OAKLAND MANAGEMENT CORP has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan OAKLAND MANAGEMENT CORP CAFETERIA PLAN
| Measure | Date | Value |
|---|
| 2022: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 503 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 477 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 10 |
| Total of all active and inactive participants | 2022-01-01 | 487 |
| 2021: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 531 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 503 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 7 |
| Total of all active and inactive participants | 2021-01-01 | 510 |
| 2020: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 456 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 531 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 9 |
| Total of all active and inactive participants | 2020-01-01 | 540 |
| 2019: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 361 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 456 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 4 |
| Total of all active and inactive participants | 2019-01-01 | 460 |
| 2018: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 314 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 361 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 3 |
| Total of all active and inactive participants | 2018-01-01 | 364 |
| 2017: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 305 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 314 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 3 |
| Total of all active and inactive participants | 2017-01-01 | 317 |
| 2016: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 247 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 305 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 3 |
| Total of all active and inactive participants | 2016-01-01 | 308 |
| 2015: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 237 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 247 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 3 |
| Total of all active and inactive participants | 2015-01-01 | 250 |
| 2014: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 213 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 233 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 4 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 237 |
| 2013: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 233 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 212 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
| Total of all active and inactive participants | 2013-01-01 | 213 |
| 2012: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 179 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 232 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 1 |
| Total of all active and inactive participants | 2012-01-01 | 233 |
| 2011: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 197 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 174 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 4 |
| Total of all active and inactive participants | 2011-01-01 | 178 |
| 2010: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 183 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 188 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 8 |
| Total of all active and inactive participants | 2010-01-01 | 196 |
| 2009: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 180 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 179 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 4 |
| Total of all active and inactive participants | 2009-01-01 | 183 |
| 2022: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | Yes |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: OAKLAND MANAGEMENT CORP CAFETERIA PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000400001000 |
| Policy instance | 7 |
| Insurance contract or identification number | 000400001000 | | Number of Individuals Covered | 263 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $6,506 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | VOLUNTARY LIFE/CHILD/SPOUSE | | Welfare Benefit Premiums Paid to Carrier | USD $43,376 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,506 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000403007209 |
| Policy instance | 8 |
| Insurance contract or identification number | 000403007209 | | Number of Individuals Covered | 264 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $672 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | VOLUNTARY AD&D/SPOUSE/CHILD | | Welfare Benefit Premiums Paid to Carrier | USD $4,482 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $672 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10198121001 |
| Policy instance | 9 |
| Insurance contract or identification number | 10198121001 | | Number of Individuals Covered | 779 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $2,138 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $39,648 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,138 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 0007822 |
| Policy instance | 10 |
| Insurance contract or identification number | 0007822 | | Number of Individuals Covered | 939 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $5,480 | | Total amount of fees paid to insurance company | USD $0 | | 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 $5,480 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10198201001 |
| Policy instance | 11 |
| Insurance contract or identification number | 10198201001 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $2 | | Total amount of fees paid to insurance company | USD $0 | | 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 $2 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 150064 |
| Policy instance | 1 |
| Insurance contract or identification number | 150064 | | Number of Individuals Covered | 634 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $47,153 | | Total amount of fees paid to insurance company | USD $5,724 | | 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 $35,365 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 5724 | | Additional information about fees paid to insurance broker | INCENTIVE PAYMENTS |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010248799 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010248799 | | Number of Individuals Covered | 347 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $5,073 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $114,690 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,073 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010248800 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010248800 | | Number of Individuals Covered | 820 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $2,912 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $50,104 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,912 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010248801 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010248801 | | Number of Individuals Covered | 347 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $3,994 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | WEEKLY INCOME STD | | Welfare Benefit Premiums Paid to Carrier | USD $133,367 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,994 | | Insurance broker organization code? | 3 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 150064 |
| Policy instance | 5 |
| Insurance contract or identification number | 150064 | | Number of Individuals Covered | 146 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $5,719 | | Total amount of fees paid to insurance company | USD $1,044 | | 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 $2,988 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1044 | | Additional information about fees paid to insurance broker | INCENTIVE PAYMENT |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010249415 |
