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BAY HUMAN SERVICES WELFARE PLAN 401k Plan overview

Plan NameBAY HUMAN SERVICES WELFARE PLAN
Plan identification number 501

BAY HUMAN SERVICES WELFARE 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

401k Sponsoring company profile

BAY HUMAN SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name:BAY HUMAN SERVICES, INC.
Employer identification number (EIN):382335441
NAIC Classification:624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BAY HUMAN SERVICES WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-06-01AMY NASH2023-11-07 AMY NASH2023-11-07
5012021-06-01JOHN CHAGNON2022-10-31 JOHN CHAGNON2022-10-31
5012020-06-01KORRIE SCHARICH2021-11-03 KORRIE SCHARICH2021-11-03
5012019-06-01KORRIE SCHARICH2020-09-16 KORRIE SCHARICH2020-09-16
5012018-06-01
5012017-06-01KORRIE SCHARICH KORRIE SCHARICH2018-09-27
5012016-06-01KORRIE SCHARICH KORRIE SCHARICH2017-09-21
5012015-06-01KORRIE SCHARICH KORRIE SCHARICH2016-10-05
5012014-06-01KORRIE SCHARICH KORRIE SCHARICH2015-09-26
5012013-06-01KORRIE SCHARICH KORRIE SCHARICH2014-09-26
5012012-06-01KORRIE SCHARICH KORRIE SCHARICH2013-09-06
5012011-06-01KORRIE SCHARICH KORRIE SCHARICH2012-09-28
5012009-04-01J JOSEPH PILOT

Plan Statistics for BAY HUMAN SERVICES WELFARE PLAN

401k plan membership statisitcs for BAY HUMAN SERVICES WELFARE PLAN

Measure Date Value
2022: BAY HUMAN SERVICES WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-01289
Total number of active participants reported on line 7a of the Form 55002022-06-01298
Total of all active and inactive participants2022-06-01298
2021: BAY HUMAN SERVICES WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-01272
Total number of active participants reported on line 7a of the Form 55002021-06-01289
Total of all active and inactive participants2021-06-01289
2020: BAY HUMAN SERVICES WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01254
Total number of active participants reported on line 7a of the Form 55002020-06-01272
Total of all active and inactive participants2020-06-01272
2019: BAY HUMAN SERVICES WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-01214
Total number of active participants reported on line 7a of the Form 55002019-06-01254
Total of all active and inactive participants2019-06-01254
2018: BAY HUMAN SERVICES WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-01160
Total number of active participants reported on line 7a of the Form 55002018-06-01214
Total of all active and inactive participants2018-06-01214
2017: BAY HUMAN SERVICES WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-06-01146
Total number of active participants reported on line 7a of the Form 55002017-06-01160
Total of all active and inactive participants2017-06-01160
2016: BAY HUMAN SERVICES WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-06-01140
Total number of active participants reported on line 7a of the Form 55002016-06-01146
Total of all active and inactive participants2016-06-01146
2015: BAY HUMAN SERVICES WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-01148
Total number of active participants reported on line 7a of the Form 55002015-06-01140
Total of all active and inactive participants2015-06-01140
2014: BAY HUMAN SERVICES WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-01142
Total number of active participants reported on line 7a of the Form 55002014-06-01148
Total of all active and inactive participants2014-06-01148
2013: BAY HUMAN SERVICES WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-01163
Total number of active participants reported on line 7a of the Form 55002013-06-01142
Total of all active and inactive participants2013-06-01142
2012: BAY HUMAN SERVICES WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-06-01175
Total number of active participants reported on line 7a of the Form 55002012-06-01163
Total of all active and inactive participants2012-06-01163
2011: BAY HUMAN SERVICES WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-06-0165
Total number of active participants reported on line 7a of the Form 55002011-06-01175
Total of all active and inactive participants2011-06-01175
2009: BAY HUMAN SERVICES WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-04-01219
Total number of active participants reported on line 7a of the Form 55002009-04-01152
Total of all active and inactive participants2009-04-01152

