?>
Logo

HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 401k Plan overview

Plan NameHERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN
Plan identification number 503

HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Prepaid legal
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

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

Company Name:MILLERKNOLL, INC.
Employer identification number (EIN):380837640
NAIC Classification:337000

Additional information about MILLERKNOLL, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1981-09-28
Company Identification Number: 0005234806
Legal Registered Office Address: 855 E MAIN AVE DEPT 110

ZEELAND
United States of America (USA)
49464

More information about MILLERKNOLL, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-01-01
5032021-01-01
5032020-01-01
5032019-06-01
5032018-06-01
5032018-06-01
5032017-06-01HEATHER BRAZEE
5032016-06-01HEATHER BRAZEE
5032015-06-01MIKE KOPPENOL
5032014-06-01MIKE KOPPENOL
5032013-06-01MIKE KOPPENOL
5032012-06-01JEFF STUTZ MIKE KOPPENOL2014-03-17
5032011-06-01JEFF STUTZ MIKE KOPPENOL2013-03-15
5032009-05-31JEFF STUTZ MIKE KOPPENOL2011-03-14

Plan Statistics for HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN

401k plan membership statisitcs for HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN

Measure Date Value
2022: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-015,342
Total number of active participants reported on line 7a of the Form 55002022-01-015,995
Number of retired or separated participants receiving benefits2022-01-0182
Number of other retired or separated participants entitled to future benefits2022-01-01204
Total of all active and inactive participants2022-01-016,281
2021: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-015,524
Total number of active participants reported on line 7a of the Form 55002021-01-015,165
Number of retired or separated participants receiving benefits2021-01-01160
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-015,325
2020: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-015,231
Total number of active participants reported on line 7a of the Form 55002020-01-015,352
Number of retired or separated participants receiving benefits2020-01-01172
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-015,524
2019: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-015,427
Total number of active participants reported on line 7a of the Form 55002019-06-015,118
Number of retired or separated participants receiving benefits2019-06-01341
Number of other retired or separated participants entitled to future benefits2019-06-010
Total of all active and inactive participants2019-06-015,459
2018: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-015,040
Total number of active participants reported on line 7a of the Form 55002018-06-015,032
Number of retired or separated participants receiving benefits2018-06-01195
Number of other retired or separated participants entitled to future benefits2018-06-010
Total of all active and inactive participants2018-06-015,227
2017: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-06-015,042
Total number of active participants reported on line 7a of the Form 55002017-06-014,669
Number of retired or separated participants receiving benefits2017-06-01206
Number of other retired or separated participants entitled to future benefits2017-06-010
Total of all active and inactive participants2017-06-014,875
2016: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-06-015,095
Total number of active participants reported on line 7a of the Form 55002016-06-014,834
Number of retired or separated participants receiving benefits2016-06-01208
Number of other retired or separated participants entitled to future benefits2016-06-010
Total of all active and inactive participants2016-06-015,042
2015: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-015,160
Total number of active participants reported on line 7a of the Form 55002015-06-015,095
Number of retired or separated participants receiving benefits2015-06-01285
Number of other retired or separated participants entitled to future benefits2015-06-010
Total of all active and inactive participants2015-06-015,380
2014: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-015,131
Total number of active participants reported on line 7a of the Form 55002014-06-015,160
Number of retired or separated participants receiving benefits2014-06-01194
Number of other retired or separated participants entitled to future benefits2014-06-010
Total of all active and inactive participants2014-06-015,354
2013: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-014,868
Total number of active participants reported on line 7a of the Form 55002013-06-015,131
Number of retired or separated participants receiving benefits2013-06-01206
Number of other retired or separated participants entitled to future benefits2013-06-010
Total of all active and inactive participants2013-06-015,337
2012: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-06-014,964
Total number of active participants reported on line 7a of the Form 55002012-06-014,868
Number of retired or separated participants receiving benefits2012-06-01339
Number of other retired or separated participants entitled to future benefits2012-06-010
Total of all active and inactive participants2012-06-015,207
2011: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-06-014,835
Total number of active participants reported on line 7a of the Form 55002011-06-014,964
Number of retired or separated participants receiving benefits2011-06-01397
Number of other retired or separated participants entitled to future benefits2011-06-010
Total of all active and inactive participants2011-06-015,361
2009: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-05-314,981
Total number of active participants reported on line 7a of the Form 55002009-05-315,126
Number of retired or separated participants receiving benefits2009-05-31451
Number of other retired or separated participants entitled to future benefits2009-05-310
Total of all active and inactive participants2009-05-315,577

