401k Plan data: SHORT TERM DISABILITY PLAN plan

SHORT TERM DISABILITY PLAN 401k Plan overview

Plan Name	SHORT TERM DISABILITY PLAN
Plan identification number	501

SHORT TERM DISABILITY PLAN Benefits

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

401k Sponsoring company profile

POLISH AND SLAVIC FEDERAL CREDIT UNION has sponsored the creation of one or more 401k plans.

Company Name: POLISH AND SLAVIC FEDERAL CREDIT UNION

Employer identification number (EIN): 112433592

NAIC Classification: 522130
NAIC Description: Credit Unions

Form 5500 Filing Information

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

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-02-01 AGATA KROL 2024-11-06
501 2022-02-01 AGATA KROL 2023-10-10
501 2021-02-01 AGATA KROL 2022-11-14
501 2020-02-01 AGATA KROL 2021-11-03
501 2019-07-01 AGATA KROL 2020-11-12
501 2016-07-01
501 2015-07-01 AGATA KROL
501 2014-07-01 AGATA KROL
501 2013-12-01 AGATA KROL
501 2012-12-01 AGATA KROL
501 2011-12-01 AGATA KROL
501 2010-12-01 LORI O'TOOLE
501 2009-12-01 LORI OTOOLE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2023-02-01	AGATA KROL	2024-11-06
501	2022-02-01	AGATA KROL	2023-10-10
501	2021-02-01	AGATA KROL	2022-11-14
501	2020-02-01	AGATA KROL	2021-11-03
501	2019-07-01	AGATA KROL	2020-11-12
501	2016-07-01
501	2015-07-01	AGATA KROL
501	2014-07-01	AGATA KROL
501	2013-12-01	AGATA KROL
501	2012-12-01	AGATA KROL
501	2011-12-01	AGATA KROL
501	2010-12-01	LORI O'TOOLE
501	2009-12-01	LORI OTOOLE

Plan Statistics for SHORT TERM DISABILITY PLAN

401k plan membership statisitcs for SHORT TERM DISABILITY PLAN

Measure Date Value
2023: SHORT TERM DISABILITY PLAN 2023 401k membership
Total participants, beginning-of-year 2023-02-01 346
Total number of active participants reported on line 7a of the Form 5500 2023-02-01 348
Number of retired or separated participants receiving benefits 2023-02-01 0
Number of other retired or separated participants entitled to future benefits 2023-02-01 0
Total of all active and inactive participants 2023-02-01 348
Number of employers contributing to the scheme 2023-02-01 0
2022: SHORT TERM DISABILITY PLAN 2022 401k membership
Total participants, beginning-of-year 2022-02-01 339
Total number of active participants reported on line 7a of the Form 5500 2022-02-01 347
Number of retired or separated participants receiving benefits 2022-02-01 0
Number of other retired or separated participants entitled to future benefits 2022-02-01 0
Total of all active and inactive participants 2022-02-01 347
Number of employers contributing to the scheme 2022-02-01 0
2021: SHORT TERM DISABILITY PLAN 2021 401k membership
Total participants, beginning-of-year 2021-02-01 342
Total number of active participants reported on line 7a of the Form 5500 2021-02-01 337
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 2021-02-01 337
Number of employers contributing to the scheme 2021-02-01 0
2020: SHORT TERM DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year 2020-02-01 155
Total number of active participants reported on line 7a of the Form 5500 2020-02-01 158
Number of retired or separated participants receiving benefits 2020-02-01 0
Number of other retired or separated participants entitled to future benefits 2020-02-01 0
Total of all active and inactive participants 2020-02-01 158
Number of employers contributing to the scheme 2020-02-01 0
2019: SHORT TERM DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year 2019-07-01 147
Total number of active participants reported on line 7a of the Form 5500 2019-07-01 147
Number of retired or separated participants receiving benefits 2019-07-01 0
Number of other retired or separated participants entitled to future benefits 2019-07-01 0
Total of all active and inactive participants 2019-07-01 147
Number of employers contributing to the scheme 2019-07-01 0
2016: SHORT TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 124
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 124
Number of retired or separated participants receiving benefits 2016-07-01 0
Number of other retired or separated participants entitled to future benefits 2016-07-01 0
Total of all active and inactive participants 2016-07-01 124
2015: SHORT TERM DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 110
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 123
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 123
2014: SHORT TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 110
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 110
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 0
Total of all active and inactive participants 2014-07-01 110
2013: SHORT TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year 2013-12-01 109
Total number of active participants reported on line 7a of the Form 5500 2013-12-01 110
Number of retired or separated participants receiving benefits 2013-12-01 0
Number of other retired or separated participants entitled to future benefits 2013-12-01 0
Total of all active and inactive participants 2013-12-01 110
2012: SHORT TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year 2012-12-01 112
Total number of active participants reported on line 7a of the Form 5500 2012-12-01 109
Number of retired or separated participants receiving benefits 2012-12-01 0
Number of other retired or separated participants entitled to future benefits 2012-12-01 0
Total of all active and inactive participants 2012-12-01 109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-12-01 0
Total participants 2012-12-01 109
Number of participants with account balances 2012-12-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-12-01 0
2011: SHORT TERM DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year 2011-12-01 118
Total number of active participants reported on line 7a of the Form 5500 2011-12-01 112
Number of retired or separated participants receiving benefits 2011-12-01 0
Number of other retired or separated participants entitled to future benefits 2011-12-01 0
Total of all active and inactive participants 2011-12-01 112
2010: SHORT TERM DISABILITY PLAN 2010 401k membership
Total participants, beginning-of-year 2010-12-01 109
Total number of active participants reported on line 7a of the Form 5500 2010-12-01 118
Total of all active and inactive participants 2010-12-01 118
2009: SHORT TERM DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year 2009-12-01 95
Total number of active participants reported on line 7a of the Form 5500 2009-12-01 109
Total of all active and inactive participants 2009-12-01 109