Form 5500 Responses for BAY HUMAN SERVICES WELFARE PLAN

2022: BAY HUMAN SERVICES WELFARE PLAN 2022 form 5500 responses
2022-06-01Type of plan entitySingle employer plan
2022-06-01Plan funding arrangement – InsuranceYes
2022-06-01Plan benefit arrangement – InsuranceYes
2021: BAY HUMAN SERVICES WELFARE PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan benefit arrangement – InsuranceYes
2020: BAY HUMAN SERVICES WELFARE PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan benefit arrangement – InsuranceYes
2019: BAY HUMAN SERVICES WELFARE PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan benefit arrangement – InsuranceYes
2018: BAY HUMAN SERVICES WELFARE PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan benefit arrangement – InsuranceYes
2017: BAY HUMAN SERVICES WELFARE PLAN 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan benefit arrangement – InsuranceYes
2016: BAY HUMAN SERVICES WELFARE PLAN 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan benefit arrangement – InsuranceYes
2015: BAY HUMAN SERVICES WELFARE PLAN 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan benefit arrangement – InsuranceYes
2014: BAY HUMAN SERVICES WELFARE PLAN 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan benefit arrangement – InsuranceYes
2013: BAY HUMAN SERVICES WELFARE PLAN 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan benefit arrangement – InsuranceYes
2012: BAY HUMAN SERVICES WELFARE PLAN 2012 form 5500 responses
2012-06-01Type of plan entitySingle employer plan
2012-06-01Plan funding arrangement – InsuranceYes
2012-06-01Plan benefit arrangement – InsuranceYes
2011: BAY HUMAN SERVICES WELFARE PLAN 2011 form 5500 responses
2011-06-01Type of plan entitySingle employer plan
2011-06-01First time form 5500 has been submittedYes
2011-06-01Plan funding arrangement – InsuranceYes
2011-06-01Plan benefit arrangement – InsuranceYes
2009: BAY HUMAN SERVICES WELFARE PLAN 2009 form 5500 responses
2009-04-01Type of plan entitySingle employer plan
2009-04-01Plan funding arrangement – InsuranceYes
2009-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number100751
Policy instance 3
Insurance contract or identification number100751
Number of Individuals Covered26
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $10,272
Total amount of fees paid to insurance companyUSD $222
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $202,146
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,272
Insurance broker organization code?3
Amount paid for insurance broker fees222
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00048615
Policy instance 2
Insurance contract or identification number00048615
Number of Individuals Covered298
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $13,501
Total amount of fees paid to insurance companyUSD $1,531
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $155,173
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,501
Amount paid for insurance broker fees1531
Insurance broker organization code?3
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number00100751/0001
Policy instance 1
Insurance contract or identification number00100751/0001
Number of Individuals Covered67
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $20,127
Total amount of fees paid to insurance companyUSD $914
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $374,712
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,127
Insurance broker organization code?3
Amount paid for insurance broker fees914
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number100751
Policy instance 3
Insurance contract or identification number100751
Number of Individuals Covered21
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $8,174
Total amount of fees paid to insurance companyUSD $183
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $162,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,174
Insurance broker organization code?3
Amount paid for insurance broker fees183
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00048615
Policy instance 2
Insurance contract or identification number00048615
Number of Individuals Covered289
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $11,974
Total amount of fees paid to insurance companyUSD $347
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $134,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,974
Amount paid for insurance broker fees347
Insurance broker organization code?3
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number00100751/0001
Policy instance 1
Insurance contract or identification number00100751/0001
Number of Individuals Covered71
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $18,923
Total amount of fees paid to insurance companyUSD $859
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $383,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,923
Insurance broker organization code?3
Amount paid for insurance broker fees859
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number00100751/0001
Policy instance 1
Insurance contract or identification number00100751/0001
Number of Individuals Covered73
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $12,265
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $286,551
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,265
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00048615
Policy instance 2
Insurance contract or identification number00048615
Number of Individuals Covered272
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $11,275
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $128,809
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,275
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number100751
Policy instance 3
Insurance contract or identification number100751
Number of Individuals Covered25
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $6,485
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $138,827
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,485
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number100751
Policy instance 3
Insurance contract or identification number100751
Number of Individuals Covered19
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $4,385
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $104,726
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,385
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00048615
Policy instance 2
Insurance contract or identification number00048615
Number of Individuals Covered254
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $10,878
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $124,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,878
Insurance broker organization code?3
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number00100751/0001
Policy instance 1
Insurance contract or identification number00100751/0001
Number of Individuals Covered57