Financial Data on HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN

Measure Date Value
2021 : HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$8,043,446
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$7,200,601
Total income from all sources (including contributions)2021-12-31$75,516,893
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$76,586,246
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$72,072,918
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$75,516,752
Value of total assets at end of year2021-12-31$0
Value of total assets at beginning of year2021-12-31$226,508
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$4,513,328
Total interest from all sources2021-12-31$141
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$14,227,104
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$9
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-1,069,353
Value of net assets at end of year (total assets less liabilities)2021-12-31$-8,043,446
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$-6,974,093
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$226,499
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$226,499
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$141
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$71,953,844
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31Yes
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$61,289,648
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$119,074
Contract administrator fees2021-12-31$4,513,328
Liabilities. Value of benefit claims payable at end of year2021-12-31$8,043,446
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$7,200,601
Did the plan have assets held for investment2021-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31BDO USA, LLP
Accountancy firm EIN2021-12-31135381590
2020 : HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$7,200,601
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$5,914,226
Total income from all sources (including contributions)2020-12-31$64,648,910
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$69,453,503
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$65,288,341
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$64,637,194
Value of total assets at end of year2020-12-31$226,508
Value of total assets at beginning of year2020-12-31$3,744,726
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$4,165,162
Total interest from all sources2020-12-31$11,716
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$14,232,909
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$9
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$4,184
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-4,804,593
Value of net assets at end of year (total assets less liabilities)2020-12-31$-6,974,093
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$-2,169,500
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$226,499
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$3,740,542
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$3,740,542
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$11,716
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$64,704,038
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31Yes
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$50,404,285
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$584,303
Contract administrator fees2020-12-31$4,165,162
Liabilities. Value of benefit claims payable at end of year2020-12-31$7,200,601
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$5,914,226
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31BDO USA, LLP
Accountancy firm EIN2020-12-31135381590
2019 : HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$5,784,392
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$5,784,392
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$5,784,392
Total income from all sources (including contributions)2019-12-31$37,210,102
Total income from all sources (including contributions)2019-12-31$37,210,102
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$37,044,111
Total of all expenses incurred2019-12-31$37,044,111
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$34,858,437
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$34,858,437
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$37,167,733
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$37,167,733
Value of total assets at end of year2019-12-31$3,744,726
Value of total assets at end of year2019-12-31$3,744,726
Value of total assets at beginning of year2019-12-31$3,578,735
Value of total assets at beginning of year2019-12-31$3,578,735
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$2,185,674
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$2,185,674
Total interest from all sources2019-12-31$42,369
Total interest from all sources2019-12-31$42,369
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$7,013,180
Contributions received from participants2019-12-31$7,013,180
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$4,184
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$4,184
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$7,417
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$7,417
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$165,991
Value of net income/loss2019-12-31$165,991
Value of net assets at end of year (total assets less liabilities)2019-12-31$-2,039,666
Value of net assets at end of year (total assets less liabilities)2019-12-31$-2,039,666
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$-2,205,657
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$-2,205,657
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$3,740,542
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$3,740,542
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$3,571,318
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$3,571,318
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$3,571,318
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$3,571,318
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$42,369
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$42,369
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$34,655,721
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$34,655,721
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$30,154,553
Contributions received in cash from employer2019-12-31$30,154,553
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$202,716
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$202,716
Contract administrator fees2019-12-31$2,185,674
Contract administrator fees2019-12-31$2,185,674
Liabilities. Value of benefit claims payable at end of year2019-12-31$5,784,392
Liabilities. Value of benefit claims payable at end of year2019-12-31$5,784,392
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$5,784,392
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$5,784,392
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Total unrealized appreciation/depreciation of assets2019-05-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-05-31$5,784,392
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-05-31$5,227,576
Total income from all sources (including contributions)2019-05-31$55,468,678
Total loss/gain on sale of assets2019-05-31$0
Total of all expenses incurred2019-05-31$61,144,826
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-05-31$58,116,825
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-05-31$55,379,938
Value of total assets at end of year2019-05-31$3,578,735
Value of total assets at beginning of year2019-05-31$8,698,067
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-05-31$3,028,001
Total interest from all sources2019-05-31$88,740
Total dividends received (eg from common stock, registered investment company shares)2019-05-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-05-31No
Administrative expenses professional fees incurred2019-05-31$10,000
Was this plan covered by a fidelity bond2019-05-31Yes
Value of fidelity bond cover2019-05-31$1,000,000
If this is an individual account plan, was there a blackout period2019-05-31No
Were there any nonexempt tranactions with any party-in-interest2019-05-31No
Contributions received from participants2019-05-31$14,365,390
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-05-31$7,417
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-05-31$986
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-05-31No
Value of net income/loss2019-05-31$-5,676,148
Value of net assets at end of year (total assets less liabilities)2019-05-31$-2,205,657
Value of net assets at beginning of year (total assets less liabilities)2019-05-31$3,470,491
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-05-31No
Were any leases to which the plan was party in default or uncollectible2019-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-05-31$3,571,318
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-05-31$8,697,081
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-05-31$8,697,081
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-05-31$88,740
Expenses. Payments to insurance carriers foe the provision of benefits2019-05-31$57,497,056
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-05-31Yes
Was there a failure to transmit to the plan any participant contributions2019-05-31No
Has the plan failed to provide any benefit when due under the plan2019-05-31No
Contributions received in cash from employer2019-05-31$41,014,548
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-05-31$619,769
Contract administrator fees2019-05-31$3,018,001
Liabilities. Value of benefit claims payable at end of year2019-05-31$5,784,392
Liabilities. Value of benefit claims payable at beginning of year2019-05-31$5,227,576
Did the plan have assets held for investment2019-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-05-31Yes
Opinion of an independent qualified public accountant for this plan2019-05-31Disclaimer
Accountancy firm name2019-05-31BDO USA, LLP
Accountancy firm EIN2019-05-31135381590
2018 : HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-05-31$5,227,576
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-05-31$4,954,010
Total income from all sources (including contributions)2018-05-31$65,502,649
Total of all expenses incurred2018-05-31$62,032,158
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-05-31$58,675,392
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-05-31$65,499,878
Value of total assets at end of year2018-05-31$8,698,067
Value of total assets at beginning of year2018-05-31$4,954,010
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-05-31$3,356,766
Total interest from all sources2018-05-31$2,771
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-05-31No
Was this plan covered by a fidelity bond2018-05-31Yes
