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EXTANG CORPORATION MEDICAL BENEFITS PLAN 401k Plan overview

Plan NameEXTANG CORPORATION MEDICAL BENEFITS PLAN
Plan identification number 502

EXTANG CORPORATION MEDICAL BENEFITS PLAN Benefits

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

401k Sponsoring company profile

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

Company Name:EXTANG CORPORATION
Employer identification number (EIN):382435643
NAIC Classification:336300

Additional information about EXTANG CORPORATION

Jurisdiction of Incorporation: Michigan Department of Licensing & Regulatory Affairs
Incorporation Date:
Company Identification Number: 241179

More information about EXTANG CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EXTANG CORPORATION MEDICAL BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022015-06-01RONDA COOGAN
5022014-06-01BILL REMINDER
5022013-06-01JOHNATHAN BRANSON
5022012-06-01DEBRA BUCKSON

Plan Statistics for EXTANG CORPORATION MEDICAL BENEFITS PLAN

401k plan membership statisitcs for EXTANG CORPORATION MEDICAL BENEFITS PLAN

Measure Date Value
2015: EXTANG CORPORATION MEDICAL BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-01200
Total number of active participants reported on line 7a of the Form 55002015-06-010
Number of retired or separated participants receiving benefits2015-06-010
Number of other retired or separated participants entitled to future benefits2015-06-010
Total of all active and inactive participants2015-06-010
2014: EXTANG CORPORATION MEDICAL BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-01181
Total number of active participants reported on line 7a of the Form 55002014-06-01200
Number of retired or separated participants receiving benefits2014-06-010
Number of other retired or separated participants entitled to future benefits2014-06-010
Total of all active and inactive participants2014-06-01200
2013: EXTANG CORPORATION MEDICAL BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-01181
Total number of active participants reported on line 7a of the Form 55002013-06-01181
Number of retired or separated participants receiving benefits2013-06-010
Number of other retired or separated participants entitled to future benefits2013-06-010
Total of all active and inactive participants2013-06-01181
2012: EXTANG CORPORATION MEDICAL BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-06-01167
Total number of active participants reported on line 7a of the Form 55002012-06-01181
Number of retired or separated participants receiving benefits2012-06-010
Number of other retired or separated participants entitled to future benefits2012-06-010
Total of all active and inactive participants2012-06-01181

Form 5500 Responses for EXTANG CORPORATION MEDICAL BENEFITS PLAN

2015: EXTANG CORPORATION MEDICAL BENEFITS PLAN 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01This submission is the final filingYes
2015-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan benefit arrangement – InsuranceYes
2014: EXTANG CORPORATION MEDICAL BENEFITS 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: EXTANG CORPORATION MEDICAL BENEFITS PLAN 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01Submission has been amendedNo
2013-06-01This submission is the final filingNo
2013-06-01This return/report is a short plan year return/report (less than 12 months)No
2013-06-01Plan is a collectively bargained planNo
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan benefit arrangement – InsuranceYes
2012: EXTANG CORPORATION MEDICAL BENEFITS PLAN 2012 form 5500 responses
2012-06-01Type of plan entitySingle employer plan
2012-06-01First time form 5500 has been submittedYes
2012-06-01Submission has been amendedNo
2012-06-01This submission is the final filingNo
2012-06-01This return/report is a short plan year return/report (less than 12 months)No
2012-06-01Plan is a collectively bargained planNo
2012-06-01Plan funding arrangement – InsuranceYes
2012-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number00201340/0001
Policy instance 1
Insurance contract or identification number00201340/0001
Number of Individuals Covered326
Insurance policy start date2015-06-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $30,165
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $688,817
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,165
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number37254-223
Policy instance 2
Insurance contract or identification number37254-223
Number of Individuals Covered38
Insurance policy start date2015-06-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $12,534
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $229,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,261
Insurance broker organization code?3
Insurance broker nameJULIE S. SESSION
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number08419-367
Policy instance 3
Insurance contract or identification number08419-367
Number of Individuals Covered18
Insurance policy start date2015-06-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,691
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $105,205
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,458
Insurance broker organization code?3
Insurance broker nameJULIE S. SESSIONS
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number00201340/0001
Policy instance 1
Insurance contract or identification number00201340/0001
Number of Individuals Covered273
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $34,248
Total amount of fees paid to insurance companyUSD $704
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $986,110
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,248
Amount paid for insurance broker fees704
Additional information about fees paid to insurance brokerMANAGING AGENT FEES
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number37254-223
Policy instance 2
Insurance contract or identification number37254-223
Number of Individuals Covered64
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $11,846
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $327,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,846
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number201340
Policy instance 1
Insurance contract or identification number201340
Number of Individuals Covered0
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number201340
Policy instance 1
Insurance contract or identification number201340
Number of Individuals Covered181
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $32,330
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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 $533,998
Commission paid to Insurance BrokerUSD $32,330
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES LLC

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