THI, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan THI, INC. HEALTH CARE COVERAGE
401k plan membership statisitcs for THI, INC. HEALTH CARE COVERAGE
| Measure | Date | Value |
|---|
| 2022: THI, INC. HEALTH CARE COVERAGE 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 248 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 204 |
| Total of all active and inactive participants | 2022-01-01 | 204 |
| 2021: THI, INC. HEALTH CARE COVERAGE 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 280 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 248 |
| Total of all active and inactive participants | 2021-01-01 | 248 |
| 2020: THI, INC. HEALTH CARE COVERAGE 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 292 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 280 |
| Total of all active and inactive participants | 2020-01-01 | 280 |
| 2019: THI, INC. HEALTH CARE COVERAGE 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 274 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 292 |
| Total of all active and inactive participants | 2019-01-01 | 292 |
| 2018: THI, INC. HEALTH CARE COVERAGE 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 293 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 274 |
| Total of all active and inactive participants | 2018-01-01 | 274 |
| 2017: THI, INC. HEALTH CARE COVERAGE 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 320 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 293 |
| Total of all active and inactive participants | 2017-01-01 | 293 |
| 2016: THI, INC. HEALTH CARE COVERAGE 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 336 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 320 |
| Total of all active and inactive participants | 2016-01-01 | 320 |
| 2015: THI, INC. HEALTH CARE COVERAGE 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 275 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 336 |
| Total of all active and inactive participants | 2015-01-01 | 336 |
| 2014: THI, INC. HEALTH CARE COVERAGE 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 178 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 275 |
| Total of all active and inactive participants | 2014-01-01 | 275 |
| 2013: THI, INC. HEALTH CARE COVERAGE 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 181 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 178 |
| Total of all active and inactive participants | 2013-01-01 | 178 |
| 2012: THI, INC. HEALTH CARE COVERAGE 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 234 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 181 |
| Total of all active and inactive participants | 2012-01-01 | 181 |
| 2011: THI, INC. HEALTH CARE COVERAGE 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 196 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 234 |
| Total of all active and inactive participants | 2011-01-01 | 234 |
| 2010: THI, INC. HEALTH CARE COVERAGE 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 160 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 196 |
| Total of all active and inactive participants | 2010-01-01 | 196 |
| Number of employers contributing to the scheme | 2010-01-01 | 4 |
| 2009: THI, INC. HEALTH CARE COVERAGE 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 250 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 160 |
| Total of all active and inactive participants | 2009-01-01 | 160 |
| Total participants | 2009-01-01 | 160 |
| 2022: THI, INC. HEALTH CARE COVERAGE 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: THI, INC. HEALTH CARE COVERAGE 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: THI, INC. HEALTH CARE COVERAGE 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: THI, INC. HEALTH CARE COVERAGE 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: THI, INC. HEALTH CARE COVERAGE 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: THI, INC. HEALTH CARE COVERAGE 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: THI, INC. HEALTH CARE COVERAGE 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: THI, INC. HEALTH CARE COVERAGE 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Mulitple employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: THI, INC. HEALTH CARE COVERAGE 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Mulitple employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: THI, INC. HEALTH CARE COVERAGE 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Mulitple employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: THI, INC. HEALTH CARE COVERAGE 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Mulitple employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: THI, INC. HEALTH CARE COVERAGE 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Mulitple employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: THI, INC. HEALTH CARE COVERAGE 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Mulitple employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: THI, INC. HEALTH CARE COVERAGE 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Mulitple employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 219211 |
| Policy instance | 2 |
| Insurance contract or identification number | 219211 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2021-08-01 | | Insurance policy end date | 2022-07-31 | | Total amount of commissions paid to insurance broker | USD $2,886 | | Total amount of fees paid to insurance company | USD $0 | | 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 $2,862 | | Insurance broker organization code? | 3 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 219211 |
| Policy instance | 1 |
| Insurance contract or identification number | 219211 | | Number of Individuals Covered | 202 | | Insurance policy start date | 2021-08-01 | | Insurance policy end date | 2022-07-31 | | Total amount of commissions paid to insurance broker | USD $40,082 | | Total amount of fees paid to insurance company | USD $0 | | 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 $38,834 | | Insurance broker organization code? | 3 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 219211 |
| Policy instance | 1 |
| Insurance contract or identification number | 219211 | | Number of Individuals Covered | 244 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2021-07-31 | | Total amount of commissions paid to insurance broker | USD $37,389 | | Total amount of fees paid to insurance company | USD $0 | | 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 $36,607 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 219211 |
| Policy instance | 2 |
| Insurance contract or identification number | 219211 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2021-07-31 | | Total amount of commissions paid to insurance broker | USD $1,577 | | Total amount of fees paid to insurance company | USD $0 | | 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 $1,568 | | Insurance broker organization code? | 3 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 219211 |
| Policy instance | 1 |
| Insurance contract or identification number | 219211 | | Number of Individuals Covered | 277 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-07-31 | | Total amount of commissions paid to insurance broker | USD $60,078 | | Total amount of fees paid to insurance company | USD $0 | | 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 $59,235 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 219211 |
| Policy instance | 2 |
| Insurance contract or identification number | 219211 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-07-31 | | Total amount of commissions paid to insurance broker | USD $2,290 | | Total amount of fees paid to insurance company | USD $0 | | 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 $2,281 | | Insurance broker organization code? | 3 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 219211 |
| Policy instance | 1 |
