Document Type
Secure File Uploading
To securely send a form with personal information to FCMM, please use our secure file exchange portal.
Displaying 12 of 15
Forms (Churches/Employers)
, Information
pdf 121 Benefit Plan Employer Guide
Contains helpful resources for whomever is administering the Benefit Plan at an organization. The guide contains information regarding coverage highlights, form descriptions, how to complete the Employer Benefit Agreement, premium amounts, payment method descriptions, paying invoice online, and frequently asked questions.
Filename:
121-Benefit Plan Employer Guide - 2309.pdf
Size:
2107 KB
Forms (Churches/Employers)
, Information
pdf 120 Benefit Plan Employer Agreement
New employers to the Benefit Plan must complete this form upon initially entering the plan. Current employers can only updated benefits and coverage during the annual open enrollment period by completing this form. The form details two benefit plan options, employee eligibility, payment methods, and Life/AD&D coverage amounts.
Filename:
120-Benefit Plan Employer Benefit Agreement FILLABLE - 2309.pdf
Size:
554 KB
Forms (Churches/Employers)
pdf 104 Benefit Plan Application Addendum for Updates
This form can only be completed during the annual open enrollment period after an employer updates their Employer Benefit Agreement (Form 120). Employees receiving a change to their benefits must complete this form.
Filename:
104-Benefit Plan Application Addendum for Updates FILLABLE - 2309.pdf
Size:
432 KB
Forms (Churches/Employers)
pdf 27 TEMPLATE-Annual Notice of Right to Participate in 403b
FCMM recommends that employers annually notify employees of their eligibility to participate in the Retirement Plan. This fillable form template can serve that purpose. The template also provides documentation for the eligible employee to opt out of participating. If an employer wishes to customize the template, it may request an editable Word version of the notice by emailing fcmm@fcmmbenefits.org.
Filename:
27 FORM_Annual Notice of Right to Participate in 403b (FILLABLE) 2501.pdf
Size:
205 KB
Forms (Participants)
, Forms (Churches/Employers)
pdf 135 Benefit Plan - How to File a Claim
Steps to follow when filing a claim for the Benefit Plan
Filename:
135 - Benefit Plan Filing A Claim - 2309.pdf
Size:
373 KB
Forms (Churches/Employers)
, Information
pdf ICHRA Individual Coverage HRA Summary and Checklist
Information and policy checklist for a church employer considering implementing an ICHRA (Individual Coverage Health Reimbursement Arrangement) for reimbursing individual health insurance premiums tax-free.
Filename:
ICHRA-Summary-Checklist-Policy-201909_0.pdf
Size:
183 KB
Forms (Churches/Employers)
pdf 25 Contribution Remittance Form
Blank form for employer to complete and send with the remittance of Retirement Plan contribution(s) to FCMM. See Form 24 for instructions. More information is also available in Form 21 Employer Guide. A customized remittance form is provided with each confirmation of contributions. The customized remittance is also available as an Excel file upon request.
Filename:
25 Contribution Remittance Form (FILLABLE) 2501.pdf
Size:
200 KB
Forms (Participants)
, Forms (Churches/Employers)
, Brochures
pdf FCMM Retirement Plan Brochure
Advantages | How Contributions Work | Multiple Investment Options | Contribution Limits | Forms of Distributions | Contact Information
Filename:
20250101_FCMMBrochure_RetirementPlan (web).pdf
Size:
678 KB
Forms (Participants)
, Forms (Churches/Employers)
, Information
, Brochures
pdf FCMM Benefit Plan Brochure
Benefits | Features | Rates | Payment Methods
Filename:
2022 FCMMBrochure_BenefitPlan (web).pdf
Size:
1506 KB
Forms (Churches/Employers)
, Information
pdf 21 Employer Guide for Retirement Plan
Compliance and "How to" information to help a treasurer, bookkeeper, executive pastor, or administrator understand the employer’s responsibility in regard to the FCMM Retirement Plan. Updated annually.
Filename:
21 Employer Guide 2501.pdf
Size:
2981 KB
Forms (Participants)
, Forms (Churches/Employers)
, Information
pdf 30 Retirement Plan Document
The complete Plan Document for the FCMM Retirement Plan [403(b)(9)], revision effective 1/1/2025. (This is the detailed Plan Document. For a summary of features for participants, see Form 38 Summary Plan Document.)
Filename:
30 FCMM Retirement Plan Document 202501.pdf
Size:
315 KB
Forms (Participants)
, Forms (Churches/Employers)
, Information
pdf 38 Summary of Important Plan Features for Participants (Summary Plan Document)
The Summary Plan Document for participants in the FCMM Retirement Plan, Form 38. (For the detailed Plan Document, see Form 30 Retirement Plan Document.)
Filename:
38 Summary Retirement Plan Document 202501.pdf
Size:
294 KB
