THE HAYMAN COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan THE HAYMAN COMPANY SECTION 125 PLAN
Measure | Date | Value |
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2022: THE HAYMAN COMPANY SECTION 125 PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 138 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 140 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 1 |
Total of all active and inactive participants | 2022-01-01 | 141 |
2021: THE HAYMAN COMPANY SECTION 125 PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 152 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 138 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 1 |
Total of all active and inactive participants | 2021-01-01 | 139 |
2020: THE HAYMAN COMPANY SECTION 125 PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-09-01 | 171 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-09-01 | 152 |
Number of retired or separated participants receiving benefits | 2020-09-01 | 2 |
Total of all active and inactive participants | 2020-09-01 | 154 |
2019: THE HAYMAN COMPANY SECTION 125 PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-09-01 | 171 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-09-01 | 171 |
Total of all active and inactive participants | 2019-09-01 | 171 |
2018: THE HAYMAN COMPANY SECTION 125 PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-09-01 | 188 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-09-01 | 171 |
Total of all active and inactive participants | 2018-09-01 | 171 |
2017: THE HAYMAN COMPANY SECTION 125 PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-09-01 | 147 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-09-01 | 188 |
Total of all active and inactive participants | 2017-09-01 | 188 |
2016: THE HAYMAN COMPANY SECTION 125 PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-09-01 | 239 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-09-01 | 147 |
Number of retired or separated participants receiving benefits | 2016-09-01 | 4 |
Total of all active and inactive participants | 2016-09-01 | 151 |
2015: THE HAYMAN COMPANY SECTION 125 PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-09-01 | 251 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-09-01 | 239 |
Number of retired or separated participants receiving benefits | 2015-09-01 | 1 |
Total of all active and inactive participants | 2015-09-01 | 240 |
2014: THE HAYMAN COMPANY SECTION 125 PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-09-01 | 251 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-09-01 | 251 |
Total of all active and inactive participants | 2014-09-01 | 251 |
2013: THE HAYMAN COMPANY SECTION 125 PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-09-01 | 213 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-09-01 | 251 |
Total of all active and inactive participants | 2013-09-01 | 251 |
2012: THE HAYMAN COMPANY SECTION 125 PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-09-01 | 248 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-09-01 | 213 |
Total of all active and inactive participants | 2012-09-01 | 213 |
2011: THE HAYMAN COMPANY SECTION 125 PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-09-01 | 264 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-09-01 | 248 |
Total of all active and inactive participants | 2011-09-01 | 248 |
2010: THE HAYMAN COMPANY SECTION 125 PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-09-01 | 235 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-09-01 | 264 |
Total of all active and inactive participants | 2010-09-01 | 264 |
2009: THE HAYMAN COMPANY SECTION 125 PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-09-01 | 135 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-09-01 | 235 |
Total of all active and inactive participants | 2009-09-01 | 235 |
Total participants, beginning-of-year | 2009-01-01 | 22 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 16 |
Total of all active and inactive participants | 2009-01-01 | 16 |
Total participants | 2009-01-01 | 16 |
2022: THE HAYMAN COMPANY SECTION 125 PLAN 2022 form 5500 responses |
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2022-01-01 | Type of plan entity | Mulitple employer plan |
2022-01-01 | Plan funding arrangement – Insurance | Yes |
2022-01-01 | Plan benefit arrangement – Insurance | Yes |
2021: THE HAYMAN COMPANY SECTION 125 PLAN 2021 form 5500 responses |
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2021-01-01 | Type of plan entity | Mulitple employer plan |
2021-01-01 | Plan funding arrangement – Insurance | Yes |
2021-01-01 | Plan benefit arrangement – Insurance | Yes |
2020: THE HAYMAN COMPANY SECTION 125 PLAN 2020 form 5500 responses |
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2020-09-01 | Type of plan entity | Mulitple employer plan |
2020-09-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2020-09-01 | Plan funding arrangement – Insurance | Yes |
2020-09-01 | Plan benefit arrangement – Insurance | Yes |
2019: THE HAYMAN COMPANY SECTION 125 PLAN 2019 form 5500 responses |
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2019-09-01 | Type of plan entity | Mulitple employer plan |
2019-09-01 | Plan funding arrangement – Insurance | Yes |
2019-09-01 | Plan benefit arrangement – Insurance | Yes |
2018: THE HAYMAN COMPANY SECTION 125 PLAN 2018 form 5500 responses |
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2018-09-01 | Type of plan entity | Mulitple employer plan |
2018-09-01 | Plan funding arrangement – Insurance | Yes |
2018-09-01 | Plan benefit arrangement – Insurance | Yes |
2017: THE HAYMAN COMPANY SECTION 125 PLAN 2017 form 5500 responses |
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2017-09-01 | Type of plan entity | Mulitple employer plan |
