401k Plan data: NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST plan

NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST 401k Plan overview

Plan Name	NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST
Plan identification number	002

NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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.
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

NORTH STAR COMMUNITY CREDIT UNION has sponsored the creation of one or more 401k plans.

Company Name: NORTH STAR COMMUNITY CREDIT UNION

Employer identification number (EIN): 450260598

NAIC Classification: 522130
NAIC Description: Credit Unions

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2020-01-01
002 2019-01-01 WENDY L ARNE 2020-06-03
002 2018-01-01 WENDY L ARNE 2019-07-09
002 2017-01-01 WENDY L ARNE 2018-05-31
002 2016-01-01 WENDY L ARNE 2017-07-19
002 2015-01-01 WENDY ARNE 2016-06-03
002 2014-01-01 CYNTHIA HEGLAND 2015-06-22
002 2013-01-01 CYNTHIA HEGLAND 2014-06-26
002 2012-01-01 CYNTHIA HEGLAND 2013-06-20
002 2011-01-01 CYNTHIA HEGLAND 2012-04-05 CYNTHIA HEGLAND 2012-04-05
002 2010-01-01 CYNTHIA HEGLAND 2011-07-21 CYNTHIA HEGLAND 2011-07-21

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01
002	2020-01-01
002	2019-01-01	WENDY L ARNE	2020-06-03
002	2018-01-01	WENDY L ARNE	2019-07-09
002	2017-01-01	WENDY L ARNE	2018-05-31
002	2016-01-01	WENDY L ARNE	2017-07-19
002	2015-01-01	WENDY ARNE	2016-06-03
002	2014-01-01	CYNTHIA HEGLAND	2015-06-22
002	2013-01-01	CYNTHIA HEGLAND	2014-06-26
002	2012-01-01	CYNTHIA HEGLAND	2013-06-20
002	2011-01-01	CYNTHIA HEGLAND	2012-04-05	CYNTHIA HEGLAND	2012-04-05
002	2010-01-01	CYNTHIA HEGLAND	2011-07-21	CYNTHIA HEGLAND	2011-07-21

Plan Statistics for NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST

401k plan membership statisitcs for NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST

Measure Date Value
2022: NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST 2022 401k membership
Total participants, beginning-of-year 2022-01-01 121
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 0
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 0
Number of participants with account balances 2022-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST 2021 401k membership
Total participants, beginning-of-year 2021-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 90
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 28
Total of all active and inactive participants 2021-01-01 118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 118
Number of participants with account balances 2021-01-01 118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 8
2020: NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST 2020 401k membership
Total participants, beginning-of-year 2020-01-01 137
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 84
Number of retired or separated participants receiving benefits 2020-01-01 1
Number of other retired or separated participants entitled to future benefits 2020-01-01 28
Total of all active and inactive participants 2020-01-01 113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 113
Number of participants with account balances 2020-01-01 113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 19

Measure	Date	Value
2022: NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST 2022 401k membership
Total participants, beginning-of-year	2022-01-01	121
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	0
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	0
Number of participants with account balances	2022-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST 2021 401k membership
Total participants, beginning-of-year	2021-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	90
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	28
Total of all active and inactive participants	2021-01-01	118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	118
Number of participants with account balances	2021-01-01	118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	8
2020: NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST 2020 401k membership
Total participants, beginning-of-year	2020-01-01	137
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	84
Number of retired or separated participants receiving benefits	2020-01-01	1
Number of other retired or separated participants entitled to future benefits	2020-01-01	28
Total of all active and inactive participants	2020-01-01	113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	113
Number of participants with account balances	2020-01-01	113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	19

