PLUM MARKET CORPORATION, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan PLUM MARKET CORPORATION, INC.
401k plan membership statisitcs for PLUM MARKET CORPORATION, INC.
| Measure | Date | Value |
|---|
| 2022: PLUM MARKET CORPORATION, INC. 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-07-01 | 595 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 581 |
| Total of all active and inactive participants | 2022-07-01 | 581 |
| 2021: PLUM MARKET CORPORATION, INC. 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-07-01 | 602 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 595 |
| Total of all active and inactive participants | 2021-07-01 | 595 |
| 2020: PLUM MARKET CORPORATION, INC. 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-07-01 | 695 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 602 |
| Total of all active and inactive participants | 2020-07-01 | 602 |
| 2019: PLUM MARKET CORPORATION, INC. 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-07-01 | 645 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 695 |
| Total of all active and inactive participants | 2019-07-01 | 695 |
| 2018: PLUM MARKET CORPORATION, INC. 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-07-01 | 504 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 645 |
| Total of all active and inactive participants | 2018-07-01 | 645 |
| 2017: PLUM MARKET CORPORATION, INC. 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-07-01 | 463 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 504 |
| Total of all active and inactive participants | 2017-07-01 | 504 |
| 2016: PLUM MARKET CORPORATION, INC. 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-07-01 | 443 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 463 |
| Total of all active and inactive participants | 2016-07-01 | 463 |
| 2015: PLUM MARKET CORPORATION, INC. 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-07-01 | 348 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 443 |
| Total of all active and inactive participants | 2015-07-01 | 443 |
| 2014: PLUM MARKET CORPORATION, INC. 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-07-01 | 168 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 348 |
| Total of all active and inactive participants | 2014-07-01 | 348 |
| 2013: PLUM MARKET CORPORATION, INC. 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-07-01 | 135 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 168 |
| Total of all active and inactive participants | 2013-07-01 | 168 |
| 2012: PLUM MARKET CORPORATION, INC. 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-07-01 | 142 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 135 |
| Total of all active and inactive participants | 2012-07-01 | 135 |
| 2011: PLUM MARKET CORPORATION, INC. 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-07-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 142 |
| Total of all active and inactive participants | 2011-07-01 | 142 |
| 2010: PLUM MARKET CORPORATION, INC. 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-07-01 | 125 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-07-01 | 109 |
| Total of all active and inactive participants | 2010-07-01 | 109 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 10626 |
| Policy instance | 8 |
| Insurance contract or identification number | 10626 | | Number of Individuals Covered | 509 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $3,533 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,533 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 701568 |
| Policy instance | 1 |
| Insurance contract or identification number | 701568 | | Number of Individuals Covered | 581 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $3,013 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $24,946 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,013 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 692952 |
| Policy instance | 2 |
| Insurance contract or identification number | 692952 | | Number of Individuals Covered | 72 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $7,083 | | Total amount of fees paid to insurance company | USD $826 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $47,293 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,083 | | Amount paid for insurance broker fees | 826 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 701569 |
| Policy instance | 3 |
| Insurance contract or identification number | 701569 | | Number of Individuals Covered | 165 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $4,767 | | Total amount of fees paid to insurance company | USD $556 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,938 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,767 | | Amount paid for insurance broker fees | 556 | | Insurance broker organization code? | 3 |
|
| PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
| Policy contract number | 448017 |
| Policy instance | 4 |
| Insurance contract or identification number | 448017 | | Number of Individuals Covered | 67 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $2,233 | | Total amount of fees paid to insurance company | USD $351 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,187 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,233 | | Amount paid for insurance broker fees | 351 | | Insurance broker organization code? | 3 |
|
| PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
| Policy contract number | 448018 |
| Policy instance | 5 |
| Insurance contract or identification number | 448018 | | Number of Individuals Covered | 59 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $1,827 | | Total amount of fees paid to insurance company | USD $229 | | Other welfare benefits provided | ATTAINED AGE CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $12,178 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,827 | | Amount paid for insurance broker fees | 229 | | Insurance broker organization code? | 3 |
|
| PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 ) |
| Policy contract number | 796248 |
| Policy instance | 6 |
| Insurance contract or identification number | 796248 | | Number of Individuals Covered | 338 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $21,476 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,398,996 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,476 | | Insurance broker organization code? | 3 |
|
| PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 12208 ) |
| Policy contract number | 796248 |
| Policy instance | 7 |
| Insurance contract or identification number | 796248 | | Number of Individuals Covered | 121 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $9,796 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $653,077 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,796 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 701569 |
| Policy instance | 4 |
| Insurance contract or identification number | 701569 | | Number of Individuals Covered | 210 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $4,211 | | Total amount of fees paid to insurance company | USD $491 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $28,074 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,211 | | Amount paid for insurance broker fees | 491 | | Insurance broker organization code? | 3 |
|
| PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
| Policy contract number | 448017 |
| Policy instance | 5 |
| Insurance contract or identification number | 448017 | | Number of Individuals Covered | 86 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $2,466 | | Total amount of fees paid to insurance company | USD $658 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,494 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,466 | | Amount paid for insurance broker fees | 658 | | Insurance broker organization code? | 3 |
|
| PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
| Policy contract number | 448018 |
| Policy instance | 6 |
| Insurance contract or identification number | 448018 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $1,459 | | Total amount of fees paid to insurance company | USD $389 | | Other welfare benefits provided | ATTAINED AGE CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $9,726 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,459 | | Amount paid for insurance broker fees | 389 | | Insurance broker organization code? | 3 |
|
| PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
| Policy contract number | 448019 |
| Policy instance | 7 |
| Insurance contract or identification number | 448019 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $1,897 | | Total amount of fees paid to insurance company | USD $483 | | Other welfare benefits provided | HOSPITAL EE PAID | | Welfare Benefit Premiums Paid to Carrier | USD $12,650 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,897 | | Amount paid for insurance broker fees | 483 | | Insurance broker organization code? | 3 |
|
| PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 ) |
