WIRTZ MANUFACTURING COMPANY, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN
401k plan membership statisitcs for WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN
| Measure | Date | Value |
|---|
| 2022: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 117 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 127 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 127 |
| 2021: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 113 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 117 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 117 |
| 2020: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 119 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 113 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 113 |
| 2019: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 106 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 119 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 119 |
| 2018: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 115 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 106 |
| Total of all active and inactive participants | 2018-01-01 | 106 |
| 2017: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 98 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 115 |
| Total of all active and inactive participants | 2017-01-01 | 115 |
| 2016: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 110 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 98 |
| Total of all active and inactive participants | 2016-01-01 | 98 |
| 2015: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 110 |
| Total of all active and inactive participants | 2015-01-01 | 110 |
| 2014: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 127 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 109 |
| Total of all active and inactive participants | 2014-01-01 | 109 |
| 2013: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 112 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 127 |
| Total of all active and inactive participants | 2013-01-01 | 127 |
| 2012: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 112 |
| Total of all active and inactive participants | 2012-01-01 | 112 |
| 2011: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 121 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 132 |
| Total of all active and inactive participants | 2011-01-01 | 132 |
| 2010: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 121 |
| Total of all active and inactive participants | 2010-01-01 | 121 |
| 2009: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 127 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 103 |
| Total of all active and inactive participants | 2009-01-01 | 103 |
| 2022: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | Yes |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: WIRTZ MANUFACTURING COMPANY, INC. HOSPITAL SERVICE DRUGS & DENTAL PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-050177 |
| Policy instance | 2 |
| Insurance contract or identification number | 010-050177 | | Number of Individuals Covered | 279 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2023-01-31 | | Total amount of commissions paid to insurance broker | USD $12,562 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $116,744 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,172 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 160239 |
| Policy instance | 1 |
| Insurance contract or identification number | 160239 | | Number of Individuals Covered | 330 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2023-01-31 | | Total amount of commissions paid to insurance broker | USD $5,370 | | Total amount of fees paid to insurance company | USD $18,825 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,370 | | Amount paid for insurance broker fees | 18000 | | Additional information about fees paid to insurance broker | AGENT FEE | | Insurance broker organization code? | 3 |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-050177 |
| Policy instance | 2 |
| Insurance contract or identification number | 010-050177 | | Number of Individuals Covered | 304 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $15,287 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $218,380 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,287 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 160239 |
| Policy instance | 1 |
| Insurance contract or identification number | 160239 | | Number of Individuals Covered | 304 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $4,607 | | Total amount of fees paid to insurance company | USD $17,166 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,607 | | Amount paid for insurance broker fees | 17166 | | Additional information about fees paid to insurance broker | AGENT FEE FEES AND OTHER COMMISSIONS | | Insurance broker organization code? | 3 |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-050177 |
| Policy instance | 2 |
| Insurance contract or identification number | 010-050177 | | Number of Individuals Covered | 298 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $6,822 | | Total amount of fees paid to insurance company | USD $1,542 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $97,452 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,822 | | Amount paid for insurance broker fees | 1542 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 160239 |
| Policy instance | 1 |
| Insurance contract or identification number | 160239 | | Number of Individuals Covered | 298 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $6,558 | | Total amount of fees paid to insurance company | USD $19,416 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,558 | | Amount paid for insurance broker fees | 19416 | | Additional information about fees paid to insurance broker | AGENT FEE FEES AND OTHER COMMISSIONS | | Insurance broker organization code? | 3 |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-050177 |
| Policy instance | 2 |
| Insurance contract or identification number | 010-050177 | | Number of Individuals Covered | 261 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $6,661 | | Total amount of fees paid to insurance company | USD $528 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $95,159 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,661 | | Amount paid for insurance broker fees | 528 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 160239 |
| Policy instance | 1 |
| Insurance contract or identification number | 160239 | | Number of Individuals Covered | 261 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $6,390 | | Total amount of fees paid to insurance company | USD $18,757 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,390 | | Amount paid for insurance broker fees | 18757 | | Additional information about fees paid to insurance broker | AGENT FEE FEES AND OTHER COMMISSIONS | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 13211 |
| Policy instance | 1 |
| Insurance contract or identification number | 13211 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $5,636 | | Total amount of fees paid to insurance company | USD $18,000 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,636 | | Amount paid for insurance broker fees | 18000 | | Insurance broker organization code? | 3 | | Insurance broker name | MARK VANDENBRANDEN |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 13211 |
| Policy instance | 1 |
| Insurance contract or identification number | 13211 | | Insurance policy start date | 2015-02-01 | | Insurance policy end date | 2016-01-31 | | Total amount of commissions paid to insurance broker | USD $5,876 | | Total amount of fees paid to insurance company | USD $18,000 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,876 | | Amount paid for insurance broker fees | 18000 | | Insurance broker organization code? | 3 | | Insurance broker name | MARK VANDENBRANDEN |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 13211 |
| Policy instance | 1 |
| Insurance contract or identification number | 13211 | | Insurance policy start date | 2014-02-01 | | Insurance policy end date | 2015-01-31 | | Total amount of commissions paid to insurance broker | USD $6,147 | | Total amount of fees paid to insurance company | USD $18,000 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,147 | | Amount paid for insurance broker fees | 18000 | | Insurance broker organization code? | 3 | | Insurance broker name | MARK VANDENBRANDEN |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 13211 |
| Policy instance | 1 |
| Insurance contract or identification number | 13211 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2013-02-01 | | Insurance policy end date | 2014-01-31 | | Total amount of commissions paid to insurance broker | USD $4,893 | | Total amount of fees paid to insurance company | USD $18,000 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,893 | | Amount paid for insurance broker fees | 18000 | | Insurance broker organization code? | 3 | | Insurance broker name | MARK VANDENBRANDEN |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | GROUP 13211 |
| Policy instance | 1 |
| Insurance contract or identification number | GROUP 13211 | | Number of Individuals Covered | 132 | | Insurance policy start date | 2012-02-01 | | Insurance policy end date | 2013-01-31 | | Total amount of commissions paid to insurance broker | USD $24,336 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,336 | | Insurance broker name | MARK VANDENBRANDEN |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | GROUP 13211 |
| Policy instance | 1 |
| Insurance contract or identification number | GROUP 13211 | | Number of Individuals Covered | 132 | | Insurance policy start date | 2011-02-01 | | Insurance policy end date | 2012-01-31 | | Total amount of commissions paid to insurance broker | USD $19,026 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | GROUP 13211 |
| Policy instance | 1 |
| Insurance contract or identification number | GROUP 13211 | | Number of Individuals Covered | 121 | | Insurance policy start date | 2010-02-01 | | Insurance policy end date | 2011-01-31 | | Total amount of commissions paid to insurance broker | USD $17,969 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,969 | | Insurance broker organization code? | 3 | | Insurance broker name | WILLIAM A ROBBINS |
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