5500 Schedule A, SUMMIT STATE BANK's broker of record is ACRISURE WEST INS SERVICES.
What insurance carrier does SUMMIT STATE BANK use?
SUMMIT STATE BANK's benefit plan is written through CIGNA HEALTH AND LIFE INSURANCE COMPANY, among 6 disclosed carriers.
When does SUMMIT STATE BANK's group plan renew?
The most recent Schedule A policy period for SUMMIT STATE BANK ended in December. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from SUMMIT STATE BANK's public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.