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ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN
Plan identification number 501

ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

ALPENA POWER COMPANY has sponsored the creation of one or more 401k plans.

Company Name:ALPENA POWER COMPANY
Employer identification number (EIN):380293450
NAIC Classification:221100

Additional information about ALPENA POWER COMPANY

Jurisdiction of Incorporation: Michigan Secretary of State
Incorporation Date: 0000-00-00
Company Identification Number: 084314
Legal Registered Office Address: 401 N 9TH AVE ALPENA


United States of America (USA)
49707

More information about ALPENA POWER COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01KEN DRAGIEWICZ2024-07-05
5012022-01-01KEN DRAGIEWICZ2023-07-24
5012021-01-01KEN DRAGIEWICZ2022-02-01
5012021-01-01KEN DRAGIEWICZ2023-08-15
5012020-01-01
5012019-01-01
5012019-01-01
5012019-01-01KEN DRAGIEWICZ
5012018-01-01
5012018-01-01
5012018-01-01KEN DRAGIEWICZ
5012017-01-01GARY D. GRAHAM
5012017-01-01
5012017-01-01KEN DRAGIEWICZ
5012016-01-01GARY D. GRAHAM
5012015-01-01ANN K. BURTON
5012014-01-01ANN K. BURTON
5012013-01-01ANN BURTON ANN BURTON2014-10-06
5012012-01-01ANN BURTON
5012011-01-01ANN BURTON
5012009-01-01ANN BURTON
5012008-01-01ANN BURTON
5012007-01-01ANN BURTON

