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AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameAJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN
Plan identification number 501

AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

AJM PACKAGING CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:AJM PACKAGING CORPORATION
Employer identification number (EIN):381556263
NAIC Classification:322200

Additional information about AJM PACKAGING CORPORATION

Jurisdiction of Incorporation: Georgia Department of States Corporations Division
Incorporation Date:
Company Identification Number: 951472

More information about AJM PACKAGING CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-05-01TERRY JACKSON2023-11-29
5012021-05-01TERRY JACKSON2023-02-09
5012020-05-01TERRY JACKSON2022-01-18
5012019-05-01TERRY JACKSON2021-02-10
5012018-05-01TERRY JACKSON2019-12-20
5012017-05-01
5012016-05-01
5012015-05-01
5012014-05-01
5012013-05-01
5012012-05-01TERRY JACKSON
5012011-05-01TERRY JACKSON
5012010-05-01TERRY JACKSON
5012009-05-01TERRY JACKSON

Plan Statistics for AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN

Measure Date Value
2022: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-05-012,820
Total number of active participants reported on line 7a of the Form 55002022-05-012,103
Total of all active and inactive participants2022-05-012,103
2021: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-05-011,931
Total number of active participants reported on line 7a of the Form 55002021-05-012,820
Total of all active and inactive participants2021-05-012,820
2020: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-05-011,841
Total number of active participants reported on line 7a of the Form 55002020-05-011,931
Total of all active and inactive participants2020-05-011,931
2019: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-011,665
Total number of active participants reported on line 7a of the Form 55002019-05-011,841
Total of all active and inactive participants2019-05-011,841
2018: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-05-011,617
Total number of active participants reported on line 7a of the Form 55002018-05-011,665
Total of all active and inactive participants2018-05-011,665
2017: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-05-011,634
Total number of active participants reported on line 7a of the Form 55002017-05-011,617
Total of all active and inactive participants2017-05-011,617
2016: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-05-011,402
Total number of active participants reported on line 7a of the Form 55002016-05-011,634
Number of retired or separated participants receiving benefits2016-05-010
Number of other retired or separated participants entitled to future benefits2016-05-010
Total of all active and inactive participants2016-05-011,634
2015: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-05-011,327
Total number of active participants reported on line 7a of the Form 55002015-05-011,402
Total of all active and inactive participants2015-05-011,402
2014: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-05-011,227
Total number of active participants reported on line 7a of the Form 55002014-05-011,327
Total of all active and inactive participants2014-05-011,327
2013: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-05-011,169
Total number of active participants reported on line 7a of the Form 55002013-05-011,227
Total of all active and inactive participants2013-05-011,227
2012: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-05-011,174
Total number of active participants reported on line 7a of the Form 55002012-05-011,169
Total of all active and inactive participants2012-05-011,169
2011: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-05-011,123
Total number of active participants reported on line 7a of the Form 55002011-05-011,174
Total of all active and inactive participants2011-05-011,174
2010: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-05-011,098
Total number of active participants reported on line 7a of the Form 55002010-05-011,123
Total of all active and inactive participants2010-05-011,123
2009: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-05-011,037
Total number of active participants reported on line 7a of the Form 55002009-05-011,098
Total of all active and inactive participants2009-05-011,098