2017-09-01 | Plan funding arrangement – Insurance | Yes |
2017-09-01 | Plan benefit arrangement – Insurance | Yes |
2016: THE HAYMAN COMPANY SECTION 125 PLAN 2016 form 5500 responses |
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2016-09-01 | Type of plan entity | Mulitple employer plan |
2016-09-01 | Plan funding arrangement – Insurance | Yes |
2016-09-01 | Plan benefit arrangement – Insurance | Yes |
2015: THE HAYMAN COMPANY SECTION 125 PLAN 2015 form 5500 responses |
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2015-09-01 | Type of plan entity | Mulitple employer plan |
2015-09-01 | Plan funding arrangement – Insurance | Yes |
2015-09-01 | Plan benefit arrangement – Insurance | Yes |
2014: THE HAYMAN COMPANY SECTION 125 PLAN 2014 form 5500 responses |
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2014-09-01 | Type of plan entity | Mulitple employer plan |
2014-09-01 | Plan funding arrangement – Insurance | Yes |
2014-09-01 | Plan benefit arrangement – Insurance | Yes |
2013: THE HAYMAN COMPANY SECTION 125 PLAN 2013 form 5500 responses |
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2013-09-01 | Type of plan entity | Single employer plan |
2013-09-01 | Plan funding arrangement – Insurance | Yes |
2013-09-01 | Plan benefit arrangement – Insurance | Yes |
2012: THE HAYMAN COMPANY SECTION 125 PLAN 2012 form 5500 responses |
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2012-09-01 | Type of plan entity | Single employer plan |
2012-09-01 | Plan funding arrangement – Insurance | Yes |
2012-09-01 | Plan benefit arrangement – Insurance | Yes |
2011: THE HAYMAN COMPANY SECTION 125 PLAN 2011 form 5500 responses |
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2011-09-01 | Type of plan entity | Single employer plan |
2011-09-01 | Plan funding arrangement – Insurance | Yes |
2011-09-01 | Plan benefit arrangement – Insurance | Yes |
2010: THE HAYMAN COMPANY SECTION 125 PLAN 2010 form 5500 responses |
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2010-09-01 | Type of plan entity | Single employer plan |
2010-09-01 | Plan funding arrangement – Insurance | Yes |
2010-09-01 | Plan benefit arrangement – Insurance | Yes |
2009: THE HAYMAN COMPANY SECTION 125 PLAN 2009 form 5500 responses |
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2009-09-01 | Type of plan entity | Single employer plan |
2009-09-01 | This submission is the final filing | No |
2009-09-01 | Plan funding arrangement – Insurance | Yes |
2009-09-01 | Plan benefit arrangement – Insurance | Yes |
2009-01-01 | Type of plan entity | Single employer plan |
2009-01-01 | Submission has been amended | No |
2009-01-01 | This submission is the final filing | No |
2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-01-01 | Plan is a collectively bargained plan | No |
2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 01-020388-00 |
Policy instance | 7 |
Insurance contract or identification number | 01-020388-00 | Number of Individuals Covered | 172 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $9,278 | Total amount of fees paid to insurance company | USD $611 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $64,462 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,958 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 611 |
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BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 262487 |
Policy instance | 1 |
Insurance contract or identification number | 262487 | Number of Individuals Covered | 223 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $34,229 | Total amount of fees paid to insurance company | USD $1,071 | Health Insurance Welfare Benefit | Yes | Vision 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 $25,672 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1071 |
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BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
Policy contract number | 262487 |
Policy instance | 2 |
Insurance contract or identification number | 262487 | Number of Individuals Covered | 75 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $8,557 | Total amount of fees paid to insurance company | USD $322 | 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 $9,829 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 322 |
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EMPLOYEE HEALTH INSURANCE MANAGEMENT (National Association of Insurance Commissioners NAIC id number: 0 ) |
Policy contract number | 50002239-01 |
Policy instance | 3 |
Insurance contract or identification number | 50002239-01 | Number of Individuals Covered | 135 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $2,543 | Total amount of fees paid to insurance company | USD $5,564 | Welfare Benefit Premiums Paid to Carrier | USD $102,510 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,543 | Amount paid for insurance broker fees | 5564 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEE | Insurance broker organization code? | 0 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 574616 0001 |
Policy instance | 4 |
Insurance contract or identification number | 574616 0001 | Number of Individuals Covered | 24 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $2,939 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $19,594 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,939 | Insurance broker organization code? | 3 |
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STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
Policy contract number | 851563 |
Policy instance | 5 |
