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ALCONA CITIZENS FOR HEALTH, INC. LIFE & DISABILITY PLAN 401k Plan overview

Plan NameALCONA CITIZENS FOR HEALTH, INC. LIFE & DISABILITY PLAN
Plan identification number 504

ALCONA CITIZENS FOR HEALTH, INC. LIFE & DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

ALCONA CITIZENS FOR HEALTH WELFARE BENEFIT PLAN has sponsored the creation of one or more 401k plans.

Company Name:ALCONA CITIZENS FOR HEALTH WELFARE BENEFIT PLAN
Employer identification number (EIN):382170985
NAIC Classification:621112
NAIC Description:Offices of Physicians, Mental Health Specialists

Additional information about ALCONA CITIZENS FOR HEALTH WELFARE BENEFIT PLAN

Jurisdiction of Incorporation: Michigan Secretary of State
Incorporation Date: 0000-00-00
Company Identification Number: 873031
Legal Registered Office Address: 177 N. BARLOW RD. LINCOLN


United States of America (USA)
48742

More information about ALCONA CITIZENS FOR HEALTH WELFARE BENEFIT PLAN

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ALCONA CITIZENS FOR HEALTH, INC. LIFE & DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042016-09-01JOHN PINES
5042015-09-01JOHN PINES
5042014-01-01JOHN PINES
5042013-09-01JOHN PINES
5042012-09-01BRENDA MOTLEY

Plan Statistics for ALCONA CITIZENS FOR HEALTH, INC. LIFE & DISABILITY PLAN

401k plan membership statisitcs for ALCONA CITIZENS FOR HEALTH, INC. LIFE & DISABILITY PLAN

Measure Date Value
2016: ALCONA CITIZENS FOR HEALTH, INC. LIFE & DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-01241
Total number of active participants reported on line 7a of the Form 55002016-09-01278
Total of all active and inactive participants2016-09-01278
Total participants2016-09-01278
2015: ALCONA CITIZENS FOR HEALTH, INC. LIFE & DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-01187
Total number of active participants reported on line 7a of the Form 55002015-09-01241
Number of retired or separated participants receiving benefits2015-09-010
Total of all active and inactive participants2015-09-01241
Total participants2015-09-01241
2014: ALCONA CITIZENS FOR HEALTH, INC. LIFE & DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01174
Total number of active participants reported on line 7a of the Form 55002014-01-01187
Number of retired or separated participants receiving benefits2014-01-014
Total of all active and inactive participants2014-01-01191
Total participants2014-01-01191
2013: ALCONA CITIZENS FOR HEALTH, INC. LIFE & DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year2013-09-01164
Total number of active participants reported on line 7a of the Form 55002013-09-01174
Number of retired or separated participants receiving benefits2013-09-014
Total of all active and inactive participants2013-09-01178
Total participants2013-09-01178
2012: ALCONA CITIZENS FOR HEALTH, INC. LIFE & DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-01171
Total number of active participants reported on line 7a of the Form 55002012-09-01164
Number of retired or separated participants receiving benefits2012-09-013
Total of all active and inactive participants2012-09-01167
Total participants2012-09-01167
Number of employers contributing to the scheme2012-09-010

Form 5500 Responses for ALCONA CITIZENS FOR HEALTH, INC. LIFE & DISABILITY PLAN

2016: ALCONA CITIZENS FOR HEALTH, INC. LIFE & DISABILITY PLAN 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Submission has been amendedNo
2016-09-01This submission is the final filingNo
2016-09-01This return/report is a short plan year return/report (less than 12 months)No
2016-09-01Plan is a collectively bargained planNo
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes
2015: ALCONA CITIZENS FOR HEALTH, INC. LIFE & DISABILITY PLAN 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Submission has been amendedNo
2015-09-01This submission is the final filingNo
2015-09-01This return/report is a short plan year return/report (less than 12 months)No
2015-09-01Plan is a collectively bargained planNo
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – InsuranceYes
2014: ALCONA CITIZENS FOR HEALTH, INC. LIFE & DISABILITY PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: ALCONA CITIZENS FOR HEALTH, INC. LIFE & DISABILITY PLAN 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Submission has been amendedNo
2013-09-01This submission is the final filingNo
2013-09-01This return/report is a short plan year return/report (less than 12 months)No
2013-09-01Plan is a collectively bargained planNo
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – InsuranceYes
2012: ALCONA CITIZENS FOR HEALTH, INC. LIFE & DISABILITY PLAN 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01First time form 5500 has been submittedYes
2012-09-01Submission has been amendedNo
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)No
2012-09-01Plan is a collectively bargained planNo
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF018045
Policy instance 1
Insurance contract or identification numberF018045
Number of Individuals Covered187
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $20,012
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $133,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,012
Amount paid for insurance broker fees169
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameLAPPAN AGENCY
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF018045
Policy instance 1
Insurance contract or identification numberF018045
Number of Individuals Covered174
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $17,635
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $116,879
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,635
Insurance broker organization code?3
Insurance broker nameLAPPAN AGENCY
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFO18045
Policy instance 1
Insurance contract or identification numberFO18045
Number of Individuals Covered164
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $1,836,124
Total amount of fees paid to insurance companyUSD $17,670
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $12,209,084
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,836,124
Amount paid for insurance broker fees17670
Additional information about fees paid to insurance brokerADDITIONAL COMPENSTATION
Insurance broker nameLAPPAN, THOMA A.

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