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THE HAYMAN COMPANY SECTION 125 PLAN 401k Plan overview

Plan NameTHE HAYMAN COMPANY SECTION 125 PLAN
Plan identification number 501

THE HAYMAN COMPANY SECTION 125 PLAN Benefits

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

THE HAYMAN COMPANY has sponsored the creation of one or more 401k plans.

Company Name:THE HAYMAN COMPANY
Employer identification number (EIN):381910691
NAIC Classification:531120
NAIC Description:Lessors of Nonresidential Buildings (except Miniwarehouses)

Additional information about THE HAYMAN COMPANY

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1988-04-12
Company Identification Number: 0007615806
Legal Registered Office Address: 29100 NORTHWESTERN HWY STE 410

SOUTHFIELD
United States of America (USA)
48034

More information about THE HAYMAN COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE HAYMAN COMPANY SECTION 125 PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01KATHY KUJAWA2023-10-09
5012021-01-01STUART FREEDLAND2022-10-17
5012020-09-01STUART FREEDLAND2021-10-04
5012019-09-01STUART FREEDLAND2021-06-11
5012018-09-01STUART FREEDLAND2020-07-10
5012017-09-01STUART FREEDLAND2019-06-17
5012016-09-01
5012015-09-01
5012014-09-01
5012013-09-01
5012012-09-01KAREN GERSTENBERGER
5012011-09-01KAREN GERSTENBERGER
5012010-09-01BARBARA VANDERHEUVEL
5012009-09-01JUDY BIRETTO
5012009-01-01 JUDITH BIRETTO2010-07-22
5012009-01-01JUDITH BIRETTO

Plan Statistics for THE HAYMAN COMPANY SECTION 125 PLAN

401k plan membership statisitcs for THE HAYMAN COMPANY SECTION 125 PLAN

Measure Date Value
2022: THE HAYMAN COMPANY SECTION 125 PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01138
Total number of active participants reported on line 7a of the Form 55002022-01-01140
Number of retired or separated participants receiving benefits2022-01-011
Total of all active and inactive participants2022-01-01141
2021: THE HAYMAN COMPANY SECTION 125 PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01152
Total number of active participants reported on line 7a of the Form 55002021-01-01138
Number of retired or separated participants receiving benefits2021-01-011
Total of all active and inactive participants2021-01-01139
2020: THE HAYMAN COMPANY SECTION 125 PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-01171
Total number of active participants reported on line 7a of the Form 55002020-09-01152
Number of retired or separated participants receiving benefits2020-09-012
Total of all active and inactive participants2020-09-01154
2019: THE HAYMAN COMPANY SECTION 125 PLAN 2019 401k membership
Total participants, beginning-of-year2019-09-01171
Total number of active participants reported on line 7a of the Form 55002019-09-01171
Total of all active and inactive participants2019-09-01171
2018: THE HAYMAN COMPANY SECTION 125 PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01188
Total number of active participants reported on line 7a of the Form 55002018-09-01171
Total of all active and inactive participants2018-09-01171
2017: THE HAYMAN COMPANY SECTION 125 PLAN 2017 401k membership
Total participants, beginning-of-year2017-09-01147
Total number of active participants reported on line 7a of the Form 55002017-09-01188
Total of all active and inactive participants2017-09-01188
2016: THE HAYMAN COMPANY SECTION 125 PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-01239
Total number of active participants reported on line 7a of the Form 55002016-09-01147
Number of retired or separated participants receiving benefits2016-09-014
Total of all active and inactive participants2016-09-01151
2015: THE HAYMAN COMPANY SECTION 125 PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-01251
Total number of active participants reported on line 7a of the Form 55002015-09-01239
Number of retired or separated participants receiving benefits2015-09-011
Total of all active and inactive participants2015-09-01240
2014: THE HAYMAN COMPANY SECTION 125 PLAN 2014 401k membership
Total participants, beginning-of-year2014-09-01251
Total number of active participants reported on line 7a of the Form 55002014-09-01251
Total of all active and inactive participants2014-09-01251
2013: THE HAYMAN COMPANY SECTION 125 PLAN 2013 401k membership
Total participants, beginning-of-year2013-09-01213
Total number of active participants reported on line 7a of the Form 55002013-09-01251
Total of all active and inactive participants2013-09-01251
2012: THE HAYMAN COMPANY SECTION 125 PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-01248
Total number of active participants reported on line 7a of the Form 55002012-09-01213
Total of all active and inactive participants2012-09-01213
2011: THE HAYMAN COMPANY SECTION 125 PLAN 2011 401k membership
Total participants, beginning-of-year2011-09-01264
Total number of active participants reported on line 7a of the Form 55002011-09-01248
Total of all active and inactive participants2011-09-01248
2010: THE HAYMAN COMPANY SECTION 125 PLAN 2010 401k membership
Total participants, beginning-of-year2010-09-01235
Total number of active participants reported on line 7a of the Form 55002010-09-01264
Total of all active and inactive participants2010-09-01264
2009: THE HAYMAN COMPANY SECTION 125 PLAN 2009 401k membership
Total participants, beginning-of-year2009-09-01135
Total number of active participants reported on line 7a of the Form 55002009-09-01235
Total of all active and inactive participants2009-09-01235
Total participants, beginning-of-year2009-01-0122
Total number of active participants reported on line 7a of the Form 55002009-01-0116
Total of all active and inactive participants2009-01-0116
Total participants2009-01-0116