| Policy contract number | 796248 |
| Policy instance | 8 |
| Insurance contract or identification number | 796248 | | Number of Individuals Covered | 318 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $20,264 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,323,611 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,264 | | Insurance broker organization code? | 3 |
|
| PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 12208 ) |
| Policy contract number | 796248 |
| Policy instance | 9 |
| Insurance contract or identification number | 796248 | | Number of Individuals Covered | 124 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $8,946 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $596,515 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,946 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 10626 |
| Policy instance | 10 |
| Insurance contract or identification number | 10626 | | Number of Individuals Covered | 458 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $3,135 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,135 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 692952 |
| Policy instance | 3 |
| Insurance contract or identification number | 692952 | | Number of Individuals Covered | 72 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $6,915 | | Total amount of fees paid to insurance company | USD $807 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $50,498 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,915 | | Amount paid for insurance broker fees | 807 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 701568 |
| Policy instance | 2 |
| Insurance contract or identification number | 701568 | | Number of Individuals Covered | 595 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $2,835 | | Total amount of fees paid to insurance company | USD $408 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,333 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,835 | | Amount paid for insurance broker fees | 408 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 280189 |
| Policy instance | 1 |
| Insurance contract or identification number | 280189 | | Number of Individuals Covered | 404 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $757 | | Total amount of fees paid to insurance company | USD $239 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $757 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 239 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 280189 |
| Policy instance | 1 |
| Insurance contract or identification number | 280189 | | Number of Individuals Covered | 576 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $37,195 | | Total amount of fees paid to insurance company | USD $5,560 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37,195 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 5560 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 701568 |
| Policy instance | 2 |
| Insurance contract or identification number | 701568 | | Number of Individuals Covered | 602 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $2,629 | | Total amount of fees paid to insurance company | USD $379 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,577 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,629 | | Amount paid for insurance broker fees | 240 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0700286 |
| Policy instance | 3 |
| Insurance contract or identification number | R0700286 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $4,252 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,486 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,697 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 692952 |
| Policy instance | 4 |
| Insurance contract or identification number | 692952 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $7,657 | | Total amount of fees paid to insurance company | USD $893 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $46,648 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,657 | | Amount paid for insurance broker fees | 893 | | Insurance broker organization code? | 7 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 701569 |
| Policy instance | 5 |
| Insurance contract or identification number | 701569 | | Number of Individuals Covered | 208 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $5,194 | | Total amount of fees paid to insurance company | USD $606 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $34,629 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,194 | | Amount paid for insurance broker fees | 406 | | Insurance broker organization code? | 5 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 280189 |
| Policy instance | 6 |
| Insurance contract or identification number | 280189 | | Number of Individuals Covered | 93 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $6,370 | | Total amount of fees paid to insurance company | USD $1,101 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,370 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1101 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 280189 |
| Policy instance | 1 |
| Insurance contract or identification number | 280189 | | Number of Individuals Covered | 577 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $40,530 | | Total amount of fees paid to insurance company | USD $4,926 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $40,530 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 4926 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 701568 |
| Policy instance | 2 |
| Insurance contract or identification number | 701568 | | Number of Individuals Covered | 695 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $2,676 | | Total amount of fees paid to insurance company | USD $561 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,102 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,676 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 561 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 280189 |
| Policy instance | 6 |
| Insurance contract or identification number | 280189 | | Number of Individuals Covered | 84 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $4,103 | | Total amount of fees paid to insurance company | USD $624 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,103 | | Insurance broker organization code? | 4 | | Amount paid for insurance broker fees | 624 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 701569 |
| Policy instance | 5 |
| Insurance contract or identification number | 701569 | | Number of Individuals Covered | 189 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $4,964 | | Total amount of fees paid to insurance company | USD $579 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,096 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,964 | | Insurance broker organization code? | 4 | | Amount paid for insurance broker fees | 579 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 692952 |
| Policy instance | 4 |
| Insurance contract or identification number | 692952 | | Number of Individuals Covered | 108 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $8,726 | | Total amount of fees paid to insurance company | USD $1,226 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $55,583 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,726 | | Amount paid for insurance broker fees | 1226 | | Insurance broker organization code? | 4 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0700286 |
| Policy instance | 3 |
| Insurance contract or identification number | R0700286 | | Number of Individuals Covered | 77 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $3,766 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,373 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,275 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 280189 |
| Policy instance | 1 |
| Insurance contract or identification number | 280189 | | Number of Individuals Covered | 553 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $42,218 | | Total amount of fees paid to insurance company | USD $9,145 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $42,218 | | Amount paid for insurance broker fees | 1400 | | Insurance broker organization code? | 2 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 000000701568 |
| Policy instance | 2 |
| Insurance contract or identification number | 000000701568 | | Number of Individuals Covered | 645 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $759 | | Total amount of fees paid to insurance company | USD $163 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,591 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $759 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 163 |
|
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 0001639 |
| Policy instance | 1 |
| Insurance contract or identification number | 0001639 | | Number of Individuals Covered | 504 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $3,921 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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