WEST BLOOMFIELD HEALTH & REHAB. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan WEST BLOOMFIELD HEALTH AND REHABILITATION CENTER, LLC WELFARE BENEFIT PLAN
401k plan membership statisitcs for WEST BLOOMFIELD HEALTH AND REHABILITATION CENTER, LLC WELFARE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2022: WEST BLOOMFIELD HEALTH AND REHABILITATION CENTER, LLC WELFARE BENEFIT PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 325 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 307 |
| Total of all active and inactive participants | 2022-01-01 | 307 |
| Total participants | 2022-01-01 | 307 |
| 2021: WEST BLOOMFIELD HEALTH AND REHABILITATION CENTER, LLC WELFARE BENEFIT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 267 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 325 |
| Total of all active and inactive participants | 2021-01-01 | 325 |
| Total participants | 2021-01-01 | 325 |
| 2020: WEST BLOOMFIELD HEALTH AND REHABILITATION CENTER, LLC WELFARE BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 232 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 267 |
| Total of all active and inactive participants | 2020-01-01 | 267 |
| Total participants | 2020-01-01 | 267 |
| 2019: WEST BLOOMFIELD HEALTH AND REHABILITATION CENTER, LLC WELFARE BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-09-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-09-01 | 232 |
| Number of retired or separated participants receiving benefits | 2019-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-09-01 | 0 |
| Total of all active and inactive participants | 2019-09-01 | 232 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | EAB1000190 |
| Policy instance | 3 |
| Insurance contract or identification number | EAB1000190 | | Number of Individuals Covered | 132 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $7,332 | | Total amount of fees paid to insurance company | USD $4,743 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $48,578 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,332 | | Amount paid for insurance broker fees | 4743 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 290734 |
| Policy instance | 2 |
| Insurance contract or identification number | 290734 | | Number of Individuals Covered | 66 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $16,770 | | Total amount of fees paid to insurance company | USD $783 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,770 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 783 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 290734 |
| Policy instance | 1 |
| Insurance contract or identification number | 290734 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $9,905 | | Total amount of fees paid to insurance company | USD $616 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,905 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 616 |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | EAB1000190 |
| Policy instance | 3 |
| Insurance contract or identification number | EAB1000190 | | Number of Individuals Covered | 123 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $6,999 | | Total amount of fees paid to insurance company | USD $2,547 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $46,922 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,779 | | Amount paid for insurance broker fees | 2547 | | Insurance broker organization code? | 3 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 290734 |
| Policy instance | 2 |
| Insurance contract or identification number | 290734 | | Number of Individuals Covered | 74 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $10,778 | | Total amount of fees paid to insurance company | USD $785 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,778 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 785 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 290734 |
| Policy instance | 1 |
| Insurance contract or identification number | 290734 | | Number of Individuals Covered | 128 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $9,172 | | Total amount of fees paid to insurance company | USD $215 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,172 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 215 |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | EAB1000190 |
| Policy instance | 3 |
| Insurance contract or identification number | EAB1000190 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $7,230 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $48,026 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,230 | | Insurance broker organization code? | 3 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 290734 |
| Policy instance | 2 |
| Insurance contract or identification number | 290734 | | Number of Individuals Covered | 64 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $19,053 | | Total amount of fees paid to insurance company | USD $3,368 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,053 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 3368 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 290734 |
| Policy instance | 1 |
| Insurance contract or identification number | 290734 | | Number of Individuals Covered | 112 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $12,889 | | Total amount of fees paid to insurance company | USD $654 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,889 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 654 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 05G5604 |
| Policy instance | 4 |
| Insurance contract or identification number | 05G5604 | | Number of Individuals Covered | 63 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $462 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,624 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $462 | | Insurance broker organization code? | 3 |
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| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 9402 |
| Policy instance | 3 |
| Insurance contract or identification number | 9402 | | Number of Individuals Covered | 104 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $178 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $178 | | Insurance broker organization code? | 3 |
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| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00290734/0001 |
| Policy instance | 2 |
| Insurance contract or identification number | 00290734/0001 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2019-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $72,900 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 00858-001 |
| Policy instance | 1 |
| Insurance contract or identification number | 00858-001 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2019-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $32,927 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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