Measure	Date	Value
2023: SHORT TERM DISABILITY PLAN 2023 401k membership
Total participants, beginning-of-year	2023-02-01	346
Total number of active participants reported on line 7a of the Form 5500	2023-02-01	348
Number of retired or separated participants receiving benefits	2023-02-01	0
Number of other retired or separated participants entitled to future benefits	2023-02-01	0
Total of all active and inactive participants	2023-02-01	348
Number of employers contributing to the scheme	2023-02-01	0
2022: SHORT TERM DISABILITY PLAN 2022 401k membership
Total participants, beginning-of-year	2022-02-01	339
Total number of active participants reported on line 7a of the Form 5500	2022-02-01	347
Number of retired or separated participants receiving benefits	2022-02-01	0
Number of other retired or separated participants entitled to future benefits	2022-02-01	0
Total of all active and inactive participants	2022-02-01	347
Number of employers contributing to the scheme	2022-02-01	0
2021: SHORT TERM DISABILITY PLAN 2021 401k membership
Total participants, beginning-of-year	2021-02-01	342
Total number of active participants reported on line 7a of the Form 5500	2021-02-01	337
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	337
Number of employers contributing to the scheme	2021-02-01	0
2020: SHORT TERM DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year	2020-02-01	155
Total number of active participants reported on line 7a of the Form 5500	2020-02-01	158
Number of retired or separated participants receiving benefits	2020-02-01	0
Number of other retired or separated participants entitled to future benefits	2020-02-01	0
Total of all active and inactive participants	2020-02-01	158
Number of employers contributing to the scheme	2020-02-01	0
2019: SHORT TERM DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year	2019-07-01	147
Total number of active participants reported on line 7a of the Form 5500	2019-07-01	147
Number of retired or separated participants receiving benefits	2019-07-01	0
Number of other retired or separated participants entitled to future benefits	2019-07-01	0
Total of all active and inactive participants	2019-07-01	147
Number of employers contributing to the scheme	2019-07-01	0
2016: SHORT TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	124
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	124
Number of retired or separated participants receiving benefits	2016-07-01	0
Number of other retired or separated participants entitled to future benefits	2016-07-01	0
Total of all active and inactive participants	2016-07-01	124
2015: SHORT TERM DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	110
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	123
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	123
2014: SHORT TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	110
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	110
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	110
2013: SHORT TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year	2013-12-01	109
Total number of active participants reported on line 7a of the Form 5500	2013-12-01	110
Number of retired or separated participants receiving benefits	2013-12-01	0
Number of other retired or separated participants entitled to future benefits	2013-12-01	0
Total of all active and inactive participants	2013-12-01	110
2012: SHORT TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year	2012-12-01	112
Total number of active participants reported on line 7a of the Form 5500	2012-12-01	109
Number of retired or separated participants receiving benefits	2012-12-01	0
Number of other retired or separated participants entitled to future benefits	2012-12-01	0
Total of all active and inactive participants	2012-12-01	109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-12-01	0
Total participants	2012-12-01	109
Number of participants with account balances	2012-12-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-12-01	0
2011: SHORT TERM DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year	2011-12-01	118
Total number of active participants reported on line 7a of the Form 5500	2011-12-01	112
Number of retired or separated participants receiving benefits	2011-12-01	0
Number of other retired or separated participants entitled to future benefits	2011-12-01	0
Total of all active and inactive participants	2011-12-01	112
2010: SHORT TERM DISABILITY PLAN 2010 401k membership
Total participants, beginning-of-year	2010-12-01	109
Total number of active participants reported on line 7a of the Form 5500	2010-12-01	118
Total of all active and inactive participants	2010-12-01	118
2009: SHORT TERM DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year	2009-12-01	95
Total number of active participants reported on line 7a of the Form 5500	2009-12-01	109
Total of all active and inactive participants	2009-12-01	109