Form 5500 Responses for THE HAYMAN COMPANY SECTION 125 PLAN

2022: THE HAYMAN COMPANY SECTION 125 PLAN 2022 form 5500 responses
2022-01-01Type of plan entityMulitple employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: THE HAYMAN COMPANY SECTION 125 PLAN 2021 form 5500 responses
2021-01-01Type of plan entityMulitple employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: THE HAYMAN COMPANY SECTION 125 PLAN 2020 form 5500 responses
2020-09-01Type of plan entityMulitple employer plan
2020-09-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes
2019: THE HAYMAN COMPANY SECTION 125 PLAN 2019 form 5500 responses
2019-09-01Type of plan entityMulitple employer plan
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – InsuranceYes
2018: THE HAYMAN COMPANY SECTION 125 PLAN 2018 form 5500 responses
2018-09-01Type of plan entityMulitple employer plan
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes
2017: THE HAYMAN COMPANY SECTION 125 PLAN 2017 form 5500 responses
2017-09-01Type of plan entityMulitple employer plan
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – InsuranceYes
2016: THE HAYMAN COMPANY SECTION 125 PLAN 2016 form 5500 responses
2016-09-01Type of plan entityMulitple employer plan
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes
2015: THE HAYMAN COMPANY SECTION 125 PLAN 2015 form 5500 responses
2015-09-01Type of plan entityMulitple employer plan
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – InsuranceYes
2014: THE HAYMAN COMPANY SECTION 125 PLAN 2014 form 5500 responses
2014-09-01Type of plan entityMulitple employer plan
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan benefit arrangement – InsuranceYes
2013: THE HAYMAN COMPANY SECTION 125 PLAN 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – InsuranceYes
2012: THE HAYMAN COMPANY SECTION 125 PLAN 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan benefit arrangement – InsuranceYes
2011: THE HAYMAN COMPANY SECTION 125 PLAN 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan benefit arrangement – InsuranceYes
2010: THE HAYMAN COMPANY SECTION 125 PLAN 2010 form 5500 responses
2010-09-01Type of plan entitySingle employer plan
2010-09-01Plan funding arrangement – InsuranceYes
2010-09-01Plan benefit arrangement – InsuranceYes
2009: THE HAYMAN COMPANY SECTION 125 PLAN 2009 form 5500 responses
2009-09-01Type of plan entitySingle employer plan
2009-09-01This submission is the final filingNo
2009-09-01Plan funding arrangement – InsuranceYes
2009-09-01Plan benefit arrangement – InsuranceYes
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-020388-00
Policy instance 7
Insurance contract or identification number01-020388-00
Number of Individuals Covered172
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $9,278
Total amount of fees paid to insurance companyUSD $611
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $64,462
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,958
Insurance broker organization code?3
Amount paid for insurance broker fees611
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number262487
Policy instance 1
Insurance contract or identification number262487
Number of Individuals Covered223
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $34,229
Total amount of fees paid to insurance companyUSD $1,071
Health 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 $25,672
Insurance broker organization code?3
Amount paid for insurance broker fees1071
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number262487
Policy instance 2
Insurance contract or identification number262487
Number of Individuals Covered75
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $8,557
Total amount of fees paid to insurance companyUSD $322
Health 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 $9,829
Insurance broker organization code?3
Amount paid for insurance broker fees322
EMPLOYEE HEALTH INSURANCE MANAGEMENT (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number50002239-01
Policy instance 3
Insurance contract or identification number50002239-01
Number of Individuals Covered135
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,543
Total amount of fees paid to insurance companyUSD $5,564
Welfare Benefit Premiums Paid to CarrierUSD $102,510
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,543
Amount paid for insurance broker fees5564
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
Insurance broker organization code?0
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number574616 0001
Policy instance 4
Insurance contract or identification number574616 0001
Number of Individuals Covered24
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,939
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedGROUP LONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $19,594
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,939
Insurance broker organization code?3
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract number851563
Policy instance 5
Insurance contract or identification number851563
Number of Individuals Covered140
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $5,854
Total amount of fees paid to insurance companyUSD $549
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,539
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,390
Insurance broker organization code?3
Amount paid for insurance broker fees549
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number574616 0800
Policy instance 6
Insurance contract or identification number574616 0800
Number of Individuals Covered1
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $44
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedGROUP LONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $294
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number262487
Policy instance 1
Insurance contract or identification number262487
Number of Individuals Covered213
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $30,260
Total amount of fees paid to insurance companyUSD $0
Health 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 $22,695
Insurance broker organization code?3
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number262487
Policy instance 2
Insurance contract or identification number262487
Number of Individuals Covered59
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $16,405
Total amount of fees paid to insurance companyUSD $0
Health 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 $9,800
Insurance broker organization code?3
EMPLOYEE HEALTH INSURANCE MANAGEMENT (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number50002239-01
Policy instance 3
Insurance contract or identification number50002239-01
Number of Individuals Covered135
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,817
Welfare Benefit Premiums Paid to CarrierUSD $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 fees4817
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
Insurance broker organization code?0
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number413507