Value of fidelity bond cover2018-05-31$1,000,000
If this is an individual account plan, was there a blackout period2018-05-31No
Were there any nonexempt tranactions with any party-in-interest2018-05-31No
Contributions received from participants2018-05-31$13,809,504
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-05-31$986
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-05-31$67
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-05-31No
Value of net income/loss2018-05-31$3,470,491
Value of net assets at end of year (total assets less liabilities)2018-05-31$3,470,491
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-05-31No
Were any leases to which the plan was party in default or uncollectible2018-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-05-31$8,697,081
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-05-31$14,149
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-05-31$14,149
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-05-31$2,771
Expenses. Payments to insurance carriers foe the provision of benefits2018-05-31$58,037,131
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-05-31Yes
Was there a failure to transmit to the plan any participant contributions2018-05-31No
Has the plan failed to provide any benefit when due under the plan2018-05-31No
Contributions received in cash from employer2018-05-31$51,690,374
Employer contributions (assets) at beginning of year2018-05-31$4,939,794
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-05-31$638,261
Contract administrator fees2018-05-31$3,356,766
Liabilities. Value of benefit claims payable at end of year2018-05-31$5,227,576
Liabilities. Value of benefit claims payable at beginning of year2018-05-31$4,954,010
Did the plan have assets held for investment2018-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-05-31Yes
Opinion of an independent qualified public accountant for this plan2018-05-31Disclaimer
Accountancy firm name2018-05-31CONN GENEVA & ROBINSON
Accountancy firm EIN2018-05-31383012028
2017 : HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-05-31$4,954,010
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-05-31$5,030,110
Total income from all sources (including contributions)2017-05-31$60,214,612
Total of all expenses incurred2017-05-31$60,214,612
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-05-31$57,116,836
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-05-31$60,214,077
Value of total assets at end of year2017-05-31$4,954,010
Value of total assets at beginning of year2017-05-31$5,030,110
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-05-31$3,097,776
Total interest from all sources2017-05-31$535
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-05-31No
Was this plan covered by a fidelity bond2017-05-31Yes
Value of fidelity bond cover2017-05-31$500,000
If this is an individual account plan, was there a blackout period2017-05-31No
Were there any nonexempt tranactions with any party-in-interest2017-05-31No
Contributions received from participants2017-05-31$12,701,499
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-05-31$67
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-05-31$31
Total non interest bearing cash at beginning of year2017-05-31$84,186
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-05-31No
Value of net assets at end of year (total assets less liabilities)2017-05-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-05-31No
Were any leases to which the plan was party in default or uncollectible2017-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-05-31$14,149
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-05-31$250,000
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-05-31$250,000
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-05-31$535
Expenses. Payments to insurance carriers foe the provision of benefits2017-05-31$56,519,676
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-05-31Yes
Was there a failure to transmit to the plan any participant contributions2017-05-31No
Has the plan failed to provide any benefit when due under the plan2017-05-31No
Contributions received in cash from employer2017-05-31$47,512,578
Employer contributions (assets) at end of year2017-05-31$4,939,794
Employer contributions (assets) at beginning of year2017-05-31$4,695,893
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-05-31$597,160
Contract administrator fees2017-05-31$3,097,776
Liabilities. Value of benefit claims payable at end of year2017-05-31$4,954,010
Liabilities. Value of benefit claims payable at beginning of year2017-05-31$5,030,110
Did the plan have assets held for investment2017-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-05-31Yes
Opinion of an independent qualified public accountant for this plan2017-05-31Disclaimer
Accountancy firm name2017-05-31CONN GENEVA & ROBINSON
Accountancy firm EIN2017-05-31383012028
2016 : HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-05-31$5,030,110
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-05-31$4,747,832
Total income from all sources (including contributions)2016-05-31$62,747,105
Total of all expenses incurred2016-05-31$62,747,105
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-05-31$59,674,604
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-05-31$62,746,944
Value of total assets at end of year2016-05-31$5,030,110
Value of total assets at beginning of year2016-05-31$4,747,832
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-05-31$3,072,501
Total interest from all sources2016-05-31$161
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-05-31No
Was this plan covered by a fidelity bond2016-05-31Yes
Value of fidelity bond cover2016-05-31$10,000,000
If this is an individual account plan, was there a blackout period2016-05-31No
Were there any nonexempt tranactions with any party-in-interest2016-05-31No
Contributions received from participants2016-05-31$15,580,698
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-05-31$31
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-05-31$8
Total non interest bearing cash at end of year2016-05-31$84,186
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-05-31No
Value of net assets at end of year (total assets less liabilities)2016-05-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-05-31No
Were any leases to which the plan was party in default or uncollectible2016-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-05-31$250,000
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-05-31$41,897
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-05-31$41,897
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-05-31$161
Expenses. Payments to insurance carriers foe the provision of benefits2016-05-31$59,065,505
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-05-31Yes
Was there a failure to transmit to the plan any participant contributions2016-05-31No
Has the plan failed to provide any benefit when due under the plan2016-05-31No
Contributions received in cash from employer2016-05-31$47,166,246
Employer contributions (assets) at end of year2016-05-31$4,695,893
Employer contributions (assets) at beginning of year2016-05-31$4,705,927
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-05-31$609,099
Contract administrator fees2016-05-31$3,072,501
Liabilities. Value of benefit claims payable at end of year2016-05-31$5,030,110
Liabilities. Value of benefit claims payable at beginning of year2016-05-31$4,747,832
Did the plan have assets held for investment2016-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-05-31Yes
Opinion of an independent qualified public accountant for this plan2016-05-31Disclaimer
Accountancy firm name2016-05-31CONN GENEVA & ROBINSON
Accountancy firm EIN2016-05-31383012028
2015 : HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-05-31$4,747,832
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-05-31$4,669,782
Total income from all sources (including contributions)2015-05-31$55,072,441
Total of all expenses incurred2015-05-31$55,072,441
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-05-31$52,330,734
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-05-31$55,072,329
Value of total assets at end of year2015-05-31$4,747,832
Value of total assets at beginning of year2015-05-31$4,669,782
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-05-31$2,741,707
Total interest from all sources2015-05-31$112
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-05-31No
Was this plan covered by a fidelity bond2015-05-31Yes
Value of fidelity bond cover2015-05-31$10,000,000
If this is an individual account plan, was there a blackout period2015-05-31No
Were there any nonexempt tranactions with any party-in-interest2015-05-31No
Contributions received from participants2015-05-31$11,936,329
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-05-31$8
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-05-31$11
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-05-31No
Value of net assets at end of year (total assets less liabilities)2015-05-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-05-31No
Were any leases to which the plan was party in default or uncollectible2015-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-05-31$41,897
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-05-31$450,005
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-05-31$450,005
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-05-31$112
Expenses. Payments to insurance carriers foe the provision of benefits2015-05-31$51,735,427
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-05-31Yes
Was there a failure to transmit to the plan any participant contributions2015-05-31No
Has the plan failed to provide any benefit when due under the plan2015-05-31No
Contributions received in cash from employer2015-05-31$43,136,000
Employer contributions (assets) at end of year2015-05-31$4,705,927
Employer contributions (assets) at beginning of year2015-05-31$4,219,766
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-05-31$595,307
Contract administrator fees2015-05-31$2,741,707
Liabilities. Value of benefit claims payable at end of year2015-05-31$4,747,832
Liabilities. Value of benefit claims payable at beginning of year2015-05-31$4,669,782
Did the plan have assets held for investment2015-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-05-31Yes
Opinion of an independent qualified public accountant for this plan2015-05-31Disclaimer
Accountancy firm name2015-05-31CONN GENEVA & ROBINSON
Accountancy firm EIN2015-05-31383012028
2014 : HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-05-31$4,669,782
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-05-31$4,516,875
Total income from all sources (including contributions)2014-05-31$54,935,942
Total of all expenses incurred2014-05-31$54,935,942
