GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH
401k plan membership statisitcs for GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH
| Measure | Date | Value |
|---|
| 2023: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-09-01 | 157 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-09-01 | 141 |
| Number of retired or separated participants receiving benefits | 2023-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-09-01 | 0 |
| Total of all active and inactive participants | 2023-09-01 | 141 |
| Number of employers contributing to the scheme | 2023-09-01 | 0 |
| 2022: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-09-01 | 110 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-09-01 | 132 |
| Number of retired or separated participants receiving benefits | 2022-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-09-01 | 25 |
| Total of all active and inactive participants | 2022-09-01 | 157 |
| Number of employers contributing to the scheme | 2022-09-01 | 0 |
| 2021: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-09-01 | 123 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-09-01 | 130 |
| Number of retired or separated participants receiving benefits | 2021-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-09-01 | 37 |
| Total of all active and inactive participants | 2021-09-01 | 167 |
| Number of employers contributing to the scheme | 2021-09-01 | 0 |
| 2020: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-09-01 | 190 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-09-01 | 172 |
| Number of retired or separated participants receiving benefits | 2020-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-09-01 | 0 |
| Total of all active and inactive participants | 2020-09-01 | 172 |
| Number of employers contributing to the scheme | 2020-09-01 | 0 |
| 2019: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-09-01 | 169 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-09-01 | 190 |
| Number of retired or separated participants receiving benefits | 2019-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-09-01 | 0 |
| Total of all active and inactive participants | 2019-09-01 | 190 |
| Number of employers contributing to the scheme | 2019-09-01 | 0 |
| 2018: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-09-01 | 153 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-09-01 | 173 |
| Number of retired or separated participants receiving benefits | 2018-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-09-01 | 0 |
| Total of all active and inactive participants | 2018-09-01 | 173 |
| Number of employers contributing to the scheme | 2018-09-01 | 0 |
| 2017: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-09-01 | 172 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-09-01 | 153 |
| Number of retired or separated participants receiving benefits | 2017-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-09-01 | 0 |
| Total of all active and inactive participants | 2017-09-01 | 153 |
| Number of employers contributing to the scheme | 2017-09-01 | 0 |
| 2016: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-09-01 | 176 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-09-01 | 142 |
| Number of retired or separated participants receiving benefits | 2016-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-09-01 | 0 |
| Total of all active and inactive participants | 2016-09-01 | 142 |
| 2015: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-09-01 | 183 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-09-01 | 176 |
| Number of retired or separated participants receiving benefits | 2015-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-09-01 | 0 |
| Total of all active and inactive participants | 2015-09-01 | 176 |
| 2014: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-09-01 | 192 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-09-01 | 183 |
| Number of retired or separated participants receiving benefits | 2014-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-09-01 | 0 |
| Total of all active and inactive participants | 2014-09-01 | 183 |
| 2013: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-09-01 | 181 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-09-01 | 192 |
| Number of retired or separated participants receiving benefits | 2013-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-09-01 | 0 |
| Total of all active and inactive participants | 2013-09-01 | 192 |
| 2012: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-09-01 | 154 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-09-01 | 181 |
| Number of retired or separated participants receiving benefits | 2012-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-09-01 | 0 |
| Total of all active and inactive participants | 2012-09-01 | 181 |
| 2011: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-09-01 | 127 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-09-01 | 154 |
| Number of retired or separated participants receiving benefits | 2011-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-09-01 | 0 |
| Total of all active and inactive participants | 2011-09-01 | 154 |
| 2010: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-09-01 | 101 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-09-01 | 127 |
| Number of retired or separated participants receiving benefits | 2010-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-09-01 | 0 |
| Total of all active and inactive participants | 2010-09-01 | 127 |
| 2009: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-09-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-09-01 | 101 |
| Number of retired or separated participants receiving benefits | 2009-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-09-01 | 0 |
| Total of all active and inactive participants | 2009-09-01 | 101 |
