401k Plan data: GROUP SHORT TERM DISABILITY plan

GROUP SHORT TERM DISABILITY 401k Plan overview

Plan Name	GROUP SHORT TERM DISABILITY
Plan identification number	504

GROUP SHORT TERM DISABILITY Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Temporary disability (accident and sickness)

401k Sponsoring company profile

CAMPUS USA CREDIT UNION has sponsored the creation of one or more 401k plans.

Company Name: CAMPUS USA CREDIT UNION

Employer identification number (EIN): 590637646

NAIC Classification: 522130
NAIC Description: Credit Unions

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP SHORT TERM DISABILITY

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2015-01-01 JILL HARPER JILL HARPER 2016-07-29
504 2014-01-01 JILL E. HARPER
504 2013-01-01 JILL E. HARPER
504 2012-05-01 JILL E HARPER
504 2011-05-01 JILL HARPER JILL HARPER 2012-10-04
504 2010-05-01 JILL E HARPER
504 2009-05-01 JILL E HARPER

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
504	2015-01-01	JILL HARPER	JILL HARPER	2016-07-29
504	2014-01-01	JILL E. HARPER
504	2013-01-01	JILL E. HARPER
504	2012-05-01	JILL E HARPER
504	2011-05-01	JILL HARPER	JILL HARPER	2012-10-04
504	2010-05-01	JILL E HARPER
504	2009-05-01	JILL E HARPER

Plan Statistics for GROUP SHORT TERM DISABILITY

401k plan membership statisitcs for GROUP SHORT TERM DISABILITY

Measure Date Value
2015: GROUP SHORT TERM DISABILITY 2015 401k membership
Total participants, beginning-of-year 2015-01-01 181
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 201
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 201
Total participants 2015-01-01 201
2014: GROUP SHORT TERM DISABILITY 2014 401k membership
Total participants, beginning-of-year 2014-01-01 172
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 181
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 181
2013: GROUP SHORT TERM DISABILITY 2013 401k membership
Total participants, beginning-of-year 2013-01-01 169
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 172
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 172
Number of participants with account balances 2013-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: GROUP SHORT TERM DISABILITY 2012 401k membership
Total participants, beginning-of-year 2012-05-01 162
Total number of active participants reported on line 7a of the Form 5500 2012-05-01 169
Number of retired or separated participants receiving benefits 2012-05-01 0
Number of other retired or separated participants entitled to future benefits 2012-05-01 0
Total of all active and inactive participants 2012-05-01 169
2011: GROUP SHORT TERM DISABILITY 2011 401k membership
Total participants, beginning-of-year 2011-05-01 163
Total number of active participants reported on line 7a of the Form 5500 2011-05-01 162
Total of all active and inactive participants 2011-05-01 162
2010: GROUP SHORT TERM DISABILITY 2010 401k membership
Total participants, beginning-of-year 2010-05-01 166
Total number of active participants reported on line 7a of the Form 5500 2010-05-01 163
Number of retired or separated participants receiving benefits 2010-05-01 0
Total of all active and inactive participants 2010-05-01 163
2009: GROUP SHORT TERM DISABILITY 2009 401k membership
Total participants, beginning-of-year 2009-05-01 165
Total number of active participants reported on line 7a of the Form 5500 2009-05-01 165
Total of all active and inactive participants 2009-05-01 165

Measure	Date	Value
2015: GROUP SHORT TERM DISABILITY 2015 401k membership
Total participants, beginning-of-year	2015-01-01	181
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	201
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	201
Total participants	2015-01-01	201
2014: GROUP SHORT TERM DISABILITY 2014 401k membership
Total participants, beginning-of-year	2014-01-01	172
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	181
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	181
2013: GROUP SHORT TERM DISABILITY 2013 401k membership
Total participants, beginning-of-year	2013-01-01	169
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	172
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	172
Number of participants with account balances	2013-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: GROUP SHORT TERM DISABILITY 2012 401k membership
Total participants, beginning-of-year	2012-05-01	162
Total number of active participants reported on line 7a of the Form 5500	2012-05-01	169
Number of retired or separated participants receiving benefits	2012-05-01	0
Number of other retired or separated participants entitled to future benefits	2012-05-01	0
Total of all active and inactive participants	2012-05-01	169
2011: GROUP SHORT TERM DISABILITY 2011 401k membership
Total participants, beginning-of-year	2011-05-01	163
Total number of active participants reported on line 7a of the Form 5500	2011-05-01	162
Total of all active and inactive participants	2011-05-01	162
2010: GROUP SHORT TERM DISABILITY 2010 401k membership
Total participants, beginning-of-year	2010-05-01	166
Total number of active participants reported on line 7a of the Form 5500	2010-05-01	163
Number of retired or separated participants receiving benefits	2010-05-01	0
Total of all active and inactive participants	2010-05-01	163
2009: GROUP SHORT TERM DISABILITY 2009 401k membership
Total participants, beginning-of-year	2009-05-01	165
Total number of active participants reported on line 7a of the Form 5500	2009-05-01	165
Total of all active and inactive participants	2009-05-01	165