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-05-31$51,938,341
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-05-31$54,935,793
Value of total assets at end of year2014-05-31$4,669,782
Value of total assets at beginning of year2014-05-31$4,516,875
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-05-31$2,997,601
Total interest from all sources2014-05-31$149
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-05-31No
Was this plan covered by a fidelity bond2014-05-31Yes
Value of fidelity bond cover2014-05-31$10,000,000
If this is an individual account plan, was there a blackout period2014-05-31No
Were there any nonexempt tranactions with any party-in-interest2014-05-31No
Contributions received from participants2014-05-31$13,110,745
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-05-31$11
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-05-31$10
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-05-31No
Value of net assets at end of year (total assets less liabilities)2014-05-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-05-31No
Were any leases to which the plan was party in default or uncollectible2014-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-05-31$450,005
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-05-31$88,982
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-05-31$88,982
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-05-31$149
Expenses. Payments to insurance carriers foe the provision of benefits2014-05-31$51,451,065
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-05-31Yes
Was there a failure to transmit to the plan any participant contributions2014-05-31No
Has the plan failed to provide any benefit when due under the plan2014-05-31No
Contributions received in cash from employer2014-05-31$41,825,048
Employer contributions (assets) at end of year2014-05-31$4,219,766
Employer contributions (assets) at beginning of year2014-05-31$4,427,883
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-05-31$487,276
Contract administrator fees2014-05-31$2,997,601
Liabilities. Value of benefit claims payable at end of year2014-05-31$4,669,782
Liabilities. Value of benefit claims payable at beginning of year2014-05-31$4,516,875
Did the plan have assets held for investment2014-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-05-31Yes
Opinion of an independent qualified public accountant for this plan2014-05-31Disclaimer
Accountancy firm name2014-05-31CONN GENEVA & ROBINSON
Accountancy firm EIN2014-05-31383012028
2013 : HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-05-31$4,516,875
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-05-31$4,701,241
Total income from all sources (including contributions)2013-05-31$51,789,816
Total of all expenses incurred2013-05-31$51,789,816
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-05-31$49,438,378
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-05-31$51,789,639
Value of total assets at end of year2013-05-31$4,516,875
Value of total assets at beginning of year2013-05-31$4,701,241
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-05-31$2,351,438
Total interest from all sources2013-05-31$177
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-05-31No
Was this plan covered by a fidelity bond2013-05-31Yes
Value of fidelity bond cover2013-05-31$5,000,000
If this is an individual account plan, was there a blackout period2013-05-31No
Were there any nonexempt tranactions with any party-in-interest2013-05-31No
Contributions received from participants2013-05-31$10,028,283
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-05-31$10
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-05-31No
Value of net assets at end of year (total assets less liabilities)2013-05-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-05-31No
Were any leases to which the plan was party in default or uncollectible2013-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-05-31$88,982
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-05-31$61,249
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-05-31$61,249
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-05-31$177
Expenses. Payments to insurance carriers foe the provision of benefits2013-05-31$49,022,368
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-05-31Yes
Was there a failure to transmit to the plan any participant contributions2013-05-31No
Has the plan failed to provide any benefit when due under the plan2013-05-31No
Contributions received in cash from employer2013-05-31$41,761,356
Employer contributions (assets) at end of year2013-05-31$4,427,883
Employer contributions (assets) at beginning of year2013-05-31$4,639,992
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-05-31$416,010
Contract administrator fees2013-05-31$2,351,438
Liabilities. Value of benefit claims payable at end of year2013-05-31$4,516,875
Liabilities. Value of benefit claims payable at beginning of year2013-05-31$4,701,241
Did the plan have assets held for investment2013-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-05-31Yes
Opinion of an independent qualified public accountant for this plan2013-05-31Disclaimer
Accountancy firm name2013-05-31CONN GENEVA & ROBINSON
Accountancy firm EIN2013-05-31383012028
2012 : HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-05-31$4,701,241
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-05-31$4,370,060
Total income from all sources (including contributions)2012-05-31$59,225,041
Total of all expenses incurred2012-05-31$59,225,041
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-05-31$57,085,315
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-05-31$59,224,804
Value of total assets at end of year2012-05-31$4,701,241
Value of total assets at beginning of year2012-05-31$4,370,060
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-05-31$2,139,726
Total interest from all sources2012-05-31$237
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-05-31No
Was this plan covered by a fidelity bond2012-05-31Yes
Value of fidelity bond cover2012-05-31$5,000,000
If this is an individual account plan, was there a blackout period2012-05-31No
Were there any nonexempt tranactions with any party-in-interest2012-05-31No
Contributions received from participants2012-05-31$10,821,114
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-05-31$41
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-05-31No
Value of net assets at end of year (total assets less liabilities)2012-05-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-05-31No
Were any leases to which the plan was party in default or uncollectible2012-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-05-31$61,249
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-05-31$346,589
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-05-31$346,589
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-05-31$237
Expenses. Payments to insurance carriers foe the provision of benefits2012-05-31$56,555,370
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-05-31Yes
Was there a failure to transmit to the plan any participant contributions2012-05-31No
Has the plan failed to provide any benefit when due under the plan2012-05-31No
Contributions received in cash from employer2012-05-31$48,403,690
Employer contributions (assets) at end of year2012-05-31$4,639,992
Employer contributions (assets) at beginning of year2012-05-31$4,023,430
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-05-31$529,945
Contract administrator fees2012-05-31$2,139,726
Liabilities. Value of benefit claims payable at end of year2012-05-31$4,701,241
Liabilities. Value of benefit claims payable at beginning of year2012-05-31$4,370,060
Did the plan have assets held for investment2012-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-05-31Yes
Opinion of an independent qualified public accountant for this plan2012-05-31Disclaimer
Accountancy firm name2012-05-31CONN GENEVA & ROBINSON
Accountancy firm EIN2012-05-31383012028
2011 : HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-05-31$4,370,060
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-05-31$4,211,000
Total income from all sources (including contributions)2011-05-31$57,311,088
Total of all expenses incurred2011-05-31$57,311,088
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-05-31$57,018,244
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-05-31$57,310,410
Value of total assets at end of year2011-05-31$4,370,060
Value of total assets at beginning of year2011-05-31$4,211,000
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-05-31$292,844
Total interest from all sources2011-05-31$678
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-05-31No
Was this plan covered by a fidelity bond2011-05-31Yes
Value of fidelity bond cover2011-05-31$5,000,000
If this is an individual account plan, was there a blackout period2011-05-31No
Were there any nonexempt tranactions with any party-in-interest2011-05-31No
Contributions received from participants2011-05-31$9,844,960
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-05-31$41
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-05-31$81
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-05-31No
Value of net assets at end of year (total assets less liabilities)2011-05-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-05-31No
Were any leases to which the plan was party in default or uncollectible2011-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-05-31$346,589
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-05-31$39,211
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-05-31$39,211
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-05-31$678
Expenses. Payments to insurance carriers foe the provision of benefits2011-05-31$679,075
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-05-31Yes
Was there a failure to transmit to the plan any participant contributions2011-05-31No
Has the plan failed to provide any benefit when due under the plan2011-05-31No
Contributions received in cash from employer2011-05-31$47,465,450
Employer contributions (assets) at end of year2011-05-31$4,023,430
Employer contributions (assets) at beginning of year2011-05-31$4,171,708
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-05-31$56,339,169
Contract administrator fees2011-05-31$292,844
Liabilities. Value of benefit claims payable at end of year2011-05-31$4,370,060
Liabilities. Value of benefit claims payable at beginning of year2011-05-31$4,211,000
Did the plan have assets held for investment2011-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-05-31Yes
Opinion of an independent qualified public accountant for this plan2011-05-31Disclaimer
Accountancy firm name2011-05-31CONN GENEVA & ROBINSON
Accountancy firm EIN2011-05-31383012028