| Insurance contract or identification number | 219211 | | Number of Individuals Covered | 289 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-07-31 | | Total amount of commissions paid to insurance broker | USD $31,961 | | Total amount of fees paid to insurance company | USD $0 | | 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 $30,227 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 219211 |
| Policy instance | 2 |
| Insurance contract or identification number | 219211 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-07-31 | | Total amount of commissions paid to insurance broker | USD $19,409 | | Total amount of fees paid to insurance company | USD $0 | | 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 $19,391 | | Insurance broker organization code? | 3 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 219211 |
| Policy instance | 1 |
| Insurance contract or identification number | 219211 | | Number of Individuals Covered | 271 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-07-31 | | Total amount of commissions paid to insurance broker | USD $17,191 | | Total amount of fees paid to insurance company | USD $873 | | 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 $17,191 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 873 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 219211 |
| Policy instance | 2 |
| Insurance contract or identification number | 219211 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-07-31 | | Total amount of commissions paid to insurance broker | USD $236 | | Total amount of fees paid to insurance company | USD $9 | | 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 $236 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 9 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00219211-6,7,8 |
| Policy instance | 1 |
| Insurance contract or identification number | 00219211-6,7,8 | | Number of Individuals Covered | 291 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $16,566 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,150,475 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,566 | | Insurance broker organization code? | 3 | | Insurance broker name | OLIVIER VANDYKE AGENCY |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 219211 |
| Policy instance | 2 |
| Insurance contract or identification number | 219211 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2016-08-01 | | Insurance policy end date | 2017-07-31 | | Total amount of commissions paid to insurance broker | USD $670 | | Total amount of fees paid to insurance company | USD $4 | | 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 $670 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 4 | | Insurance broker name | OLIVIER VANDYKE AGENCY |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00219211-6,7,8 |
| Policy instance | 2 |
| Insurance contract or identification number | 00219211-6,7,8 | | Number of Individuals Covered | 333 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $50,023 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,143,070 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $50,023 | | Insurance broker name | OLIVIER VANDYKE AGENCY |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 42851-116 |
| Policy instance | 1 |
| Insurance contract or identification number | 42851-116 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $974 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $45,480 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $974 | | Insurance broker organization code? | 3 | | Insurance broker name | OLIVIER VANDYKE AGENCY |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00219211-6,7,8 |
| Policy instance | 2 |
| Insurance contract or identification number | 00219211-6,7,8 | | Number of Individuals Covered | 267 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $26,407 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $686,011 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $26,407 | | Insurance broker name | OLIVIER VANDYKE AGENCY |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 42851-116 |
| Policy instance | 1 |
| Insurance contract or identification number | 42851-116 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $1,022 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $47,848 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,022 | | Insurance broker organization code? | 3 | | Insurance broker name | OLIVIER VANDYKE AGENCY |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 42851-116 |
| Policy instance | 1 |
| Insurance contract or identification number | 42851-116 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $589 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $35,660 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $589 | | Insurance broker organization code? | 3 | | Insurance broker name | OLIVIER VANDYKE AGENCY |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00219211-6,7,8 |
| Policy instance | 2 |
| Insurance contract or identification number | 00219211-6,7,8 | | Number of Individuals Covered | 172 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $18,397 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $412,254 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,397 | | Insurance broker name | OLIVIER VANDYKE AGENCY |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 42851-116 |
| Policy instance | 1 |
| Insurance contract or identification number | 42851-116 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $885 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $30,628 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $885 | | Insurance broker organization code? | 3 | | Insurance broker name | WALDECKER AGENCY |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00219211-6,7,8 |
| Policy instance | 2 |
| Insurance contract or identification number | 00219211-6,7,8 | | Number of Individuals Covered | 175 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $24,889 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $501,556 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,889 | | Insurance broker organization code? | 3 | | Insurance broker name | WALDECKER AGENCY |
|
| GRAND VALLEY HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95453 ) |
| Policy contract number | 000284 |
| Policy instance | 2 |
| Insurance contract or identification number | 000284 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $2,894 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $64,318 | | 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 number | 49897 |
| Policy instance | 1 |
| Insurance contract or identification number | 49897 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $1,083 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,495 | | 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 number | 00219211 |
| Policy instance | 3 |
| Insurance contract or identification number | 00219211 | | Number of Individuals Covered | 228 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $29,150 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $638,244 | | 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 number | 00219211 |
| Policy instance | 3 |
| Insurance contract or identification number | 00219211 | | Number of Individuals Covered | 190 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $7,051 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $281,549 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,051 | | Insurance broker organization code? | 3 | | Insurance broker name | WALDECKER AGENCY |
|
| GRAND VALLEY HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95453 ) |
| Policy contract number | 000284 |
| Policy instance | 2 |
| Insurance contract or identification number | 000284 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $1,661 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,903 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,661 | | Insurance broker organization code? | 3 | | Insurance broker name | WALDECKER AGENCY |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 49897 |
| Policy instance | 1 |
| Insurance contract or identification number | 49897 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $205,061 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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