Insurance contract or identification number | 851563 | Number of Individuals Covered | 140 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $5,854 | Total amount of fees paid to insurance company | USD $549 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $58,539 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,390 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 549 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 574616 0800 |
Policy instance | 6 |
Insurance contract or identification number | 574616 0800 | Number of Individuals Covered | 1 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $44 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $294 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $44 | Insurance broker organization code? | 3 |
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BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 262487 |
Policy instance | 1 |
Insurance contract or identification number | 262487 | Number of Individuals Covered | 213 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $30,260 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Vision 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 $22,695 | Insurance broker organization code? | 3 |
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BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
Policy contract number | 262487 |
Policy instance | 2 |
Insurance contract or identification number | 262487 | Number of Individuals Covered | 59 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $16,405 | Total amount of fees paid to insurance company | USD $0 | 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 $9,800 | Insurance broker organization code? | 3 |
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EMPLOYEE HEALTH INSURANCE MANAGEMENT (National Association of Insurance Commissioners NAIC id number: 0 ) |
Policy contract number | 50002239-01 |
Policy instance | 3 |
Insurance contract or identification number | 50002239-01 | Number of Individuals Covered | 135 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $4,817 | Welfare Benefit Premiums Paid to Carrier | USD $71,850 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 4817 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEE | Insurance broker organization code? | 0 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 413507 |
Policy instance | 4 |
Insurance contract or identification number | 413507 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 413508 |
Policy instance | 5 |
Insurance contract or identification number | 413508 | Number of Individuals Covered | 65 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $1,677 | Total amount of fees paid to insurance company | USD $132 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,583 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 132 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 574616 |
Policy instance | 6 |
Insurance contract or identification number | 574616 | Number of Individuals Covered | 22 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $2,562 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $15,537 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,562 | Insurance broker organization code? | 3 |
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STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
Policy contract number | 851563 |
Policy instance | 7 |
Insurance contract or identification number | 851563 | Number of Individuals Covered | 138 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $4,910 | Total amount of fees paid to insurance company | USD $569 | 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 $4,555 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 569 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 574616 |
Policy instance | 8 |
Insurance contract or identification number | 574616 | Number of Individuals Covered | 1 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $625 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $4,165 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $625 | Insurance broker organization code? | 3 |
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STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
Policy contract number | 851563 |
Policy instance | 7 |
Insurance contract or identification number | 851563 | Number of Individuals Covered | 129 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-09-30 | Total amount of commissions paid to insurance broker | USD $6,128 | Total amount of fees paid to insurance company | USD $1,960 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $61,280 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,128 | Amount paid for insurance broker fees | 1960 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 574616 |
Policy instance | 6 |
Insurance contract or identification number | 574616 | Number of Individuals Covered | 26 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-09-30 | Total amount of commissions paid to insurance broker | USD $1,926 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $12,694 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,463 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 413508 |
Policy instance | 5 |
Insurance contract or identification number | 413508 | Number of Individuals Covered | 46 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-09-30 | Total amount of commissions paid to insurance broker | USD $2,318 | Total amount of fees paid to insurance company | USD $773 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $14,206 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,318 | Amount paid for insurance broker fees | 773 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 413507 |
Policy instance | 4 |