Policy instance 4
Insurance contract or identification number413507
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL 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
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number413508
Policy instance 5
Insurance contract or identification number413508
Number of Individuals Covered65
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,677
Total amount of fees paid to insurance companyUSD $132
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,583
Insurance broker organization code?3
Amount paid for insurance broker fees132
Additional information about fees paid to insurance brokerOTHER COMPENSATION
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number574616
Policy instance 6
Insurance contract or identification number574616
Number of Individuals Covered22
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,562
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedGROUP LONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $15,537
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,562
Insurance broker organization code?3
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract number851563
Policy instance 7
Insurance contract or identification number851563
Number of Individuals Covered138
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,910
Total amount of fees paid to insurance companyUSD $569
Dental 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 $4,555
Insurance broker organization code?3
Amount paid for insurance broker fees569
Additional information about fees paid to insurance brokerOTHER COMPENSATION
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number574616
Policy instance 8
Insurance contract or identification number574616
Number of Individuals Covered1
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $625
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedGROUP LONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $4,165
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $625
Insurance broker organization code?3
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract number851563
Policy instance 7
Insurance contract or identification number851563
Number of Individuals Covered129
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $6,128
Total amount of fees paid to insurance companyUSD $1,960
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $61,280
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,128
Amount paid for insurance broker fees1960
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number574616
Policy instance 6
Insurance contract or identification number574616
Number of Individuals Covered26
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $1,926
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedGROUP LONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $12,694
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,463
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number413508
Policy instance 5
Insurance contract or identification number413508
Number of Individuals Covered46
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $2,318
Total amount of fees paid to insurance companyUSD $773
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $14,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,318
Amount paid for insurance broker fees773
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number413507
Policy instance 4
Insurance contract or identification number413507
Number of Individuals Covered152
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $4,407
Total amount of fees paid to insurance companyUSD $1,781
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $33,417
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,407
Amount paid for insurance broker fees1781
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
EMPLOYEE HEALTH INSURANCE MANAGEMENT (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number50002239-01
Policy instance 3
Insurance contract or identification number50002239-01
Number of Individuals Covered99
Insurance policy start date2020-10-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,468
Total amount of fees paid to insurance companyUSD $6,584
Welfare Benefit Premiums Paid to CarrierUSD $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 fees6584
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
Insurance broker organization code?0
Commission paid to Insurance BrokerUSD $760
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number262487
Policy instance 2
Insurance contract or identification number262487
Number of Individuals Covered63
Insurance policy start date2019-10-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $8,669
Total amount of fees paid to insurance companyUSD $250
Health 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 $7,026
Insurance broker organization code?3
Amount paid for insurance broker fees250
Additional information about fees paid to insurance brokerOTHER COMPENSATION
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number262487
Policy instance 1
Insurance contract or identification number262487
Number of Individuals Covered184
Insurance policy start date2019-10-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $16,047
Total amount of fees paid to insurance companyUSD $374
Health 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 $13,310
Insurance broker organization code?3
Amount paid for insurance broker fees374
Additional information about fees paid to insurance brokerOTHER COMPENSATION
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number574616
Policy instance 8
Insurance contract or identification number574616
Number of Individuals Covered1
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $1,686
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedGROUP LONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $11,103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,668
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number262487
Policy instance 1
Insurance contract or identification number262487
Number of Individuals Covered204
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $27,820
Total amount of fees paid to insurance companyUSD $709
Health 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 $4,211
Insurance broker organization code?3
Amount paid for insurance broker fees709
Additional information about fees paid to insurance brokerOTHER COMPENSATION
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number262487
Policy instance 2
Insurance contract or identification number262487
Number of Individuals Covered89
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $15,224
Total amount of fees paid to insurance companyUSD $433
Health 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 $10,725
Amount paid for insurance broker fees433
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
EMPLOYEE HEALTH INSURANCE MANAGEMENT (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number50002239-01
