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METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 401k Plan overview

Plan NameMETROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN
Plan identification number 501

METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

METROPLEX, INC. has sponsored the creation of one or more 401k plans.

Company Name:METROPLEX, INC.
Employer identification number (EIN):362923701
NAIC Classification:531310

Additional information about METROPLEX, INC.

Jurisdiction of Incorporation: Michigan Secretary of State
Incorporation Date: 0000-00-00
Company Identification Number: 264448
Legal Registered Office Address: EUREKA RD. SOUTHGATE 48195


United States of America (USA)
19200

More information about METROPLEX, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-01-01
5012016-01-01
5012015-01-01JAMES BEEMSTER JAMES BEEMSTER2016-10-13
5012014-01-01JAMES BEEMSTER JAMES BEEMSTER2015-10-14
5012013-01-01JAMES BEEMSTER JAMES BEEMSTER2014-10-08
5012012-01-01JAMES BEEMSTER JAMES BEEMSTER2013-10-11
5012011-01-01THOMAS KORANDA
5012010-01-01THOMAS KORANDA
5012009-01-01THOMAS KORANDA

Plan Statistics for METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN

401k plan membership statisitcs for METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN

Measure Date Value
2016: METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0197
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-0197
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0197
2015: METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01128
Total number of active participants reported on line 7a of the Form 55002015-01-0197
Total of all active and inactive participants2015-01-0197
Total participants2015-01-0197
2014: METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01148
Total number of active participants reported on line 7a of the Form 55002014-01-01128
Total of all active and inactive participants2014-01-01128
Total participants2014-01-01128
2013: METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01150
Total number of active participants reported on line 7a of the Form 55002013-01-01148
Total of all active and inactive participants2013-01-01148
Total participants2013-01-01148
2012: METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01160
Total number of active participants reported on line 7a of the Form 55002012-01-01150
Total of all active and inactive participants2012-01-01150
Total participants2012-01-01150
2011: METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01155
Total number of active participants reported on line 7a of the Form 55002011-01-01160
Total of all active and inactive participants2011-01-01160
Total participants2011-01-01160
2010: METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01179
Total number of active participants reported on line 7a of the Form 55002010-01-01155
Total of all active and inactive participants2010-01-01155
Total participants2010-01-01155
2009: METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01196
Total number of active participants reported on line 7a of the Form 55002009-01-01179
Total of all active and inactive participants2009-01-01179
Total participants2009-01-01179