Form 5500 Responses for HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN

2022: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS 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: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Submission has been amendedNo
2019-06-01This submission is the final filingNo
2019-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-06-01Plan is a collectively bargained planNo
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan funding arrangement – TrustYes
2019-06-01Plan funding arrangement – General assets of the sponsorYes
2019-06-01Plan benefit arrangement – InsuranceYes
2019-06-01Plan benefit arrangement - TrustYes
2019-06-01Plan benefit arrangement – General assets of the sponsorYes
2018: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Submission has been amendedNo
2018-06-01This submission is the final filingNo
2018-06-01This return/report is a short plan year return/report (less than 12 months)No
2018-06-01Plan is a collectively bargained planNo
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan funding arrangement – TrustYes
2018-06-01Plan funding arrangement – General assets of the sponsorYes
2018-06-01Plan benefit arrangement – InsuranceYes
2018-06-01Plan benefit arrangement - TrustYes
2018-06-01Plan benefit arrangement – General assets of the sponsorYes
2017: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan funding arrangement – TrustYes
2017-06-01Plan funding arrangement – General assets of the sponsorYes
2017-06-01Plan benefit arrangement – InsuranceYes
2017-06-01Plan benefit arrangement - TrustYes
2017-06-01Plan benefit arrangement – General assets of the sponsorYes
2016: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan funding arrangement – TrustYes
2016-06-01Plan funding arrangement – General assets of the sponsorYes
2016-06-01Plan benefit arrangement – InsuranceYes
2016-06-01Plan benefit arrangement - TrustYes
2016-06-01Plan benefit arrangement – General assets of the sponsorYes
2015: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan funding arrangement – TrustYes
2015-06-01Plan funding arrangement – General assets of the sponsorYes
2015-06-01Plan benefit arrangement – InsuranceYes
2015-06-01Plan benefit arrangement - TrustYes
2015-06-01Plan benefit arrangement – General assets of the sponsorYes
2014: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan funding arrangement – TrustYes
2014-06-01Plan funding arrangement – General assets of the sponsorYes
2014-06-01Plan benefit arrangement – InsuranceYes
2014-06-01Plan benefit arrangement - TrustYes
2014-06-01Plan benefit arrangement – General assets of the sponsorYes
2013: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan funding arrangement – TrustYes
2013-06-01Plan funding arrangement – General assets of the sponsorYes
2013-06-01Plan benefit arrangement – InsuranceYes
2013-06-01Plan benefit arrangement - TrustYes
2013-06-01Plan benefit arrangement – General assets of the sponsorYes
2012: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2012 form 5500 responses
2012-06-01Type of plan entitySingle employer plan
2012-06-01Plan funding arrangement – InsuranceYes
2012-06-01Plan funding arrangement – TrustYes
2012-06-01Plan funding arrangement – General assets of the sponsorYes
2012-06-01Plan benefit arrangement – InsuranceYes
2012-06-01Plan benefit arrangement - TrustYes
2012-06-01Plan benefit arrangement – General assets of the sponsorYes
2011: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2011 form 5500 responses
2011-06-01Type of plan entitySingle employer plan
2011-06-01Plan funding arrangement – InsuranceYes
2011-06-01Plan funding arrangement – TrustYes
2011-06-01Plan funding arrangement – General assets of the sponsorYes
2011-06-01Plan benefit arrangement – InsuranceYes
2011-06-01Plan benefit arrangement - TrustYes
2011-06-01Plan benefit arrangement – General assets of the sponsorYes
2009: HERMAN MILLER, INC. WELFARE BENEFITS AND FLEXIBLE BENEFITS PLAN 2009 form 5500 responses
2009-05-31Type of plan entitySingle employer plan
2009-05-31This return/report is a short plan year return/report (less than 12 months)Yes
2009-05-31Plan funding arrangement – InsuranceYes
2009-05-31Plan funding arrangement – TrustYes
2009-05-31Plan funding arrangement – General assets of the sponsorYes
2009-05-31Plan benefit arrangement – InsuranceYes
2009-05-31Plan benefit arrangement - TrustYes
2009-05-31Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