| Policy instance | 6 |
| Insurance contract or identification number | 000010249415 | | Number of Individuals Covered | 57 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,489 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | VOLUNTARY LONG TERM DISABILTY | | Welfare Benefit Premiums Paid to Carrier | USD $9,928 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,489 | | Insurance broker organization code? | 3 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 150064 |
| Policy instance | 5 |
| Insurance contract or identification number | 150064 | | Number of Individuals Covered | 108 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $7,380 | | Total amount of fees paid to insurance company | USD $768 | | 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 $4,908 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 768 | | Additional information about fees paid to insurance broker | INCENTIVE PAYMENT |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010248801 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010248801 | | Number of Individuals Covered | 344 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $3,765 | | Total amount of fees paid to insurance company | USD $2,941 | | Other welfare benefits provided | WEEKLY INCOME STD | | Welfare Benefit Premiums Paid to Carrier | USD $110,453 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,765 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2941 | | Additional information about fees paid to insurance broker | BROKER BONUS |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010248800 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010248800 | | Number of Individuals Covered | 838 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $2,767 | | Total amount of fees paid to insurance company | USD $1,105 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $42,838 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,767 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1105 | | Additional information about fees paid to insurance broker | BROKER BONUS |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010248799 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010248799 | | Number of Individuals Covered | 345 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $5,014 | | Total amount of fees paid to insurance company | USD $2,696 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $102,776 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,014 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2696 | | Additional information about fees paid to insurance broker | BROKER BONUS |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 150064 |
| Policy instance | 1 |
| Insurance contract or identification number | 150064 | | Number of Individuals Covered | 660 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $63,885 | | 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 $44,377 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | INCENTIVE PAYMENTS |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010249414 |
| Policy instance | 6 |
| Insurance contract or identification number | 000010249414 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,380 | | Total amount of fees paid to insurance company | USD $282 | | Other welfare benefits provided | WEEKLY INCOME VOLUNTARY LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $9,198 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,380 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 282 | | Additional information about fees paid to insurance broker | BROKER BONUS |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010249415 |
| Policy instance | 7 |
| Insurance contract or identification number | 000010249415 | | 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 $1,947 | | Total amount of fees paid to insurance company | USD $364 | | Other welfare benefits provided | VOLUNTARY LONG TERM DISABILTY | | Welfare Benefit Premiums Paid to Carrier | USD $12,983 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,947 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 364 | | Additional information about fees paid to insurance broker | BROKER BONUS |
|
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 0007822 |
| Policy instance | 12 |
| Insurance contract or identification number | 0007822 | | Number of Individuals Covered | 954 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $5,804 | | Total amount of fees paid to insurance company | USD $473 | | 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 $5,804 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 473 | | Additional information about fees paid to insurance broker | RETENTION BONUS |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10198121001 |
| Policy instance | 11 |
| Insurance contract or identification number | 10198121001 | | Number of Individuals Covered | 774 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $2,344 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $43,326 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,344 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000403007209 |
| Policy instance | 10 |
| Insurance contract or identification number | 000403007209 | | Number of Individuals Covered | 290 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $658 | | Total amount of fees paid to insurance company | USD $124 | | Other welfare benefits provided | VOLUNTARY AD&D/SPOUSE/CHILD | | Welfare Benefit Premiums Paid to Carrier | USD $4,386 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $658 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 124 | | Additional information about fees paid to insurance broker | BROKER BONUS |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000400001000 |
| Policy instance | 9 |
| Insurance contract or identification number | 000400001000 | | Number of Individuals Covered | 291 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $6,346 | | Total amount of fees paid to insurance company | USD $1,135 | | Other welfare benefits provided | VOLUNTARY LIFE/CHILD/SPOUSE | | Welfare Benefit Premiums Paid to Carrier | USD $42,305 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,346 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1135 | | Additional information about fees paid to insurance broker | BROKER BONUS |
|
| LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
| Policy contract number | 000010249492 |
| Policy instance | 8 |
| Insurance contract or identification number | 000010249492 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $2 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | FAMILY LEAVE | | Welfare Benefit Premiums Paid to Carrier | USD $350 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 2 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 150064 |
| Policy instance | 1 |
| Insurance contract or identification number | 150064 | | Number of Individuals Covered | 754 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $46,804 | | Total amount of fees paid to insurance company | USD $4,749 | | 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 $36,110 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 4749 | | Additional information about fees paid to insurance broker | INCENTIVE PAYMENTS |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10198201001 |
| Policy instance | 13 |
| Insurance contract or identification number | 10198201001 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $12 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $245 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 0007822 |
| Policy instance | 12 |