Form 5500 Responses for AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN

2022: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – General assets of the sponsorYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement – General assets of the sponsorYes
2021: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – General assets of the sponsorYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – General assets of the sponsorYes
2020: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan funding arrangement – General assets of the sponsorYes
2020-05-01Plan benefit arrangement – InsuranceYes
2020-05-01Plan benefit arrangement – General assets of the sponsorYes
2019: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – General assets of the sponsorYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – General assets of the sponsorYes
2018: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan funding arrangement – General assets of the sponsorYes
2018-05-01Plan benefit arrangement – InsuranceYes
2018-05-01Plan benefit arrangement – General assets of the sponsorYes
2017: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan funding arrangement – General assets of the sponsorYes
2017-05-01Plan benefit arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – General assets of the sponsorYes
2016: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan funding arrangement – General assets of the sponsorYes
2016-05-01Plan benefit arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – General assets of the sponsorYes
2015: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan funding arrangement – General assets of the sponsorYes
2015-05-01Plan benefit arrangement – InsuranceYes
2015-05-01Plan benefit arrangement – General assets of the sponsorYes
2014: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan funding arrangement – General assets of the sponsorYes
2014-05-01Plan benefit arrangement – InsuranceYes
2014-05-01Plan benefit arrangement – General assets of the sponsorYes
2013: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan funding arrangement – General assets of the sponsorYes
2013-05-01Plan benefit arrangement – InsuranceYes
2013-05-01Plan benefit arrangement – General assets of the sponsorYes
2012: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan funding arrangement – General assets of the sponsorYes
2012-05-01Plan benefit arrangement – InsuranceYes
2012-05-01Plan benefit arrangement – General assets of the sponsorYes
2011: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan funding arrangement – General assets of the sponsorYes
2011-05-01Plan benefit arrangement – InsuranceYes
2011-05-01Plan benefit arrangement – General assets of the sponsorYes
2010: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2010 form 5500 responses
2010-05-01Type of plan entitySingle employer plan
2010-05-01Plan funding arrangement – InsuranceYes
2010-05-01Plan funding arrangement – General assets of the sponsorYes
2010-05-01Plan benefit arrangement – InsuranceYes
2010-05-01Plan benefit arrangement – General assets of the sponsorYes
2009: AJM PACKAGING CORPORATION EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-05-01Type of plan entitySingle employer plan
2009-05-01This submission is the final filingNo
2009-05-01Plan funding arrangement – InsuranceYes
2009-05-01Plan funding arrangement – General assets of the sponsorYes
2009-05-01Plan benefit arrangement – InsuranceYes
2009-05-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0011965511
Policy instance 6
Insurance contract or identification number0011965511
Number of Individuals Covered839
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $292,967
Total amount of fees paid to insurance companyUSD $47,105
Life Insurance Welfare BenefitYes
Other welfare benefits providedWHOLE LIFE
Welfare Benefit Premiums Paid to CarrierUSD $318,291
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $229,016
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0737031
Policy instance 5
Insurance contract or identification numberR0737031
Number of Individuals Covered2555
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $180,750
Total amount of fees paid to insurance companyUSD $31,798
Other welfare benefits providedGCIEE , GRPACCVOEN, GRPHSPVOEN
Welfare Benefit Premiums Paid to CarrierUSD $646,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $129,223
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0000171381
Policy instance 4
Insurance contract or identification number0000171381
Number of Individuals Covered20
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $18,982
Total amount of fees paid to insurance companyUSD $11,646
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $38,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,982
Amount paid for insurance broker fees10127
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number693883
Policy instance 3
Insurance contract or identification number693883
Number of Individuals Covered252
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $31,988
Total amount of fees paid to insurance companyUSD $2,132
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSELECT LTD, SELECT STD
Welfare Benefit Premiums Paid to CarrierUSD $213,250
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,590
Amount paid for insurance broker fees1279
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number473258
Policy instance 2
Insurance contract or identification number473258
Number of Individuals Covered2103
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $52,249
Total amount of fees paid to insurance companyUSD $3,589
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedFLEX AD&D, FLEX LIFE, FLEX LTD
Welfare Benefit Premiums Paid to CarrierUSD $420,436
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $43,532
Amount paid for insurance broker fees2892
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract numberCID 250463
Policy instance 1
Insurance contract or identification numberCID 250463
Number of Individuals Covered3257
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $28,381
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,381
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract numberCID 250463
Policy instance 1
Insurance contract or identification numberCID 250463
Number of Individuals Covered3826
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $27,304
Total amount of fees paid to insurance companyUSD $28,208
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 fees28208
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number473258 0001
Policy instance 2
Insurance contract or identification number473258 0001
Number of Individuals Covered2398
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $47,818
Total amount of fees paid to insurance companyUSD $2,585
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedFLEX AD&D, FLEX LIFE, FLEX LTD
Welfare Benefit Premiums Paid to CarrierUSD $337,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,426
Amount paid for insurance broker fees1914
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number940380
Policy instance 3
Insurance contract or identification number940380
Number of Individuals Covered2089
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $87,874
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $1,757,488
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $87,874
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number693883
Policy instance 4
Insurance contract or identification number693883
Number of Individuals Covered382
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $27,181
Total amount of fees paid to insurance companyUSD $3,473
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSELECT LTD, SELECT STD
Welfare Benefit Premiums Paid to CarrierUSD $205,057
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,745
Amount paid for insurance broker fees2125
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number473258 0001
Policy instance 2
Insurance contract or identification number473258 0001
Number of Individuals Covered1931
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $43,572
Total amount of fees paid to insurance companyUSD $2,607
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedFLEX AD&D, FLEX LIFE, FLEX LTD
Welfare Benefit Premiums Paid to CarrierUSD $277,975
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,435
Amount paid for insurance broker fees2356
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBROKERAGE FEE
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract numberCID 250463
Policy instance 1
Insurance contract or identification numberCID 250463
Number of Individuals Covered1774
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $23,233
Total amount of fees paid to insurance companyUSD $26,138
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 fees26138
Additional information about fees paid to insurance brokerAGENT FEE
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number940380
Policy instance 3
Insurance contract or identification number940380
Number of Individuals Covered1777
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $84,191
Total amount of fees paid to insurance companyUSD $30,000
Welfare Benefit Premiums Paid to CarrierUSD $1,683,819
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $84,191