HERITAGE VISION PLANS, INC (National Association of Insurance Commissioners NAIC id number: 11204 )
Policy contract number1235-00-1032
Policy instance 1
Insurance contract or identification number1235-00-1032
Number of Individuals Covered2492
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
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 $183,265
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN GENERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 39950 )
Policy contract number400010
Policy instance 8
Insurance contract or identification number400010
Number of Individuals Covered842
Insurance policy start date2022-08-01
Insurance policy end date2022-12-31
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 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
Other welfare benefits providedLEGAL
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 $52,730
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26298 )
Policy contract number400010
Policy instance 2
Insurance contract or identification number400010
Number of Individuals Covered892
Insurance policy start date2022-01-01
Insurance policy end date2022-07-31
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 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
Other welfare benefits providedLEGAL
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 $91,967
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10080051001*
Policy instance 3
Insurance contract or identification number10080051001*
Number of Individuals Covered4487
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
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 $303,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberE00067138118
Policy instance 4
Insurance contract or identification numberE00067138118
Number of Individuals Covered33
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 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 $156,485
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK970574*
Policy instance 5
Insurance contract or identification numberOK970574*
Number of Individuals Covered5995
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $3,018,863
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 )
Policy contract number38710
Policy instance 6
Insurance contract or identification number38710
Number of Individuals Covered71
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 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 $255,485
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number802315
Policy instance 7
Insurance contract or identification number802315
Number of Individuals Covered1964
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $42,458
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 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
Other welfare benefits providedACCIDENT, HOSPITAL INDEMNITY
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 $497,338
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,458
Insurance broker organization code?3
HERITAGE VISION PLANS, INC (National Association of Insurance Commissioners NAIC id number: 11204 )
Policy contract number1235-00-1032
Policy instance 1
Insurance contract or identification number1235-00-1032
Number of Individuals Covered2813
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
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 $190,104
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26298 )
Policy contract number400010
Policy instance 2
Insurance contract or identification number400010
Number of Individuals Covered842
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 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
Other welfare benefits providedPREPAID LEGAL
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 $150,201
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number10080061001
Policy instance 4
Insurance contract or identification number10080061001
Number of Individuals Covered65
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
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 $4,975
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE430299
Policy instance 5
Insurance contract or identification numberAE430299
Number of Individuals Covered36
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 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 $185,422
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 970574
Policy instance 6
Insurance contract or identification numberOK 970574
Number of Individuals Covered5200
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 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
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $222,854
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX969120
Policy instance 7
Insurance contract or identification numberFLX969120
Number of Individuals Covered5200
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 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 $1,327,371
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT962935
Policy instance 8
Insurance contract or identification numberVDT962935
Number of Individuals Covered5200
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
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 $31,750
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 )
Policy contract number387100 S014
Policy instance 9
Insurance contract or identification number387100 S014
Number of Individuals Covered76
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 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 $316,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number10080051001
Policy instance 3
Insurance contract or identification number10080051001
Number of Individuals Covered4383
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
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 $291,042
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HERITAGE VISION PLANS, INC (National Association of Insurance Commissioners NAIC id number: 11204 )
Policy contract number1235-00-1032
Policy instance 1
Insurance contract or identification number1235-00-1032
Number of Individuals Covered2992
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
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 $210,197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26298 )
Policy contract number400010
Policy instance 2
Insurance contract or identification number400010
Number of Individuals Covered845
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 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
Other welfare benefits providedPREPAID LEGAL
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 $158,613
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number10080051001
Policy instance 3
Insurance contract or identification number10080051001
Number of Individuals Covered4413
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
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 $270,995
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number10080061001
Policy instance 4
Insurance contract or identification number10080061001
Number of Individuals Covered71
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
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 $4,498
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE430299
Policy instance 5
Insurance contract or identification numberAE430299
Number of Individuals Covered40
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 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 $218,893
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 970574
Policy instance 6
Insurance contract or identification numberOK 970574
Number of Individuals Covered5341
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,423
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 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
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $205,396
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1423
Additional information about fees paid to insurance brokerSALES & SERVICE/OTHER
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX969120
Policy instance 7
Insurance contract or identification numberFLX969120
Number of Individuals Covered5341
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $6,384
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 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 $1,225,767
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees6384
Additional information about fees paid to insurance brokerSALES & SERVICE/OTHER
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT962935
Policy instance 8
Insurance contract or identification numberVDT962935
Number of Individuals Covered198
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $440
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
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 $91,256
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees440
Additional information about fees paid to insurance brokerSALES & SERVICE/OTHER
Insurance broker organization code?3
PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 )
Policy contract number387100 S014
Policy instance 9
Insurance contract or identification number387100 S014
Number of Individuals Covered92
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 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 $419,522
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE430301
Policy instance 8
Insurance contract or identification numberAE430301
Number of Individuals Covered18
Insurance policy start date2019-06-01
Insurance policy end date2019-12-31
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 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 $47,286
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 964799
Policy instance 10
Insurance contract or identification numberLK 964799
Number of Individuals Covered5118
Insurance policy start date2019-06-01
Insurance policy end date2019-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $757,003
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26298 )
Policy contract number400010
Policy instance 2
Insurance contract or identification number400010
Number of Individuals Covered793
Insurance policy start date2019-06-01
Insurance policy end date2019-12-31
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 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
Other welfare benefits providedPREPAID LEGAL
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 $82,451
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1049019
Policy instance 3
Insurance contract or identification number1049019
Number of Individuals Covered7709
Insurance policy start date2019-06-01
Insurance policy end date2019-12-31
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 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
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $990,531
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 )
Policy contract number387100S014
Policy instance 4
Insurance contract or identification number387100S014
Number of Individuals Covered102
Insurance policy start date2019-06-01
Insurance policy end date2019-12-31
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 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 $273,027
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNYD075384
Policy instance 9
Insurance contract or identification numberNYD075384
Number of Individuals Covered56
Insurance policy start date2019-06-01
Insurance policy end date2019-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
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 $3,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number10080061001
Policy instance 6
Insurance contract or identification number10080061001
Number of Individuals Covered44
Insurance policy start date2019-06-01
Insurance policy end date2019-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