Insurance contract or identification number | 413507 | Number of Individuals Covered | 152 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-09-30 | Total amount of commissions paid to insurance broker | USD $4,407 | Total amount of fees paid to insurance company | USD $1,781 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $33,417 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,407 | Amount paid for insurance broker fees | 1781 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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EMPLOYEE HEALTH INSURANCE MANAGEMENT (National Association of Insurance Commissioners NAIC id number: 0 ) |
Policy contract number | 50002239-01 |
Policy instance | 3 |
Insurance contract or identification number | 50002239-01 | Number of Individuals Covered | 99 | Insurance policy start date | 2020-10-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,468 | Total amount of fees paid to insurance company | USD $6,584 | Welfare Benefit Premiums Paid to Carrier | USD $56,957 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 6584 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEE | Insurance broker organization code? | 0 | Commission paid to Insurance Broker | USD $760 |
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BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
Policy contract number | 262487 |
Policy instance | 2 |
Insurance contract or identification number | 262487 | Number of Individuals Covered | 63 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $8,669 | Total amount of fees paid to insurance company | USD $250 | 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 $7,026 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 250 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 262487 |
Policy instance | 1 |
Insurance contract or identification number | 262487 | Number of Individuals Covered | 184 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $16,047 | Total amount of fees paid to insurance company | USD $374 | Health Insurance Welfare Benefit | Yes | Vision 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 $13,310 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 374 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 574616 |
Policy instance | 8 |
Insurance contract or identification number | 574616 | Number of Individuals Covered | 1 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-09-30 | Total amount of commissions paid to insurance broker | USD $1,686 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $11,103 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,668 | Insurance broker organization code? | 3 |
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BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 262487 |
Policy instance | 1 |
Insurance contract or identification number | 262487 | Number of Individuals Covered | 204 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-08-31 | Total amount of commissions paid to insurance broker | USD $27,820 | Total amount of fees paid to insurance company | USD $709 | Health Insurance Welfare Benefit | Yes | Vision 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 $4,211 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 709 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
Policy contract number | 262487 |
Policy instance | 2 |
Insurance contract or identification number | 262487 | Number of Individuals Covered | 89 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-08-31 | Total amount of commissions paid to insurance broker | USD $15,224 | Total amount of fees paid to insurance company | USD $433 | 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 $10,725 | Amount paid for insurance broker fees | 433 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
EMPLOYEE HEALTH INSURANCE MANAGEMENT (National Association of Insurance Commissioners NAIC id number: 0 ) |
Policy contract number | 50002239-01 |
Policy instance | 3 |
Insurance contract or identification number | 50002239-01 | Number of Individuals Covered | 152 | Insurance policy start date | 2018-10-01 | Insurance policy end date | 2019-09-30 | Total amount of commissions paid to insurance broker | USD $1,313 | Total amount of fees paid to insurance company | USD $5,798 | Welfare Benefit Premiums Paid to Carrier | USD $52,078 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 5798 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEE | Insurance broker organization code? | 0 | Commission paid to Insurance Broker | USD $903 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 413507 |
Policy instance | 4 |
Insurance contract or identification number | 413507 | Number of Individuals Covered | 171 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $2,344 | Total amount of fees paid to insurance company | USD $418 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $23,219 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,050 | Amount paid for insurance broker fees | 418 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 413508 |
Policy instance | 5 |
Insurance contract or identification number | 413508 | Number of Individuals Covered | 38 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,562 | Total amount of fees paid to insurance company | USD $233 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $14,110 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $699 | Amount paid for insurance broker fees | 233 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 574616 |
Policy instance | 6 |
Insurance contract or identification number | 574616 | Number of Individuals Covered | 32 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $2,208 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $18,809 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,723 | Insurance broker organization code? | 3 |
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STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
Policy contract number | 851563 |