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $10,626
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $259,585
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,626
Insurance broker organization code?3
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number00100751/0001
Policy instance 1
Insurance contract or identification number00100751/0001
Number of Individuals Covered68
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $20,153
Total amount of fees paid to insurance companyUSD $804
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $407,016
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,610
Insurance broker organization code?3
Amount paid for insurance broker fees804
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00048615
Policy instance 2
Insurance contract or identification number00048615
Number of Individuals Covered214
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $10,927
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $111,870
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,927
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00048615
Policy instance 2
Insurance contract or identification number00048615
Number of Individuals Covered160
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $7,288
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $72,926
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,100
Insurance broker organization code?3
Insurance broker nameSAGINAW BAY UNDERWRITERS
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number00100751/0001
Policy instance 1
Insurance contract or identification number00100751/0001
Number of Individuals Covered67
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $17,213
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $332,459
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,213
Insurance broker organization code?3
Insurance broker nameVOSS FINANCIAL GROUP, LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00048615
Policy instance 2
Insurance contract or identification number00048615
Number of Individuals Covered140
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $8,074
Total amount of fees paid to insurance companyUSD $5,004
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,674
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,074
Amount paid for insurance broker fees5004
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number00100751/0001
Policy instance 1
Insurance contract or identification number00100751/0001
Number of Individuals Covered62
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $16,274
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $281,887
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,274
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number00100751/0001
Policy instance 1
Insurance contract or identification number00100751/0001
Number of Individuals Covered65
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $16,082
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $280,164
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,082
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00467260
Policy instance 2
Insurance contract or identification number00467260
Number of Individuals Covered148
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $7,294
Total amount of fees paid to insurance companyUSD $5,401
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $77,664
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,294
Amount paid for insurance broker fees5401
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number230850
Policy instance 3
Insurance contract or identification number230850
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $1,425
Total amount of fees paid to insurance companyUSD $302
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,472
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,425
Amount paid for insurance broker fees302
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number230850
Policy instance 4
Insurance contract or identification number230850
Number of Individuals Covered140
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $1,693
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,244
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,693
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00467260
Policy instance 3
Insurance contract or identification number00467260
Number of Individuals Covered142
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $9,338
Total amount of fees paid to insurance companyUSD $6,285
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $105,129
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,338
Amount paid for insurance broker fees6285
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number00100751/0001
Policy instance 1
Insurance contract or identification number00100751/0001
Number of Individuals Covered72
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $19,861
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $345,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,861
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00467260
Policy instance 3
Insurance contract or identification number00467260
Number of Individuals Covered163
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $9,055
Total amount of fees paid to insurance companyUSD $6,372
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $117,408
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,055
Amount paid for insurance broker fees6372
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number00100751/0001
Policy instance 1
Insurance contract or identification number00100751/0001
Number of Individuals Covered61
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $15,853
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $294,353
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: )
Policy contract number00100751/0001
Policy instance 1
Insurance contract or identification number00100751/0001
Number of Individuals Covered65
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $13,259
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $230,274
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 number00467260
Policy instance 3
Insurance contract or identification number00467260
Number of Individuals Covered175
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $5,442
Total amount of fees paid to insurance companyUSD $2,884
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $68,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 1298274
Policy instance 1
Insurance contract or identification numberGL 1298274
Number of Individuals Covered152
Insurance policy start date2010-06-01
Insurance policy end date2011-06-01
Total amount of commissions paid to insurance brokerUSD $590
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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