401k Plan data: PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT PLAN plan

PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 401k Plan overview

Plan Name	PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT PLAN
Plan identification number	506

PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision

401k Sponsoring company profile

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

Company Name: PURDUE FEDERAL CREDIT UNION

Employer identification number (EIN): 351163349

NAIC Classification: 522130
NAIC Description: Credit Unions

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
506 2022-01-01 JACKIE HOFMAN 2023-08-16
506 2021-01-01 JACQUELINE D HOFMAN 2022-07-19
506 2020-01-01 JACQUELINE D HOFMAN 2021-06-30 JACQUELINE D HOFMAN 2021-06-30
506 2019-01-01 JACQUELINE D HOFMAN 2020-07-13 SHAUN L SENGSANITH 2020-07-13
506 2018-01-01
506 2017-01-01
506 2016-01-01 FRANK FAY
506 2015-01-01 FRANK FAY
506 2014-01-01 REGINALD HOLMES
506 2013-01-01 DENNIS LEIGH
506 2012-01-01 DENNIS A. LEIGH
506 2011-01-01 DENNIS LEIGH
506 2009-01-01 DENNIS LEIGH

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
506	2022-01-01	JACKIE HOFMAN	2023-08-16
506	2021-01-01	JACQUELINE D HOFMAN	2022-07-19
506	2020-01-01	JACQUELINE D HOFMAN	2021-06-30	JACQUELINE D HOFMAN	2021-06-30
506	2019-01-01	JACQUELINE D HOFMAN	2020-07-13	SHAUN L SENGSANITH	2020-07-13
506	2018-01-01
506	2017-01-01
506	2016-01-01	FRANK FAY
506	2015-01-01	FRANK FAY
506	2014-01-01	REGINALD HOLMES
506	2013-01-01	DENNIS LEIGH
506	2012-01-01	DENNIS A. LEIGH
506	2011-01-01	DENNIS LEIGH
506	2009-01-01	DENNIS LEIGH

Form 5500 Responses for PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT PLAN

2022: PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	This submission is the final filing	Yes
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 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 – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
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 – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT 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 – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT 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 – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: PURDUE EMPLOYEES FEDERAL CREDIT UNION SELF-FUNDED MEDICAL REIMBURSEMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
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 – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30001630

Policy instance

Insurance contract or identification number	30001630
Number of Individuals Covered	225
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $34,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

HCL32041

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30001630

Policy instance

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

HCL32041

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30001630

Policy instance

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

HCL32041

Policy instance

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

HCL32041

Policy instance

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

HCL32041

Policy instance

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Company Name:	PURDUE FEDERAL CREDIT UNION
Employer identification number (EIN):	351163349
NAIC Classification:	522130
NAIC Description:	Credit Unions