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 $1,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE430299
Policy instance 7
Insurance contract or identification numberAE430299
Number of Individuals Covered43
Insurance policy start date2019-06-01
Insurance policy end date2019-12-31
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 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 $114,702
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number10080051001
Policy instance 5
Insurance contract or identification number10080051001
Number of Individuals Covered3703
Insurance policy start date2019-06-01
Insurance policy end date2019-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
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 $136,991
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HERITAGE VISION PLANS, INC (National Association of Insurance Commissioners NAIC id number: 11204 )
Policy contract number1235-00-1032
Policy instance 1
Insurance contract or identification number1235-00-1032
Number of Individuals Covered3358
Insurance policy start date2019-06-01
Insurance policy end date2019-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
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 $131,387
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HERITAGE VISION PLANS, INC (National Association of Insurance Commissioners NAIC id number: 11204 )
Policy contract number1235-00-1032
Policy instance 1
Insurance contract or identification number1235-00-1032
Number of Individuals Covered3512
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
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 $235,096
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 )
Policy contract number387100S014
Policy instance 4
Insurance contract or identification number387100S014
Number of Individuals Covered107
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
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 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 $535,940
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 964799
Policy instance 8
Insurance contract or identification numberLK 964799
Number of Individuals Covered5032
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $6,964
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $1,304,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees6964
Additional information about fees paid to insurance brokerSALES AND SERVICE
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number10080051001
Policy instance 5
Insurance contract or identification number10080051001
Number of Individuals Covered3619
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
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 $228,439
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1049019
Policy instance 3
Insurance contract or identification number1049019
Number of Individuals Covered7781
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 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
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $1,701,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number10080061001
Policy instance 6
Insurance contract or identification number10080061001
Number of Individuals Covered25
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
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 $1,689
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26298 )
Policy contract number400010
Policy instance 2
Insurance contract or identification number400010
Number of Individuals Covered839
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
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 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
Other welfare benefits providedPREPAID LEGAL
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 $143,349
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNYD075384
Policy instance 7
Insurance contract or identification numberNYD075384
Number of Individuals Covered56
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $37
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
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 $13,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees37
Additional information about fees paid to insurance brokerSALES AND SERVICE
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE430299
Policy instance 9
Insurance contract or identification numberAE430299
Number of Individuals Covered47
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 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 $229,693
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE430301
Policy instance 10
Insurance contract or identification numberAE430301
Number of Individuals Covered19
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 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 $94,579
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number9525
Policy instance 1
Insurance contract or identification number9525
Number of Individuals Covered10704
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HERITAGE VISION PLANS, INC (National Association of Insurance Commissioners NAIC id number: 11204 )
Policy contract numberHERMAN MILLER
Policy instance 2
Insurance contract or identification numberHERMAN MILLER
Number of Individuals Covered3846
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $294,024
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE430301
Policy instance 12
Insurance contract or identification numberAE430301
Number of Individuals Covered20
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Welfare Benefit Premiums Paid to CarrierUSD $89,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE430299
Policy instance 11
Insurance contract or identification numberAE430299
Number of Individuals Covered50
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Welfare Benefit Premiums Paid to CarrierUSD $224,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL32927
Policy instance 10
Insurance contract or identification numberHCL32927
Number of Individuals Covered4144
Insurance policy start date2017-01-01
Insurance policy end date2017-10-31
Welfare Benefit Premiums Paid to CarrierUSD $636,542
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 964799
Policy instance 9
Insurance contract or identification numberLK 964799
Insurance policy start date2017-03-01
Insurance policy end date2018-03-01
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,273,547
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number10080061001
Policy instance 7
Insurance contract or identification number10080061001
Number of Individuals Covered14
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 )
Policy contract number387100S014
Policy instance 5
Insurance contract or identification number387100S014
Number of Individuals Covered124
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $650,586
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1049019
Policy instance 4
Insurance contract or identification number1049019
Number of Individuals Covered7759
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of fees paid to insurance companyUSD $20,000
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,640,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number400010
Policy instance 3
Insurance contract or identification number400010
Number of Individuals Covered787
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Other welfare benefits providedPREPAID LEGAL
Welfare Benefit Premiums Paid to CarrierUSD $145,954
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number10080051001
Policy instance 6
Insurance contract or identification number10080051001
Number of Individuals Covered3085
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $142,508
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberNYD075384
Policy instance 8
Insurance contract or identification numberNYD075384
Insurance policy start date2017-03-01
Insurance policy end date2018-03-01
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,620
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HERITAGE VISION PLANS, INC (National Association of Insurance Commissioners NAIC id number: 11204 )
Policy contract numberHERMAN MILLER
Policy instance 2
Insurance contract or identification numberHERMAN MILLER
Number of Individuals Covered6613
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $429,366
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number400010
Policy instance 3
Insurance contract or identification number400010
Number of Individuals Covered811
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Other welfare benefits providedPREPAID LEGAL
Welfare Benefit Premiums Paid to CarrierUSD $136,183
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1049019
Policy instance 4
Insurance contract or identification number1049019
Number of Individuals Covered7678
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,578,429
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 123820
Policy instance 5
Insurance contract or identification numberLTD 123820
Number of Individuals Covered5717
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $3,902
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $760,444
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,902
Insurance broker nameAON RISK SERVICES CENTRAL
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 7
Insurance contract or identification numberEXRK
Number of Individuals Covered10371
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Other welfare benefits providedINDIVIDUAL EXCESS RISK
Welfare Benefit Premiums Paid to CarrierUSD $767,200
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number9525
Policy instance 1
Insurance contract or identification number9525
Number of Individuals Covered11216
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 )
Policy contract number387100S014
Policy instance 6
Insurance contract or identification number387100S014
Number of Individuals Covered180
Insurance policy start date2015-05-30
Insurance policy end date2016-05-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $908,061
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 number40000100013792
Policy instance 5
Insurance contract or identification number40000100013792
Number of Individuals Covered3846
Insurance policy start date2014-06-01
Insurance policy end date2014-12-31
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $527,536
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 number40300140300000
Policy instance 7
Insurance contract or identification number40300140300000
Number of Individuals Covered2022
Insurance policy start date2014-06-01
Insurance policy end date2014-12-31
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $106,276
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HERITAGE VISION PLANS, INC (National Association of Insurance Commissioners NAIC id number: 11204 )
Policy contract numberHERMAN MILLER
Policy instance 2
Insurance contract or identification numberHERMAN MILLER
Number of Individuals Covered6455
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $416,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number9525
Policy instance 1
Insurance contract or identification number9525
Number of Individuals Covered11257
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number400010
Policy instance 3
Insurance contract or identification number400010
Number of Individuals Covered785
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Other welfare benefits providedPREPAID LEGAL
Welfare Benefit Premiums Paid to CarrierUSD $136,422
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 123820
Policy instance 10
Insurance contract or identification numberLTD 123820
Number of Individuals Covered5595
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of fees paid to insurance companyUSD $4,160