Form 5500 Responses for GROUP SHORT TERM DISABILITY

2015: GROUP SHORT TERM DISABILITY 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	First time form 5500 has been submitted	Yes
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: GROUP SHORT TERM DISABILITY 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: GROUP SHORT TERM DISABILITY 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: GROUP SHORT TERM DISABILITY 2012 form 5500 responses
2012-05-01	Type of plan entity	Single employer plan
2012-05-01	Submission has been amended	No
2012-05-01	This submission is the final filing	No
2012-05-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2012-05-01	Plan is a collectively bargained plan	No
2012-05-01	Plan funding arrangement – Insurance	Yes
2012-05-01	Plan benefit arrangement – Insurance	Yes
2011: GROUP SHORT TERM DISABILITY 2011 form 5500 responses
2011-05-01	Type of plan entity	Single employer plan
2011-05-01	Submission has been amended	No
2011-05-01	This submission is the final filing	No
2011-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-05-01	Plan is a collectively bargained plan	No
2011-05-01	Plan funding arrangement – Insurance	Yes
2011-05-01	Plan benefit arrangement – Insurance	Yes
2010: GROUP SHORT TERM DISABILITY 2010 form 5500 responses
2010-05-01	Type of plan entity	Single employer plan
2010-05-01	Submission has been amended	No
2010-05-01	This submission is the final filing	No
2010-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-05-01	Plan is a collectively bargained plan	No
2010-05-01	Plan funding arrangement – Insurance	Yes
2010-05-01	Plan benefit arrangement – Insurance	Yes
2009: GROUP SHORT TERM DISABILITY 2009 form 5500 responses
2009-05-01	Type of plan entity	Single employer plan
2009-05-01	Submission has been amended	No
2009-05-01	This submission is the final filing	No
2009-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-05-01	Plan is a collectively bargained plan	No
2009-05-01	Plan funding arrangement – Insurance	Yes
2009-05-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

000010183205

Policy instance

Insurance contract or identification number	000010183205
Number of Individuals Covered	201
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2,842
Total amount of fees paid to insurance company	USD $1,268
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	Yes
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 $46,591
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $317
Insurance broker organization code?	3
Amount paid for insurance broker fees	1268
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker name	DIGITAL INSURANCE AGENCY

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

000010183205 00

Policy instance

Insurance contract or identification number	000010183205 00
Number of Individuals Covered	181
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $2,755
Total amount of fees paid to insurance company	USD $2,007
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	Yes
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 $42,251
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,755
Amount paid for insurance broker fees	2007
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE AGENCY

CUNA MUTUAL GROUP (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

009-0115-4

Policy instance

Insurance contract or identification number	009-0115-4
Number of Individuals Covered	172
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
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	Yes
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 $46,383
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CUNA MUTUAL GROUP (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

009-0115-4

Policy instance

Insurance contract or identification number	009-0115-4
Number of Individuals Covered	169
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
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	Yes
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 $44,614
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CUNA MUTUAL GROUP (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

009-0115-4

Policy instance

Insurance contract or identification number	009-0115-4
Number of Individuals Covered	162
Insurance policy start date	2011-05-01
Insurance policy end date	2012-04-30
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	Yes
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 $40,941
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CUNA MUTUAL GROUP (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

009-0115-4

Policy instance

Insurance contract or identification number	009-0115-4
Number of Individuals Covered	163
Insurance policy start date	2010-05-01
Insurance policy end date	2011-04-30
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	Yes
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 $40,055
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	CAMPUS USA CREDIT UNION
Employer identification number (EIN):	590637646
NAIC Classification:	522130
NAIC Description:	Credit Unions