Policy instance | 7 |
Insurance contract or identification number | 851563 | Number of Individuals Covered | 156 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $6,145 | Total amount of fees paid to insurance company | USD $1,838 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $62,502 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,676 | Amount paid for insurance broker fees | 1838 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 262487 |
Policy instance | 1 |
Insurance contract or identification number | 262487 | Number of Individuals Covered | 204 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-09-30 | Total amount of commissions paid to insurance broker | USD $27,820 | Total amount of fees paid to insurance company | USD $709 | Health Insurance Welfare Benefit | Yes | Vision 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 $20,340 | Amount paid for insurance broker fees | 709 | Insurance broker organization code? | 3 |
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BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
Policy contract number | 262487 |
Policy instance | 2 |
Insurance contract or identification number | 262487 | Number of Individuals Covered | 89 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-09-30 | Total amount of commissions paid to insurance broker | USD $15,224 | Total amount of fees paid to insurance company | USD $433 | 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 $10,725 | Amount paid for insurance broker fees | 433 | Insurance broker organization code? | 3 |
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EMPLOYEE HEALTH INSURANCE MANAGEMENT (National Association of Insurance Commissioners NAIC id number: 0 ) |
Policy contract number | 50002239-01 |
Policy instance | 3 |
Insurance contract or identification number | 50002239-01 | Number of Individuals Covered | 152 | Insurance policy start date | 2018-10-01 | Insurance policy end date | 2019-09-30 | Total amount of commissions paid to insurance broker | USD $1,313 | Total amount of fees paid to insurance company | USD $5,798 | Welfare Benefit Premiums Paid to Carrier | USD $52,078 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 5798 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEE | Insurance broker organization code? | 0 | Commission paid to Insurance Broker | USD $903 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 413507 |
Policy instance | 4 |
Insurance contract or identification number | 413507 | Number of Individuals Covered | 171 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $2,344 | Total amount of fees paid to insurance company | USD $418 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $23,219 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,050 | Amount paid for insurance broker fees | 418 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 413508 |
Policy instance | 5 |
Insurance contract or identification number | 413508 | Number of Individuals Covered | 38 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,562 | Total amount of fees paid to insurance company | USD $233 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $14,110 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $699 | Amount paid for insurance broker fees | 233 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 574616 |
Policy instance | 6 |
Insurance contract or identification number | 574616 | Number of Individuals Covered | 32 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $2,208 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $18,809 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,723 | Insurance broker organization code? | 3 |
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STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
Policy contract number | 851563 |
Policy instance | 7 |
Insurance contract or identification number | 851563 | Number of Individuals Covered | 156 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $6,145 | Total amount of fees paid to insurance company | USD $1,838 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $62,502 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,676 | Amount paid for insurance broker fees | 1838 | Insurance broker organization code? | 3 |
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EMPLOYEE HEALTH INSURANCE MANAGEMENT (National Association of Insurance Commissioners NAIC id number: 0 ) |
Policy contract number | 50002239-01 |
Policy instance | 4 |
Insurance contract or identification number | 50002239-01 | Number of Individuals Covered | 121 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $1,313 | Total amount of fees paid to insurance company | USD $5,131 | Welfare Benefit Premiums Paid to Carrier | USD $53,245 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
Policy contract number | 262487 |
Policy instance | 3 |
Insurance contract or identification number | 262487 | Number of Individuals Covered | 63 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $14,390 | Total amount of fees paid to insurance company | USD $1,036 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 262487 |
Policy instance | 2 |
Insurance contract or identification number | 262487 | Number of Individuals Covered | 188 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $22,080 | Total amount of fees paid to insurance company | USD $4,355 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00362101 |
Policy instance | 1 |
Insurance contract or identification number | 00362101 | Number of Individuals Covered | 148 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2017-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,730 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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