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $841,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees4160
Insurance broker nameAON RISK SERVICES CENTRAL
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number1014749600000
Policy instance 4
Insurance contract or identification number1014749600000
Number of Individuals Covered4781
Insurance policy start date2014-06-01
Insurance policy end date2014-12-31
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $278,135
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberDBL 251817
Policy instance 9
Insurance contract or identification numberDBL 251817
Number of Individuals Covered48
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of fees paid to insurance companyUSD $21
Other welfare benefits providedDISABILITY BENEFIT LAW
Welfare Benefit Premiums Paid to CarrierUSD $3,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees21
Insurance broker nameAON RISK SERVICES CENTRAL
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number1014753600000
Policy instance 6
Insurance contract or identification number1014753600000
Number of Individuals Covered279
Insurance policy start date2014-06-01
Insurance policy end date2014-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $94,527
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 number40300149400000
Policy instance 8
Insurance contract or identification number40300149400000
Number of Individuals Covered34
Insurance policy start date2014-06-01
Insurance policy end date2014-12-31
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $907
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 )
Policy contract number387100S014
Policy instance 11
Insurance contract or identification number387100S014
Number of Individuals Covered199
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $784,910
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 number1014753600000
Policy instance 6
Insurance contract or identification number1014753600000
Number of Individuals Covered279
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of fees paid to insurance companyUSD $4,887
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $182,917
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees4887
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameAON RISK SERVICES CENTRAL
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number40000100013792
Policy instance 5
Insurance contract or identification number40000100013792
Number of Individuals Covered4460
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of fees paid to insurance companyUSD $11,250
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $983,241
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees11250
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameAON RISK SERVICES CENTRAL
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number1014749600000
Policy instance 4
Insurance contract or identification number1014749600000
Number of Individuals Covered4756
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of fees paid to insurance companyUSD $11,250
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $506,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees11250
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameAON RISK SERVICES
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number9525
Policy instance 1
Insurance contract or identification number9525
Number of Individuals Covered11482
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Dental Insurance Welfare BenefitYes
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 number40300140300000
Policy instance 7
Insurance contract or identification number40300140300000
Number of Individuals Covered256
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of fees paid to insurance companyUSD $5,429
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $207,192
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees5429
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameAON RISK SERVICES CENTRAL
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number40300149400000
Policy instance 8
Insurance contract or identification number40300149400000
Number of Individuals Covered34
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,426
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberDBL 251817
Policy instance 9
Insurance contract or identification numberDBL 251817
Number of Individuals Covered60
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Other welfare benefits providedDISABILITY BENEFIT LAW
Welfare Benefit Premiums Paid to CarrierUSD $4,488
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 123820
Policy instance 10
Insurance contract or identification numberLTD 123820
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $892,568
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 )
Policy contract number387100S014
Policy instance 11
Insurance contract or identification number387100S014
Number of Individuals Covered223
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $935,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HERITAGE VISION PLANS, INC (National Association of Insurance Commissioners NAIC id number: 11204 )
Policy contract numberHERMAN MILLER
Policy instance 2
Insurance contract or identification numberHERMAN MILLER
Number of Individuals Covered7209
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $411,815
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number400010
Policy instance 3
Insurance contract or identification number400010
Number of Individuals Covered764
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Other welfare benefits providedPREPAID LEGAL
Welfare Benefit Premiums Paid to CarrierUSD $122,047
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 number40300140300000
Policy instance 9
Insurance contract or identification number40300140300000
Number of Individuals Covered2111
Insurance policy start date2012-01-01
Insurance policy end date2012-11-30
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $164,693
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 number1014753600000
Policy instance 8
Insurance contract or identification number1014753600000
Number of Individuals Covered311
Insurance policy start date2012-01-01
Insurance policy end date2012-11-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $162,901
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 number1014749600000
Policy instance 6
Insurance contract or identification number1014749600000
Number of Individuals Covered4322
Insurance policy start date2012-01-01
Insurance policy end date2012-11-30
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $360,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number400010
Policy instance 5
Insurance contract or identification number400010
Number of Individuals Covered743
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Other welfare benefits providedPREPAID LEGAL
Welfare Benefit Premiums Paid to CarrierUSD $112,872
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HERITAGE VISION PLANS, INC (National Association of Insurance Commissioners NAIC id number: 11204 )
Policy contract numberHERMAN MILLER
Policy instance 4
Insurance contract or identification numberHERMAN MILLER
Number of Individuals Covered6995
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $388,192
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number469618
Policy instance 3
Insurance contract or identification number469618
Number of Individuals Covered4136
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1000116
Policy instance 2
Insurance contract or identification number1000116
Number of Individuals Covered5724
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $755,826
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerSERVICE FEE 3
Insurance broker nameAON CORPORATION
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number40300149400000
Policy instance 10
Insurance contract or identification number40300149400000
Number of Individuals Covered34
Insurance policy start date2012-01-01
Insurance policy end date2012-11-30
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $3,331
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 number40000100013792
Policy instance 7
Insurance contract or identification number40000100013792
Number of Individuals Covered3982
Insurance policy start date2012-01-01
Insurance policy end date2012-11-30
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $654,546
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number9525
Policy instance 1
Insurance contract or identification number9525
Number of Individuals Covered11747
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number400010
Policy instance 5
Insurance contract or identification number400010
Number of Individuals Covered687
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Other welfare benefits providedPREPAID LEGAL
Welfare Benefit Premiums Paid to CarrierUSD $108,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HERITAGE VISION PLANS, INC (National Association of Insurance Commissioners NAIC id number: 11204 )
Policy contract numberHERMAN MILLER
Policy instance 4
Insurance contract or identification numberHERMAN MILLER
Number of Individuals Covered6348
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $378,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number677126G
Policy instance 3
Insurance contract or identification number677126G
Insurance policy start date2011-06-01
Insurance policy end date2011-12-31
Welfare Benefit Premiums Paid to CarrierUSD $208,257
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1000116
Policy instance 2
Insurance contract or identification number1000116
Number of Individuals Covered5625
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $2,331
Total amount of fees paid to insurance companyUSD $17,662
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,165,568
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number9525
Policy instance 1
Insurance contract or identification number9525
Number of Individuals Covered12120
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number9525
Policy instance 1
Insurance contract or identification number9525
Number of Individuals Covered12732
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1000116
Policy instance 2
Insurance contract or identification number1000116
Number of Individuals Covered4493
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $9,296
Total amount of fees paid to insurance companyUSD $21,771
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,186,177
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number677126G
Policy instance 3
Insurance contract or identification number677126G
Number of Individuals Covered5193
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $9,996
Life Insurance Welfare BenefitYes
Other welfare benefits providedA D D
Welfare Benefit Premiums Paid to CarrierUSD $802,108
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HERITAGE VISION PLANS, INC (National Association of Insurance Commissioners NAIC id number: 11204 )
Policy contract numberHM-1235
Policy instance 4
Insurance contract or identification numberHM-1235
Number of Individuals Covered6334
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $377,203
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number400010
Policy instance 5
Insurance contract or identification number400010
Number of Individuals Covered687
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Other welfare benefits providedPREPAID LEGAL
Welfare Benefit Premiums Paid to CarrierUSD $110,983
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

Was this data useful?
If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us.

Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer
The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Copyright © Market Footprint Ltd
Contact us   Datalog Company Directory
401k Lookup     VAT Lookup S3