Amount paid for insurance broker fees30000
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number473258 0001
Policy instance 3
Insurance contract or identification number473258 0001
Number of Individuals Covered1841
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $36,936
Total amount of fees paid to insurance companyUSD $4,373
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedFLEX AD&D, FLEX LIFE, FLEX LTD
Welfare Benefit Premiums Paid to CarrierUSD $272,044
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,350
Amount paid for insurance broker fees4656
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number71395
Policy instance 2
Insurance contract or identification number71395
Number of Individuals Covered1736
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $11,070
Total amount of fees paid to insurance companyUSD $24,713
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 fees13899
Additional information about fees paid to insurance brokerAGENT FEE
Insurance broker organization code?3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number45380
Policy instance 1
Insurance contract or identification number45380
Number of Individuals Covered0
Insurance policy start date2018-08-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $17,252
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $115,013
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,252
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number473258 0002
Policy instance 4
Insurance contract or identification number473258 0002
Number of Individuals Covered225
Insurance policy start date2019-01-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $7,070
Total amount of fees paid to insurance companyUSD $736
Life Insurance Welfare BenefitYes
Other welfare benefits providedFLEX LIFE
Welfare Benefit Premiums Paid to CarrierUSD $28,281
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,656
Amount paid for insurance broker fees453
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number473258 0001
Policy instance 3
Insurance contract or identification number473258 0001
Number of Individuals Covered1665
Insurance policy start date2019-01-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $4,395
Total amount of fees paid to insurance companyUSD $719
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedFLEX AD&D, FLEX LIFE, FLEX LTD
Welfare Benefit Premiums Paid to CarrierUSD $35,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,395
Amount paid for insurance broker fees719
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number71395
Policy instance 2
Insurance contract or identification number71395
Number of Individuals Covered1591
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $22,851
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,851
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number45380
Policy instance 1
Insurance contract or identification number45380
Number of Individuals Covered1518
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $39,904
Total amount of fees paid to insurance companyUSD $2,645
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $532,056
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,680
Insurance broker organization code?3
Amount paid for insurance broker fees2645
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number71395
Policy instance 2
Insurance contract or identification number71395
Number of Individuals Covered1581
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $59,044
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 fees39452
Additional information about fees paid to insurance brokerCONTRACT ADMIN
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS, LLC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number45380
Policy instance 1
Insurance contract or identification number45380
Number of Individuals Covered1617
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Total amount of commissions paid to insurance brokerUSD $36,594
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $445,414
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,594
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS, LLC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number45380
Policy instance 1
Insurance contract or identification number45380
Number of Individuals Covered1388
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $29,431
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $356,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,431
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS, LLC
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number71395
Policy instance 2
Insurance contract or identification number71395
Number of Individuals Covered1402
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $91,332
Total amount of fees paid to insurance companyUSD $20,643
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $91,332
Amount paid for insurance broker fees20643
Additional information about fees paid to insurance brokerRX DISPENSING FEES.
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS, LLC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number45380
Policy instance 1
Insurance contract or identification number45380
Number of Individuals Covered1327
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $24,001
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $320,019
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,001
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS, LLC
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number71395
Policy instance 2
Insurance contract or identification number71395
Number of Individuals Covered1276
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $2,746,622
Total amount of fees paid to insurance companyUSD $20,128
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,746,622
Amount paid for insurance broker fees20128
Additional information about fees paid to insurance brokerRX DISPENSING FEES.
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS, LLC
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number71395
Policy instance 2
Insurance contract or identification number71395
Number of Individuals Covered1048
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $60,672
Total amount of fees paid to insurance companyUSD $19,151
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $60,672
Amount paid for insurance broker fees19151
Additional information about fees paid to insurance brokerRX DISPENSING FEES.
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS, LLC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number45380
Policy instance 1
Insurance contract or identification number45380
Number of Individuals Covered1227
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $21,408
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $285,440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,408
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS, LLC
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number71395
Policy instance 2
Insurance contract or identification number71395
Number of Individuals Covered999
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $78,684
Total amount of fees paid to insurance companyUSD $18,629
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $661,996
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $78,684
Amount paid for insurance broker fees18629
Additional information about fees paid to insurance brokerRX DISPENSING FEES.
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS, LLC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number45380
Policy instance 1
Insurance contract or identification number45380
Number of Individuals Covered1169
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $20,178
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $269,036
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,178
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS, LLC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number45380
Policy instance 1
Insurance contract or identification number45380
Number of Individuals Covered1174
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $19,797
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $263,954
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 number71395
Policy instance 2
Insurance contract or identification number71395
Number of Individuals Covered970
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $72,264
Total amount of fees paid to insurance companyUSD $18,572
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $669,822
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 number71395
Policy instance 2
Insurance contract or identification number71395
Number of Individuals Covered991
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $72,048
Total amount of fees paid to insurance companyUSD $18,442
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $621,952
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number45380
Policy instance 1
Insurance contract or identification number45380
Number of Individuals Covered1123
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $18,354
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $244,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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