| Insurance contract or identification number | 0007822 | | Number of Individuals Covered | 981 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $7,433 | | Total amount of fees paid to insurance company | USD $673 | | 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 $6,785 | | Amount paid for insurance broker fees | 673 | | Additional information about fees paid to insurance broker | NEW BUSINESS BONUS, RETENTION BONUS | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10198121001 |
| Policy instance | 11 |
| Insurance contract or identification number | 10198121001 | | Number of Individuals Covered | 807 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,991 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $40,310 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,802 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000403007209 |
| Policy instance | 10 |
| Insurance contract or identification number | 000403007209 | | Number of Individuals Covered | 347 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $675 | | Total amount of fees paid to insurance company | USD $57 | | Other welfare benefits provided | VOLUNTARY AD&D/SPOUSE/CHILD | | Welfare Benefit Premiums Paid to Carrier | USD $4,497 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $675 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 57 | | Additional information about fees paid to insurance broker | BROKER BONUS |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000400001000 |
| Policy instance | 9 |
| Insurance contract or identification number | 000400001000 | | Number of Individuals Covered | 345 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $6,192 | | Total amount of fees paid to insurance company | USD $479 | | Other welfare benefits provided | VOLUNTARY LIFE/CHILD/SPOUSE | | Welfare Benefit Premiums Paid to Carrier | USD $41,282 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,192 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 479 | | Additional information about fees paid to insurance broker | BROKER BONUS |
|
| LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
| Policy contract number | 000010249492 |
| Policy instance | 8 |
| Insurance contract or identification number | 000010249492 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $1 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | FAMILY LEAVE | | Welfare Benefit Premiums Paid to Carrier | USD $202 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010248799 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010248799 | | Number of Individuals Covered | 369 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $4,980 | | Total amount of fees paid to insurance company | USD $1,107 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $98,048 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,980 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1107 | | Additional information about fees paid to insurance broker | BROKER BONUS |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010248800 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010248800 | | Number of Individuals Covered | 881 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $2,714 | | Total amount of fees paid to insurance company | USD $477 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $40,178 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,714 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 477 | | Additional information about fees paid to insurance broker | BROKER BONUS |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010248801 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010248801 | | Number of Individuals Covered | 368 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $3,729 | | Total amount of fees paid to insurance company | USD $1,187 | | Other welfare benefits provided | WEEKLY INCOME | | Welfare Benefit Premiums Paid to Carrier | USD $106,937 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,729 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1187 | | Additional information about fees paid to insurance broker | BROKER BONUS |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 150064 |
| Policy instance | 5 |
| Insurance contract or identification number | 150064 | | Number of Individuals Covered | 44 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,487 | | Total amount of fees paid to insurance company | USD $183 | | 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 $1,143 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 183 | | Additional information about fees paid to insurance broker | BROKER INCENTIVE |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010249414 |
| Policy instance | 6 |
| Insurance contract or identification number | 000010249414 | | Number of Individuals Covered | 104 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,541 | | Total amount of fees paid to insurance company | USD $143 | | Other welfare benefits provided | WEEKLY INCOME | | Welfare Benefit Premiums Paid to Carrier | USD $10,271 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,541 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 143 | | Additional information about fees paid to insurance broker | BROKER BONUS |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010249415 |
| Policy instance | 7 |
| Insurance contract or identification number | 000010249415 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,986 | | Total amount of fees paid to insurance company | USD $189 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,242 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,986 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 189 | | Additional information about fees paid to insurance broker | BROKER BONUS |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010249415 |
| Policy instance | 7 |
| Insurance contract or identification number | 000010249415 | | Number of Individuals Covered | 77 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,887 | | Total amount of fees paid to insurance company | USD $862 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,583 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,887 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 862 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010249414 |
| Policy instance | 6 |
| Insurance contract or identification number | 000010249414 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,427 | | Total amount of fees paid to insurance company | USD $630 | | Other welfare benefits provided | WEEKLY INCOME | | Welfare Benefit Premiums Paid to Carrier | USD $9,510 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,427 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 630 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 150064 |
| Policy instance | 5 |
| Insurance contract or identification number | 150064 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,313 | | 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 $913 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010248801 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010248801 | | Number of Individuals Covered | 312 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $3,347 | | Total amount of fees paid to insurance company | USD $3,105 | | Other welfare benefits provided | WEEKLY INCOME | | Welfare Benefit Premiums Paid to Carrier | USD $79,145 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,347 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 3105 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010248800 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010248800 | | Number of Individuals Covered | 751 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $2,546 | | Total amount of fees paid to insurance company | USD $1,648 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $31,785 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,546 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1648 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 00010248799 |
| Policy instance | 2 |
