401k Plan data: MY COMMUNITY FEDERAL CREDIT UNION EMPLOYEE BENEFITS THROUGH GUARDIAN plan

MY COMMUNITY FEDERAL CREDIT UNION EMPLOYEE BENEFITS THROUGH GUARDIAN 401k Plan overview

Plan Name	MY COMMUNITY FEDERAL CREDIT UNION EMPLOYEE BENEFITS THROUGH GUARDIAN
Plan identification number	935

MY COMMUNITY FEDERAL CREDIT UNION EMPLOYEE BENEFITS THROUGH GUARDIAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

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

Company Name: MY COMMUNITY CREDIT UNION

Employer identification number (EIN): 750969777

NAIC Classification: 522130
NAIC Description: Credit Unions

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MY COMMUNITY FEDERAL CREDIT UNION EMPLOYEE BENEFITS THROUGH GUARDIAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
935 2015-01-01 ALTON OVERALL
935 2014-01-01 ALTON OVERALL ALTON OVERALL 2015-07-23

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
935	2015-01-01	ALTON OVERALL
935	2014-01-01	ALTON OVERALL		ALTON OVERALL	2015-07-23

Plan Statistics for MY COMMUNITY FEDERAL CREDIT UNION EMPLOYEE BENEFITS THROUGH GUARDIAN

401k plan membership statisitcs for MY COMMUNITY FEDERAL CREDIT UNION EMPLOYEE BENEFITS THROUGH GUARDIAN

Measure Date Value
2015: MY COMMUNITY FEDERAL CREDIT UNION EMPLOYEE BENEFITS THROUGH GUARDIAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 108
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 107
Total of all active and inactive participants 2015-01-01 107
Total participants 2015-01-01 107
2014: MY COMMUNITY FEDERAL CREDIT UNION EMPLOYEE BENEFITS THROUGH GUARDIAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 108
Total of all active and inactive participants 2014-01-01 108
Total participants 2014-01-01 108

Measure	Date	Value
2015: MY COMMUNITY FEDERAL CREDIT UNION EMPLOYEE BENEFITS THROUGH GUARDIAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	108
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	107
Total of all active and inactive participants	2015-01-01	107
Total participants	2015-01-01	107
2014: MY COMMUNITY FEDERAL CREDIT UNION EMPLOYEE BENEFITS THROUGH GUARDIAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	108
Total of all active and inactive participants	2014-01-01	108
Total participants	2014-01-01	108

Form 5500 Responses for MY COMMUNITY FEDERAL CREDIT UNION EMPLOYEE BENEFITS THROUGH GUARDIAN

2015: MY COMMUNITY FEDERAL CREDIT UNION EMPLOYEE BENEFITS THROUGH GUARDIAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
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: MY COMMUNITY FEDERAL CREDIT UNION EMPLOYEE BENEFITS THROUGH GUARDIAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	First time form 5500 has been submitted	Yes
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

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00432935

Policy instance

Insurance contract or identification number	00432935
Number of Individuals Covered	108
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $15,584
Total amount of fees paid to insurance company	USD $1,684
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	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
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 $133,798
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $20
Insurance broker organization code?	3
Amount paid for insurance broker fees	1681
Insurance broker name	DIGITAL INS INC

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00432935

Policy instance

Insurance contract or identification number	00432935
Number of Individuals Covered	108
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $13,766
Total amount of fees paid to insurance company	USD $1,688
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	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
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 $118,887
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $69
Insurance broker organization code?	3
Amount paid for insurance broker fees	1688
Insurance broker name	DIGITAL INS INC

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Company Name:	MY COMMUNITY CREDIT UNION
Employer identification number (EIN):	750969777
NAIC Classification:	522130
NAIC Description:	Credit Unions