401k Plan data: MEMBERS CREDIT UNION ANCILLARY BENEFITS PLAN plan

MEMBERS CREDIT UNION ANCILLARY BENEFITS PLAN 401k Plan overview

Plan Name	MEMBERS CREDIT UNION ANCILLARY BENEFITS PLAN
Plan identification number	502

MEMBERS CREDIT UNION ANCILLARY BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Dental Vision Long-term disability cover

401k Sponsoring company profile

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

Company Name: MEMBERS CREDIT UNION

Employer identification number (EIN): 566043259

NAIC Classification: 522130
NAIC Description: Credit Unions

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEMBERS CREDIT UNION ANCILLARY BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2021-02-01
502 2021-02-01 ROBERT C. DONLEY 2023-08-21

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2021-02-01
502	2021-02-01	ROBERT C. DONLEY	2023-08-21

Plan Statistics for MEMBERS CREDIT UNION ANCILLARY BENEFITS PLAN

401k plan membership statisitcs for MEMBERS CREDIT UNION ANCILLARY BENEFITS PLAN

Measure Date Value
2021: MEMBERS CREDIT UNION ANCILLARY BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-02-01 105
Total number of active participants reported on line 7a of the Form 5500 2021-02-01 106
Number of retired or separated participants receiving benefits 2021-02-01 0
Number of other retired or separated participants entitled to future benefits 2021-02-01 0
Total of all active and inactive participants 2021-02-01 106

Measure	Date	Value
2021: MEMBERS CREDIT UNION ANCILLARY BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-02-01	105
Total number of active participants reported on line 7a of the Form 5500	2021-02-01	106
Number of retired or separated participants receiving benefits	2021-02-01	0
Number of other retired or separated participants entitled to future benefits	2021-02-01	0
Total of all active and inactive participants	2021-02-01	106

Form 5500 Responses for MEMBERS CREDIT UNION ANCILLARY BENEFITS PLAN

2021: MEMBERS CREDIT UNION ANCILLARY BENEFITS PLAN 2021 form 5500 responses
2021-02-01	Type of plan entity	Single employer plan
2021-02-01	First time form 5500 has been submitted	Yes
2021-02-01	Submission has been amended	No
2021-02-01	This submission is the final filing	No
2021-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-02-01	Plan is a collectively bargained plan	No
2021-02-01	Plan funding arrangement – Insurance	Yes
2021-02-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1137629

Policy instance

Insurance contract or identification number	1137629
Number of Individuals Covered	233
Insurance policy start date	2021-02-01
Insurance policy end date	2022-01-31
Total amount of commissions paid to insurance broker	USD $20,388
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	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	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
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 $143,940
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,544
Insurance broker organization code?	3

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Company Name:	MEMBERS CREDIT UNION
Employer identification number (EIN):	566043259
NAIC Classification:	522130
NAIC Description:	Credit Unions