Form 5500 Responses for SHORT TERM DISABILITY PLAN

2023: SHORT TERM DISABILITY PLAN 2023 form 5500 responses
2023-02-01	Type of plan entity	Single employer plan
2023-02-01	Plan funding arrangement – Insurance	Yes
2023-02-01	Plan benefit arrangement – Insurance	Yes
2022: SHORT TERM DISABILITY PLAN 2022 form 5500 responses
2022-02-01	Type of plan entity	Single employer plan
2022-02-01	Plan funding arrangement – Insurance	Yes
2022-02-01	Plan benefit arrangement – Insurance	Yes
2021: SHORT TERM DISABILITY PLAN 2021 form 5500 responses
2021-02-01	Type of plan entity	Single employer plan
2021-02-01	Plan funding arrangement – Insurance	Yes
2021-02-01	Plan benefit arrangement – Insurance	Yes
2020: SHORT TERM DISABILITY PLAN 2020 form 5500 responses
2020-02-01	Type of plan entity	Single employer plan
2020-02-01	Plan funding arrangement – Insurance	Yes
2020-02-01	Plan benefit arrangement – Insurance	Yes
2019: SHORT TERM DISABILITY PLAN 2019 form 5500 responses
2019-07-01	Type of plan entity	Single employer plan
2019-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2019-07-01	Plan funding arrangement – Insurance	Yes
2019-07-01	Plan benefit arrangement – Insurance	Yes
2016: SHORT TERM DISABILITY PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2015: SHORT TERM DISABILITY PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2014: SHORT TERM DISABILITY PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2013: SHORT TERM DISABILITY PLAN 2013 form 5500 responses
2013-12-01	Type of plan entity	Single employer plan
2013-12-01	Submission has been amended	No
2013-12-01	This submission is the final filing	No
2013-12-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2013-12-01	Plan is a collectively bargained plan	No
2013-12-01	Plan funding arrangement – Insurance	Yes
2013-12-01	Plan benefit arrangement – Insurance	Yes
2012: SHORT TERM DISABILITY PLAN 2012 form 5500 responses
2012-12-01	Type of plan entity	Single employer plan
2012-12-01	Submission has been amended	No
2012-12-01	This submission is the final filing	No
2012-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-12-01	Plan is a collectively bargained plan	No
2012-12-01	Plan funding arrangement – Insurance	Yes
2012-12-01	Plan benefit arrangement – Insurance	Yes
2011: SHORT TERM DISABILITY PLAN 2011 form 5500 responses
2011-12-01	Type of plan entity	Single employer plan
2011-12-01	Submission has been amended	Yes
2011-12-01	This submission is the final filing	No
2011-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-12-01	Plan is a collectively bargained plan	No
2011-12-01	Plan funding arrangement – Insurance	Yes
2011-12-01	Plan benefit arrangement – Insurance	Yes
2010: SHORT TERM DISABILITY PLAN 2010 form 5500 responses
2010-12-01	Type of plan entity	Single employer plan
2010-12-01	Submission has been amended	No
2010-12-01	This submission is the final filing	No
2010-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-12-01	Plan is a collectively bargained plan	No
2010-12-01	Plan funding arrangement – Insurance	Yes
2010-12-01	Plan benefit arrangement – Insurance	Yes
2009: SHORT TERM DISABILITY PLAN 2009 form 5500 responses
2009-12-01	Type of plan entity	Single employer plan
2009-12-01	Submission has been amended	No
2009-12-01	This submission is the final filing	No
2009-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-12-01	Plan is a collectively bargained plan	No
2009-12-01	Plan funding arrangement – Insurance	Yes
2009-12-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

NYK700234

Policy instance

Insurance contract or identification number	NYK700234
Number of Individuals Covered	348
Insurance policy start date	2023-02-01
Insurance policy end date	2024-01-31
Total amount of commissions paid to insurance broker	USD $11,522
Total amount of fees paid to insurance company	USD $0
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
Welfare Benefit Premiums Paid to Carrier	USD $71,498
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SDJ0600309

Policy instance

Insurance contract or identification number	SDJ0600309
Number of Individuals Covered	348
Insurance policy start date	2023-02-01
Insurance policy end date	2024-01-31
Total amount of commissions paid to insurance broker	USD $12,162
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $98,221
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

NYK700234

Policy instance

Insurance contract or identification number	NYK700234
Number of Individuals Covered	347
Insurance policy start date	2022-02-01
Insurance policy end date	2023-01-31
Total amount of commissions paid to insurance broker	USD $6,369
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $42,461
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

NYK700234

Policy instance

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

NYK700234

Policy instance

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

NYK700234

Policy instance

UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

10201402

Policy instance

LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )

Policy contract number

10201402

Policy instance

LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )

Policy contract number

10201402

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

932317

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

932317

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

932317

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

932316

Policy instance

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

932317

Policy instance

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Company Name:	POLISH AND SLAVIC FEDERAL CREDIT UNION
Employer identification number (EIN):	112433592
NAIC Classification:	522130
NAIC Description:	Credit Unions