Financial Data on METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN

Measure Date Value
2016 : METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$17,429
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$109,220
Total income from all sources (including contributions)2016-12-31$823,766
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$759,927
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$673,567
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$823,766
Value of total assets at end of year2016-12-31$513,079
Value of total assets at beginning of year2016-12-31$541,031
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$86,360
Total interest from all sources2016-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$14,500
Was this plan covered by a fidelity bond2016-12-31No
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$212,771
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$490
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$59,315
Liabilities. Value of operating payables at end of year2016-12-31$16,939
Liabilities. Value of operating payables at beginning of year2016-12-31$24,776
Total non interest bearing cash at end of year2016-12-31$513,079
Total non interest bearing cash at beginning of year2016-12-31$541,031
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$63,839
Value of net assets at end of year (total assets less liabilities)2016-12-31$495,650
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$431,811
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$166,151
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$610,995
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$507,416
Contract administrator fees2016-12-31$71,860
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Liabilities. Value of benefit claims payable at end of year2016-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$25,129
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31MAYER HOFFMAN MCCANN P.C.
Accountancy firm EIN2016-12-31431947695
2015 : METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$109,220
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$138,691
Total income from all sources (including contributions)2015-12-31$1,308,373
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$1,036,932
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$908,372
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,308,373
Value of total assets at end of year2015-12-31$541,031
Value of total assets at beginning of year2015-12-31$299,061
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$128,560
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$14,500
Was this plan covered by a fidelity bond2015-12-31No
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$337,216
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$59,315
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$86,759
Liabilities. Value of operating payables at end of year2015-12-31$24,776
Liabilities. Value of operating payables at beginning of year2015-12-31$25,490
Total non interest bearing cash at end of year2015-12-31$541,031
Total non interest bearing cash at beginning of year2015-12-31$299,061
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$271,441
Value of net assets at end of year (total assets less liabilities)2015-12-31$431,811
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$160,370
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$242,297
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$971,157
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$666,075
Contract administrator fees2015-12-31$114,060
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Liabilities. Value of benefit claims payable at end of year2015-12-31$25,129
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$26,442
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31MAYER HOFFMAN MCCANN P.C.
Accountancy firm EIN2015-12-31431947695
2014 : METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$138,691
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$151,417
Total income from all sources (including contributions)2014-12-31$1,308,044
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$1,134,514
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$1,011,941
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$1,308,044
Value of total assets at end of year2014-12-31$299,061
Value of total assets at beginning of year2014-12-31$138,257
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$122,573
Total interest from all sources2014-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$14,250
Was this plan covered by a fidelity bond2014-12-31No
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$356,630
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$86,759
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$54,362
Administrative expenses (other) incurred2014-12-31$1,505
Liabilities. Value of operating payables at end of year2014-12-31$25,490
Liabilities. Value of operating payables at beginning of year2014-12-31$25,628
Total non interest bearing cash at end of year2014-12-31$299,061
Total non interest bearing cash at beginning of year2014-12-31$138,257
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$173,530
Value of net assets at end of year (total assets less liabilities)2014-12-31$160,370
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$-13,160
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$254,358
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$951,414
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$757,583
Contract administrator fees2014-12-31$106,818
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31No
Liabilities. Value of benefit claims payable at end of year2014-12-31$26,442
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$71,427
Did the plan have assets held for investment2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31MAYER HOFFMAN MCCANN P.C.
Accountancy firm EIN2014-12-31431947695
2013 : METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$151,417
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$127,955
Total income from all sources (including contributions)2013-12-31$1,384,508
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$1,398,308
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$1,268,229
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$1,384,508
Value of total assets at end of year2013-12-31$138,257
Value of total assets at beginning of year2013-12-31$128,595
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$130,079
Total interest from all sources2013-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$14,000
Was this plan covered by a fidelity bond2013-12-31No
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$359,546
Participant contributions at end of year2013-12-31$0
Participant contributions at beginning of year2013-12-31$1,488
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$54,362
Administrative expenses (other) incurred2013-12-31$2,567
Liabilities. Value of operating payables at end of year2013-12-31$25,628
Total non interest bearing cash at end of year2013-12-31$138,257
Total non interest bearing cash at beginning of year2013-12-31$127,107
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-13,800
Value of net assets at end of year (total assets less liabilities)2013-12-31$-13,160
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$640
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$320,269
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$1,024,962
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$947,960
Contract administrator fees2013-12-31$113,512
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Liabilities. Value of benefit claims payable at end of year2013-12-31$71,427
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$127,955
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31MAYER HOFFMAN MCCANN P.C.
Accountancy firm EIN2013-12-31431947695
2012 : METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$127,955
Total income from all sources (including contributions)2012-12-31$1,428,969
Total of all expenses incurred2012-12-31$1,428,329
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$1,376,671
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$1,428,969
Value of total assets at end of year2012-12-31$128,595
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$51,658
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31No
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$375,464
Participant contributions at end of year2012-12-31$1,488
Total non interest bearing cash at end of year2012-12-31$127,107
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$640
Value of net assets at end of year (total assets less liabilities)2012-12-31$640
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$695,439
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$1,053,505
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$681,232
Contract administrator fees2012-12-31$51,658
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Liabilities. Value of benefit claims payable at end of year2012-12-31$127,955
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31MAYER HOFFMAN MCCANN P.C.
Accountancy firm EIN2012-12-31431947695

Form 5500 Responses for METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN

2016: METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: METROPLEX, INC. EMPLOYEE GROUP INSURANCE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10179479
Policy instance 3
Insurance contract or identification number10179479
Number of Individuals Covered114
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $12,636
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $12,636
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,527
Insurance broker organization code?3
Insurance broker nameMID AMERICAN GROUP LLC
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )
Policy contract number11244
Policy instance 2
Insurance contract or identification number11244
Number of Individuals Covered83
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $4,559
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,559
Insurance broker organization code?3
Insurance broker nameMID AMERICAN GROUP, INC.
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP56325,P56335&6
Policy instance 1
Insurance contract or identification numberP56325,P56335&6
Number of Individuals Covered195
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $51,504
Total amount of fees paid to insurance companyUSD $4,373
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $187,263
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $51,504
Amount paid for insurance broker fees4373
Additional information about fees paid to insurance brokerAMOUNT PAID - SPECIAL PROGRAMS
Insurance broker organization code?3
Insurance broker nameMID AMERICAN GROUP
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10179479
Policy instance 3
Insurance contract or identification number10179479
Number of Individuals Covered136
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $2,785
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $13,923
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $275
Insurance broker organization code?3
Insurance broker nameMID AMERICAN GROUP LLC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP56325;P56335&6
Policy instance 1
Insurance contract or identification numberP56325;P56335&6
Number of Individuals Covered195
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $57,942
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $212,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $57,942
Insurance broker organization code?3
Insurance broker nameMID AMERICAN GROUP
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )
Policy contract number11244
Policy instance 2
Insurance contract or identification number11244
Number of Individuals Covered92
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $4,494
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,994
Insurance broker organization code?3
Insurance broker name
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number417002411186
Policy instance 1
Insurance contract or identification number417002411186
Number of Individuals Covered116
Insurance policy start date2012-09-01
Insurance policy end date2013-09-01
Total amount of commissions paid to insurance brokerUSD $24,629
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $246,104
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,629
Insurance broker organization code?3
Insurance broker nameMID-AMERICAN GROUP, INC.
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )
Policy contract number10475
Policy instance 2
Insurance contract or identification number10475
Number of Individuals Covered101
Insurance policy start date2012-09-01
Insurance policy end date2013-09-01
Total amount of commissions paid to insurance brokerUSD $5,601
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $61,191
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,601
Insurance broker organization code?3
Insurance broker nameMID-AMERICAN GROUP, INC.
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF018269
Policy instance 3
Insurance contract or identification numberF018269
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $4,264
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $21,303
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,264
Insurance broker organization code?3
Insurance broker nameMID-AMERICAN GROUP, INC.
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number714887
Policy instance 1
Insurance contract or identification number714887
Number of Individuals Covered122
Insurance policy start date2011-09-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $47,101
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $942,014
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,101
Amount paid for insurance broker fees3875
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameMID AMERICAN GROUP, INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF018269
Policy instance 4
Insurance contract or identification numberF018269
Number of Individuals Covered153
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $4,753
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,984
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,753
Insurance broker organization code?3
Insurance broker nameMID AMERICAN GROUP, INC.
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )
Policy contract number10475
Policy instance 3
Insurance contract or identification number10475
Number of Individuals Covered112
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $6,831
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,417
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,831
Insurance broker nameMID AMERICAN GROUP, INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number417002411186
Policy instance 2
Insurance contract or identification number417002411186
Number of Individuals Covered122
Insurance policy start date2012-05-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $7,448
Welfare Benefit Premiums Paid to CarrierUSD $74,477
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,448
Additional information about fees paid to insurance brokerMANAGING PRODUCER FEE
Insurance broker nameMID AMERICAN GROUP, INC.
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number714887
Policy instance 1
Insurance contract or identification number714887
Number of Individuals Covered122
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $69,731
Total amount of fees paid to insurance companyUSD $4,766
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,394,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )
Policy contract number10475
Policy instance 2
Insurance contract or identification number10475
Number of Individuals Covered110
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $6,112
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $61,124
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number1007169400000
Policy instance 3
Insurance contract or identification number1007169400000
Number of Individuals Covered155
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $3,273
Total amount of fees paid to insurance companyUSD $318
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number714887
Policy instance 1
Insurance contract or identification number714887
Number of Individuals Covered134
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $65,145
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,302,901
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $65,145
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameMID AMERICAN GROUP INC
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )
Policy contract number10475
Policy instance 2
Insurance contract or identification number10475
Number of Individuals Covered117
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $6,926
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $69,260
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,926
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameMID-AMERICAN GROUP, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number1007169400000
Policy instance 3
Insurance contract or identification number1007169400000
Number of Individuals Covered174
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $3,158
Total amount of fees paid to insurance companyUSD $294
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,158
Amount paid for insurance broker fees294
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameMID AMERICAN GROUP INC

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