Financial Data on ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN

Measure Date Value
2025 : ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2025 401k financial data
Total expenses incurred by plan in this plan year2025-05-02143787
Net assets as of the end of the plan year2025-05-02467628
Total assets as of the beginning of the plan year2025-05-02562201
Value of plan covered by a fidelity bond2025-05-021000000
Other expenses paid from plan in this plan year2025-05-023299
Other income to plan in this plan year2025-05-0249214
Plan net income in this plan year2025-05-02-94573
Net assets as of the end of the plan year2025-05-02467628
Net assets as of the beginning of the plan year2025-05-02562201
2024 : ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2024 401k financial data
Total expenses incurred by plan in this plan year2024-07-05138844
Net assets as of the end of the plan year2024-07-05562201
Total assets as of the beginning of the plan year2024-07-05614468
Value of plan covered by a fidelity bond2024-07-051000000
Other expenses paid from plan in this plan year2024-07-052975
Other income to plan in this plan year2024-07-0586577
Plan net income in this plan year2024-07-05-52267
Net assets as of the end of the plan year2024-07-05562201
Net assets as of the beginning of the plan year2024-07-05614468
2020 : ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2020 401k financial data
Total income from all sources2020-12-31$612,836
Expenses. Total of all expenses incurred2020-12-31$255,489
Benefits paid (including direct rollovers)2020-12-31$214,057
Total plan assets at end of year2020-12-31$3,546,997
Total plan assets at beginning of year2020-12-31$3,189,650
Value of fidelity bond covering the plan2020-12-31$1,000,000
Other income received2020-12-31$367,738
Net income (gross income less expenses)2020-12-31$357,347
Net plan assets at end of year (total assets less liabilities)2020-12-31$3,546,997
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$3,189,650
Total contributions received or receivable from employer(s)2020-12-31$245,098
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$41,432
2019 : ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2019 401k financial data
Total income from all sources2019-12-31$597,207
Expenses. Total of all expenses incurred2019-12-31$256,327
Benefits paid (including direct rollovers)2019-12-31$222,191
Total plan assets at end of year2019-12-31$3,189,650
Total plan assets at beginning of year2019-12-31$2,848,770
Value of fidelity bond covering the plan2019-12-31$1,000,000
Other income received2019-12-31$597,207
Net income (gross income less expenses)2019-12-31$340,880
Net plan assets at end of year (total assets less liabilities)2019-12-31$3,189,650
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$2,848,770
Total contributions received or receivable from employer(s)2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$34,136
2018 : ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2018 401k financial data
Total income from all sources2018-12-31$-7,603
Expenses. Total of all expenses incurred2018-12-31$243,568
Benefits paid (including direct rollovers)2018-12-31$206,210
Total plan assets at end of year2018-12-31$2,848,770
Total plan assets at beginning of year2018-12-31$3,099,941
Value of fidelity bond covering the plan2018-12-31$1,000,000
Other income received2018-12-31$-179,180
Net income (gross income less expenses)2018-12-31$-251,171
Net plan assets at end of year (total assets less liabilities)2018-12-31$2,848,770
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$3,099,941
Total contributions received or receivable from employer(s)2018-12-31$171,577
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$37,358
2017 : ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2017 401k financial data
Total income from all sources2017-12-31$499,170
Expenses. Total of all expenses incurred2017-12-31$130,471
Benefits paid (including direct rollovers)2017-12-31$101,775
Total plan assets at end of year2017-12-31$3,099,941
Total plan assets at beginning of year2017-12-31$2,731,242
Value of fidelity bond covering the plan2017-12-31$1,000,000
Other income received2017-12-31$384,513
Net income (gross income less expenses)2017-12-31$368,699
Net plan assets at end of year (total assets less liabilities)2017-12-31$3,099,941
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$2,731,242
Total contributions received or receivable from employer(s)2017-12-31$114,657
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$28,696
2016 : ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2016 401k financial data
Total income from all sources2016-12-31$264,255
Expenses. Total of all expenses incurred2016-12-31$91,135
Benefits paid (including direct rollovers)2016-12-31$61,891
Total plan assets at end of year2016-12-31$2,731,242
Total plan assets at beginning of year2016-12-31$2,558,122
Value of fidelity bond covering the plan2016-12-31$1,000,000
Other income received2016-12-31$211,148
Net income (gross income less expenses)2016-12-31$173,120
Net plan assets at end of year (total assets less liabilities)2016-12-31$2,731,242
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$2,558,122
Total contributions received or receivable from employer(s)2016-12-31$53,107
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$29,244
2015 : ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2015 401k financial data
Total income from all sources2015-12-31$405,994
Expenses. Total of all expenses incurred2015-12-31$93,887
Benefits paid (including direct rollovers)2015-12-31$71,235
Total plan assets at end of year2015-12-31$2,558,122
Total plan assets at beginning of year2015-12-31$2,246,015
Value of fidelity bond covering the plan2015-12-31$500,000
Other income received2015-12-31$-27,291
Net income (gross income less expenses)2015-12-31$312,107
Net plan assets at end of year (total assets less liabilities)2015-12-31$2,558,122
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$2,246,015
Total contributions received or receivable from employer(s)2015-12-31$433,285
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$22,652
2014 : ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2014 401k financial data
Total income from all sources2014-12-31$546,496
Expenses. Total of all expenses incurred2014-12-31$163,536
Benefits paid (including direct rollovers)2014-12-31$135,875
Total plan assets at end of year2014-12-31$2,246,015
Total plan assets at beginning of year2014-12-31$1,863,055
Value of fidelity bond covering the plan2014-12-31$500,000
Other income received2014-12-31$93,496
Net income (gross income less expenses)2014-12-31$382,960
Net plan assets at end of year (total assets less liabilities)2014-12-31$2,246,015
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,863,055
Total contributions received or receivable from employer(s)2014-12-31$453,000
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$27,661
2013 : ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2013 401k financial data
Total income from all sources2013-12-31$561,101
Expenses. Total of all expenses incurred2013-12-31$216,694
Benefits paid (including direct rollovers)2013-12-31$175,463
Total plan assets at end of year2013-12-31$1,863,055
Total plan assets at beginning of year2013-12-31$1,518,648
Value of fidelity bond covering the plan2013-12-31$500,000
Other income received2013-12-31$138,101
Net income (gross income less expenses)2013-12-31$344,407
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,863,055
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,518,648
Total contributions received or receivable from employer(s)2013-12-31$423,000
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$41,231
2012 : ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2012 401k financial data
Total income from all sources2012-12-31$485,484
Expenses. Total of all expenses incurred2012-12-31$218,075
Benefits paid (including direct rollovers)2012-12-31$162,582
Total plan assets at end of year2012-12-31$1,518,648
Total plan assets at beginning of year2012-12-31$1,251,239
Value of fidelity bond covering the plan2012-12-31$500,000
Other income received2012-12-31$132,484
Net income (gross income less expenses)2012-12-31$267,409
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,518,648
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,251,239
Total contributions received or receivable from employer(s)2012-12-31$353,000
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$55,493
2011 : ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2011 401k financial data
Total income from all sources2011-12-31$328,309
Expenses. Total of all expenses incurred2011-12-31$193,246
Benefits paid (including direct rollovers)2011-12-31$136,385
Total plan assets at end of year2011-12-31$1,251,239
Total plan assets at beginning of year2011-12-31$1,116,176
Value of fidelity bond covering the plan2011-12-31$500,000
Other income received2011-12-31$16,309
Net income (gross income less expenses)2011-12-31$135,063
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,251,239
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,116,176
Total contributions received or receivable from employer(s)2011-12-31$312,000
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$56,861
2010 : ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2010 401k financial data
Total income from all sources2010-12-31$516,707
Expenses. Total of all expenses incurred2010-12-31$118,045
Benefits paid (including direct rollovers)2010-12-31$115,734
Total plan assets at end of year2010-12-31$1,116,176
Total plan assets at beginning of year2010-12-31$717,514
Value of fidelity bond covering the plan2010-12-31$500,000
Other income received2010-12-31$63,707
Net income (gross income less expenses)2010-12-31$398,662
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,116,176
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$717,514
Total contributions received or receivable from employer(s)2010-12-31$453,000
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$2,311
2008 : ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2008 401k financial data
Total income from all sources2008-12-31$444,614
Expenses. Total of all expenses incurred2008-12-31$206,940
Benefits paid (including direct rollovers)2008-12-31$167,719
Total plan assets at end of year2008-12-31$363,628
Total plan assets at beginning of year2008-12-31$125,954
Value of fidelity bond covering the plan2008-12-31$500,000
Total contributions received or receivable from participants2008-12-31$31,934
Contributions received from other sources (not participants or employers)2008-12-31$5,035
Other income received2008-12-31$-45,355
Net income (gross income less expenses)2008-12-31$237,674
Net plan assets at end of year (total assets less liabilities)2008-12-31$363,628
Net plan assets at beginning of year (total assets less liabilities)2008-12-31$125,954
Total contributions received or receivable from employer(s)2008-12-31$453,000
Expenses. Administrative service providers (salaries,fees and commissions)2008-12-31$39,221
2007 : ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2007 401k financial data
Total income from all sources2007-12-31$147,386
Expenses. Total of all expenses incurred2007-12-31$21,432
Benefits paid (including direct rollovers)2007-12-31$0
Total plan assets at end of year2007-12-31$125,954
Total plan assets at beginning of year2007-12-31$0
Value of fidelity bond covering the plan2007-12-31$500,000
Total contributions received or receivable from participants2007-12-31$103
Expenses. Other expenses not covered elsewhere2007-12-31$682
Net income (gross income less expenses)2007-12-31$125,954
Net plan assets at end of year (total assets less liabilities)2007-12-31$125,954
Net plan assets at beginning of year (total assets less liabilities)2007-12-31$0
Total contributions received or receivable from employer(s)2007-12-31$147,283
Expenses. Administrative service providers (salaries,fees and commissions)2007-12-31$20,750