| Insurance contract or identification number | 00010248799 | | Number of Individuals Covered | 312 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $4,738 | | Total amount of fees paid to insurance company | USD $2,970 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $73,810 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,738 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2970 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 150064 |
| Policy instance | 1 |
| Insurance contract or identification number | 150064 | | Number of Individuals Covered | 719 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $78,052 | | 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 $40,248 | | Insurance broker organization code? | 3 |
|
| LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
| Policy contract number | 000010249492 |
| Policy instance | 8 |
| Insurance contract or identification number | 000010249492 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $4 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | FAMILY LEAVE | | Welfare Benefit Premiums Paid to Carrier | USD $124 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 4 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000400001000 |
| Policy instance | 9 |
| Insurance contract or identification number | 000400001000 | | Number of Individuals Covered | 309 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $4,791 | | Total amount of fees paid to insurance company | USD $1,856 | | Other welfare benefits provided | VOLUNTARY LIFE/CHILD/SPOUSE | | Welfare Benefit Premiums Paid to Carrier | USD $31,939 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,791 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1856 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000403007209 |
| Policy instance | 10 |
| Insurance contract or identification number | 000403007209 | | Number of Individuals Covered | 308 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $572 | | Total amount of fees paid to insurance company | USD $233 | | Other welfare benefits provided | VOLUNTARY LIFE/CHILD/SPOUSE | | Welfare Benefit Premiums Paid to Carrier | USD $3,816 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $572 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 233 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10198121001 |
| Policy instance | 11 |
| Insurance contract or identification number | 10198121001 | | Number of Individuals Covered | 729 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,429 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,603 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,429 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 0007822 |
| Policy instance | 12 |
| Insurance contract or identification number | 0007822 | | Number of Individuals Covered | 879 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $6,124 | | Total amount of fees paid to insurance company | USD $0 | | 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 $6,124 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 150064 |
| Policy instance | 1 |
| Insurance contract or identification number | 150064 | | Number of Individuals Covered | 537 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $75,047 | | Total amount of fees paid to insurance company | USD $1,959 | | 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 $37,977 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1959 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00345020 |
| Policy instance | 2 |
| Insurance contract or identification number | 00345020 | | Number of Individuals Covered | 417 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $5,896 | | Total amount of fees paid to insurance company | USD $4,151 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $208,640 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,422 | | Amount paid for insurance broker fees | 4151 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 000000423803 |
| Policy instance | 3 |
| Insurance contract or identification number | 000000423803 | | Number of Individuals Covered | 609 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2019-01-01 | | Total amount of commissions paid to insurance broker | USD $9,454 | | Total amount of fees paid to insurance company | USD $1,544 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $114,130 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,454 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1544 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 150064 |
| Policy instance | 5 |
| Insurance contract or identification number | 150064 | | Number of Individuals Covered | 24 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $730 | | Total amount of fees paid to insurance company | USD $65 | | 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 $561 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 65 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 000000423805 |
| Policy instance | 4 |
| Insurance contract or identification number | 000000423805 | | Number of Individuals Covered | 35 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2019-01-01 | | Total amount of commissions paid to insurance broker | USD $3,910 | | Total amount of fees paid to insurance company | USD $409 | | Other welfare benefits provided | LIFESTYLE ADD & LIFESTYLE LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $23,893 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,910 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 409 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 150064 |
| Policy instance | 1 |
| Insurance contract or identification number | 150064 | | Number of Individuals Covered | 444 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $43,631 | | Total amount of fees paid to insurance company | USD $4,211 | | 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 $26,575 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2143 | | Insurance broker name | GALLAGHER BENEFITS SERVICES INC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 000000423805 |
| Policy instance | 4 |
| Insurance contract or identification number | 000000423805 | | Number of Individuals Covered | 114 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-01-01 | | Total amount of commissions paid to insurance broker | USD $3,534 | | Total amount of fees paid to insurance company | USD $556 | | Other welfare benefits provided | VOLUNTARY LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $22,266 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,534 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 556 | | Insurance broker name | GALLAGHER BENEFITS SERVICES INC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 000000423803 |
| Policy instance | 3 |
| Insurance contract or identification number | 000000423803 | | Number of Individuals Covered | 552 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2018-01-01 | | Total amount of commissions paid to insurance broker | USD $9,744 | | Total amount of fees paid to insurance company | USD $2,622 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $104,871 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,744 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2622 | | Insurance broker name | GALLAGHER BENEFITS SERVICES INC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00345020 |
| Policy instance | 2 |
| Insurance contract or identification number | 00345020 | | Number of Individuals Covered | 338 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $9,431 | | Total amount of fees paid to insurance company | USD $5,502 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $227,191 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,712 | | Amount paid for insurance broker fees | 5502 | | Insurance broker organization code? | 3 | | Insurance broker name | DANIEL WERNER |
|