Financial Data on NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST

Measure	Date	Value
2022 : NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total transfer of assets from this plan	2022-12-31	$4,169,789
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-251,317
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$614,608
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$593,546
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$597,014
Value of total assets at end of year	2022-12-31	$0
Value of total assets at beginning of year	2022-12-31	$5,035,714
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$21,062
Total interest from all sources	2022-12-31	$4,692
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$104,715
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$104,715
Administrative expenses professional fees incurred	2022-12-31	$474
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2022-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$292,322
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$5,608
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$125,273
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-865,925
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$5,035,714
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$4,130,080
Interest on participant loans	2022-12-31	$253
Interest earned on other investments	2022-12-31	$4,439
Value of interest in common/collective trusts at end of year	2022-12-31	$0
Value of interest in common/collective trusts at beginning of year	2022-12-31	$563,443
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$336,583
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-884,185
Net investment gain or loss from common/collective trusts	2022-12-31	$-73,553
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$179,419
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$593,546
Contract administrator fees	2022-12-31	$20,588
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2022-12-31	Yes
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	BRADY, MARTZ & ASSOCIATES P.C.
Accountancy firm EIN	2022-12-31	450310328
2021 : NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,391,780
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$446,013
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$415,782
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$853,152
Value of total assets at end of year	2021-12-31	$5,035,714
Value of total assets at beginning of year	2021-12-31	$4,089,947
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$30,231
Total interest from all sources	2021-12-31	$5,584
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$68,542
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$68,542
Administrative expenses professional fees incurred	2021-12-31	$355
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$253,263
Participant contributions at end of year	2021-12-31	$5,608
Participant contributions at beginning of year	2021-12-31	$5,875
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$385,647
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$945,767
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$5,035,714
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$4,089,947
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$4,130,080
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$3,279,181
Interest on participant loans	2021-12-31	$241
Interest earned on other investments	2021-12-31	$5,343
Value of interest in common/collective trusts at end of year	2021-12-31	$563,443
Value of interest in common/collective trusts at beginning of year	2021-12-31	$466,424
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$336,583
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$338,467
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$408,866
Net investment gain or loss from common/collective trusts	2021-12-31	$55,636
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$214,242
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$415,782
Contract administrator fees	2021-12-31	$29,876
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	BRADY, MARTZ & ASSOCIATES P.C.
Accountancy firm EIN	2021-12-31	450310328
2020 : NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$1,085,400
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$196,018
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$171,409
Value of total corrective distributions	2020-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$507,175
Value of total assets at end of year	2020-12-31	$4,089,947
Value of total assets at beginning of year	2020-12-31	$3,200,565
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$24,609
Total interest from all sources	2020-12-31	$468
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$63,327
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$63,327
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$253,140
Participant contributions at end of year	2020-12-31	$5,875
Participant contributions at beginning of year	2020-12-31	$13,334
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$74,410
Total non interest bearing cash at end of year	2020-12-31	$0
Total non interest bearing cash at beginning of year	2020-12-31	$14,113
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$889,382
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$4,089,947
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$3,200,565
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$3,279,181
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$2,496,224
Interest on participant loans	2020-12-31	$468
Value of interest in common/collective trusts at end of year	2020-12-31	$466,424
Value of interest in common/collective trusts at beginning of year	2020-12-31	$505,569
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$338,467
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$171,325
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$457,028
Net investment gain or loss from common/collective trusts	2020-12-31	$57,402
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$179,625
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$171,409
Contract administrator fees	2020-12-31	$24,609
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	BRADY, MARTZ & ASSOCIATES P.C.
Accountancy firm EIN	2020-12-31	450310328

Form 5500 Responses for NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST

2022: NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	Yes
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: NORTH STAR COMMUNITY CREDIT UNION 401(K) PLAN AND TRUST 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

CMFG LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

033-0037-0

Policy instance

Insurance contract or identification number	033-0037-0
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
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	1
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CMFG LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

033-0037-0

Policy instance

Insurance contract or identification number	033-0037-0
Number of Individuals Covered	118
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
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?	0
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	1
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CMFG LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

033-0037-0

Policy instance

Insurance contract or identification number	033-0037-0
Number of Individuals Covered	113
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
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	1
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

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Company Name:	NORTH STAR COMMUNITY CREDIT UNION
Employer identification number (EIN):	450260598
NAIC Classification:	522130
NAIC Description:	Credit Unions