| Plan Name | GROUP LIFE INSURANCE LONG TERM DISABILITY PLAN |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | FIRST COMMUNITY CREDIT UNION |
| Employer identification number (EIN): | 430687711 |
| NAIC Classification: | 522130 |
| NAIC Description: | Credit Unions |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2013-09-01 | ||||
| 503 | 2012-09-01 | ANN KLUGESHERZ | |||
| 503 | 2011-09-01 | ANN KLUGESHERZ | |||
| 503 | 2009-09-01 | ANN KLUGESHERZ |
| CUNA MUTUAL GROUP (National Association of Insurance Commissioners NAIC id number: 62626 ) | |
| Policy contract number | 024-0535-7 |
| Policy instance | 1 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 874612G |
| Policy instance | 2 |