401k Plan data: SUMMIT CREDIT UNION LONG TERM CARE PLAN plan

SUMMIT CREDIT UNION LONG TERM CARE PLAN 401k Plan overview

Plan Name	SUMMIT CREDIT UNION LONG TERM CARE PLAN
Plan identification number	507

SUMMIT CREDIT UNION LONG TERM CARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Other welfare benefit cover

401k Sponsoring company profile

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

Company Name: SUMMIT CREDIT UNION

Employer identification number (EIN): 390230585

NAIC Classification: 522130
NAIC Description: Credit Unions

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SUMMIT CREDIT UNION LONG TERM CARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
507 2012-01-01 NANCY SCHMIDT
507 2011-01-01 DENISE O'HARA
507 2010-01-01 DENISE K. OHARA DENISE K. OHARA 2011-07-21
507 2009-01-01 DENISE OHARA DENISE OHARA 2010-10-13

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
507	2012-01-01	NANCY SCHMIDT
507	2011-01-01	DENISE O'HARA
507	2010-01-01	DENISE K. OHARA	DENISE K. OHARA	2011-07-21
507	2009-01-01	DENISE OHARA	DENISE OHARA	2010-10-13

Plan Statistics for SUMMIT CREDIT UNION LONG TERM CARE PLAN

401k plan membership statisitcs for SUMMIT CREDIT UNION LONG TERM CARE PLAN

Measure Date Value
2012: SUMMIT CREDIT UNION LONG TERM CARE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 320
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 259
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 259
2011: SUMMIT CREDIT UNION LONG TERM CARE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 268
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 266
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 266
2010: SUMMIT CREDIT UNION LONG TERM CARE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 289
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 268
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 268
2009: SUMMIT CREDIT UNION LONG TERM CARE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 304
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 289
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 289

Measure	Date	Value
2012: SUMMIT CREDIT UNION LONG TERM CARE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	320
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	259
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	259
2011: SUMMIT CREDIT UNION LONG TERM CARE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	268
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	266
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	266
2010: SUMMIT CREDIT UNION LONG TERM CARE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	289
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	268
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	268
2009: SUMMIT CREDIT UNION LONG TERM CARE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	304
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	289
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	289

Form 5500 Responses for SUMMIT CREDIT UNION LONG TERM CARE PLAN

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

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

000000567905

Policy instance

Insurance contract or identification number	000000567905
Number of Individuals Covered	259
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $21,475
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	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	LONG TERM CARE
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 $143,834
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,475
Insurance broker organization code?	3
Insurance broker name	RICHARDS BENEFITS & FINANCIAL

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

567905

Policy instance

Insurance contract or identification number	567905
Number of Individuals Covered	266
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $22,137
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	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	GROUP LONG TERM CARE
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 $147,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

000000567905

Policy instance

Insurance contract or identification number	000000567905
Number of Individuals Covered	268
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $22,334
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	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	LONG TERM CARE
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 $148,893
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,334
Insurance broker organization code?	3
Insurance broker name	RICHARDS BENEFITS & FINANCIAL

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Company Name:	SUMMIT CREDIT UNION
Employer identification number (EIN):	390230585
NAIC Classification:	522130
NAIC Description:	Credit Unions