Form 5500 Responses for ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN

2020: ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: ALPENA POWER COMPANY EMPLOYEE BENEFIT 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 – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: ALPENA POWER COMPANY EMPLOYEE BENEFIT 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 – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: ALPENA POWER COMPANY EMPLOYEE BENEFIT 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 – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: ALPENA POWER COMPANY EMPLOYEE BENEFIT 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 – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: ALPENA POWER COMPANY EMPLOYEE BENEFIT 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 – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: ALPENA POWER COMPANY EMPLOYEE BENEFIT 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 funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: ALPENA POWER COMPANY EMPLOYEE BENEFIT 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 funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes
2008: ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan funding arrangement – TrustYes
2008-01-01Plan benefit arrangement – InsuranceYes
2008-01-01Plan benefit arrangement - TrustYes
2007: ALPENA POWER COMPANY EMPLOYEE BENEFIT PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01First time form 5500 has been submittedYes
2007-01-01Submission has been amendedNo
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan funding arrangement – TrustYes
2007-01-01Plan funding arrangement – General assets of the sponsorYes
2007-01-01Plan benefit arrangement – InsuranceYes
2007-01-01Plan benefit arrangement - TrustYes
2007-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number09149-136
Policy instance 1
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number09149-136
Policy instance 1
Insurance contract or identification number09149-136
Number of Individuals Covered50
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $5,329
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 $113,672
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number007028622-0001
Policy instance 1
Insurance contract or identification number007028622-0001
Number of Individuals Covered49
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $5,259
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 $98,339
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number007028622-0001
Policy instance 1
Insurance contract or identification number007028622-0001
Number of Individuals Covered47
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $4,612
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 $85,238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameALPENA AGENCY INC.
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number007028622-0001
Policy instance 1
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number007028622-0001
Policy instance 1
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number007028622-0001
Policy instance 1
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number007028622-0001
Policy instance 1
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number007028622-0001
Policy instance 1
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number09149-136
Policy instance 1
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL 12158
Policy instance 1
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL 12158
Policy instance 1

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