Policy instance 3
Insurance contract or identification number50002239-01
Number of Individuals Covered152
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $1,313
Total amount of fees paid to insurance companyUSD $5,798
Welfare Benefit Premiums Paid to CarrierUSD $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 fees5798
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
Insurance broker organization code?0
Commission paid to Insurance BrokerUSD $903
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number413507
Policy instance 4
Insurance contract or identification number413507
Number of Individuals Covered171
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,344
Total amount of fees paid to insurance companyUSD $418
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $23,219
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,050
Amount paid for insurance broker fees418
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number413508
Policy instance 5
Insurance contract or identification number413508
Number of Individuals Covered38
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,562
Total amount of fees paid to insurance companyUSD $233
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $14,110
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $699
Amount paid for insurance broker fees233
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number574616
Policy instance 6
Insurance contract or identification number574616
Number of Individuals Covered32
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,208
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedGROUP LONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $18,809
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,723
Insurance broker organization code?3
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract number851563
Policy instance 7
Insurance contract or identification number851563
Number of Individuals Covered156
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,145
Total amount of fees paid to insurance companyUSD $1,838
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,502
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,676
Amount paid for insurance broker fees1838
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number262487
Policy instance 1
Insurance contract or identification number262487
Number of Individuals Covered204
Insurance policy start date2018-09-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $27,820
Total amount of fees paid to insurance companyUSD $709
Health 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 $20,340
Amount paid for insurance broker fees709
Insurance broker organization code?3
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number262487
Policy instance 2
Insurance contract or identification number262487
Number of Individuals Covered89
Insurance policy start date2018-09-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $15,224
Total amount of fees paid to insurance companyUSD $433
Health 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 $10,725
Amount paid for insurance broker fees433
Insurance broker organization code?3
EMPLOYEE HEALTH INSURANCE MANAGEMENT (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number50002239-01
Policy instance 3
Insurance contract or identification number50002239-01
Number of Individuals Covered152
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $1,313
Total amount of fees paid to insurance companyUSD $5,798
Welfare Benefit Premiums Paid to CarrierUSD $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 fees5798
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
Insurance broker organization code?0
Commission paid to Insurance BrokerUSD $903
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number413507
Policy instance 4
Insurance contract or identification number413507
Number of Individuals Covered171
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,344
Total amount of fees paid to insurance companyUSD $418
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $23,219
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,050
Amount paid for insurance broker fees418
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number413508
Policy instance 5
Insurance contract or identification number413508
Number of Individuals Covered38
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,562
Total amount of fees paid to insurance companyUSD $233
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $14,110
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $699
Amount paid for insurance broker fees233
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number574616
Policy instance 6
Insurance contract or identification number574616
Number of Individuals Covered32
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,208
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedGROUP LONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $18,809
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,723
Insurance broker organization code?3
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract number851563
Policy instance 7
Insurance contract or identification number851563
Number of Individuals Covered156
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,145
Total amount of fees paid to insurance companyUSD $1,838
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,502
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,676
Amount paid for insurance broker fees1838
Insurance broker organization code?3
EMPLOYEE HEALTH INSURANCE MANAGEMENT (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number50002239-01
Policy instance 4
Insurance contract or identification number50002239-01
Number of Individuals Covered121
Insurance policy start date2017-10-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $1,313
Total amount of fees paid to insurance companyUSD $5,131
Welfare Benefit Premiums Paid to CarrierUSD $53,245
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number262487
Policy instance 3
Insurance contract or identification number262487
Number of Individuals Covered63
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $14,390
Total amount of fees paid to insurance companyUSD $1,036
Health Insurance Welfare BenefitYes
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 number262487
Policy instance 2
Insurance contract or identification number262487
Number of Individuals Covered188
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $22,080
Total amount of fees paid to insurance companyUSD $4,355
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
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00362101
Policy instance 1
Insurance contract or identification number00362101
Number of Individuals Covered148
Insurance policy start date2017-09-01
Insurance policy end date2017-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,730
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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