| 2008: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-09-01 | 111 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-09-01 | 109 |
| Number of retired or separated participants receiving benefits | 2008-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2008-09-01 | 0 |
| Total of all active and inactive participants | 2008-09-01 | 109 |
| 2007: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-09-01 | 114 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-09-01 | 111 |
| Number of retired or separated participants receiving benefits | 2007-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2007-09-01 | 0 |
| Total of all active and inactive participants | 2007-09-01 | 111 |
| 2006: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2006 401k membership |
|---|
| Total participants, beginning-of-year | 2006-09-01 | 114 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-09-01 | 114 |
| Number of retired or separated participants receiving benefits | 2006-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2006-09-01 | 0 |
| Total of all active and inactive participants | 2006-09-01 | 114 |
| 2023: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2023 form 5500 responses |
|---|
| 2023-09-01 | Type of plan entity | Single employer plan |
| 2023-09-01 | Plan funding arrangement – Insurance | Yes |
| 2023-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2022 form 5500 responses |
|---|
| 2022-09-01 | Type of plan entity | Single employer plan |
| 2022-09-01 | Plan funding arrangement – Insurance | Yes |
| 2022-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2021 form 5500 responses |
|---|
| 2021-09-01 | Type of plan entity | Single employer plan |
| 2021-09-01 | Plan funding arrangement – Insurance | Yes |
| 2021-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2020 form 5500 responses |
|---|
| 2020-09-01 | Type of plan entity | Single employer plan |
| 2020-09-01 | Plan funding arrangement – Insurance | Yes |
| 2020-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2019 form 5500 responses |
|---|
| 2019-09-01 | Type of plan entity | Single employer plan |
| 2019-09-01 | Plan funding arrangement – Insurance | Yes |
| 2019-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2018 form 5500 responses |
|---|
| 2018-09-01 | Type of plan entity | Single employer plan |
| 2018-09-01 | Plan funding arrangement – Insurance | Yes |
| 2018-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2017 form 5500 responses |
|---|
| 2017-09-01 | Type of plan entity | Single employer plan |
| 2017-09-01 | Plan funding arrangement – Insurance | Yes |
| 2017-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2016 form 5500 responses |
|---|
| 2016-09-01 | Type of plan entity | Single employer plan |
| 2016-09-01 | Submission has been amended | No |
| 2016-09-01 | This submission is the final filing | No |
| 2016-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-09-01 | Plan is a collectively bargained plan | No |
| 2016-09-01 | Plan funding arrangement – Insurance | Yes |
| 2016-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2015 form 5500 responses |
|---|
| 2015-09-01 | Type of plan entity | Single employer plan |
| 2015-09-01 | Submission has been amended | No |
| 2015-09-01 | This submission is the final filing | No |
| 2015-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-09-01 | Plan is a collectively bargained plan | No |
| 2015-09-01 | Plan funding arrangement – Insurance | Yes |
| 2015-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2014 form 5500 responses |
|---|
| 2014-09-01 | Type of plan entity | Single employer plan |
| 2014-09-01 | Submission has been amended | No |
| 2014-09-01 | This submission is the final filing | No |
| 2014-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-09-01 | Plan is a collectively bargained plan | No |
| 2014-09-01 | Plan funding arrangement – Insurance | Yes |
| 2014-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2013 form 5500 responses |
|---|
| 2013-09-01 | Type of plan entity | Single employer plan |
| 2013-09-01 | Submission has been amended | No |
| 2013-09-01 | This submission is the final filing | No |
| 2013-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-09-01 | Plan is a collectively bargained plan | No |
| 2013-09-01 | Plan funding arrangement – Insurance | Yes |
| 2013-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2012 form 5500 responses |
|---|
| 2012-09-01 | Type of plan entity | Single employer plan |
| 2012-09-01 | Submission has been amended | No |
| 2012-09-01 | This submission is the final filing | No |
| 2012-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-09-01 | Plan is a collectively bargained plan | No |
| 2012-09-01 | Plan funding arrangement – Insurance | Yes |
| 2012-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2011 form 5500 responses |
|---|
| 2011-09-01 | Type of plan entity | Single employer plan |
| 2011-09-01 | Submission has been amended | No |
| 2011-09-01 | This submission is the final filing | No |
| 2011-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-09-01 | Plan is a collectively bargained plan | No |
| 2011-09-01 | Plan funding arrangement – Insurance | Yes |
| 2011-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2010 form 5500 responses |
|---|
| 2010-09-01 | Type of plan entity | Single employer plan |
| 2010-09-01 | Submission has been amended | No |
| 2010-09-01 | This submission is the final filing | No |
| 2010-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-09-01 | Plan is a collectively bargained plan | No |
| 2010-09-01 | Plan funding arrangement – Insurance | Yes |
| 2010-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2009 form 5500 responses |
|---|
| 2009-09-01 | Type of plan entity | Single employer plan |
| 2009-09-01 | Submission has been amended | No |
| 2009-09-01 | This submission is the final filing | No |
| 2009-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-09-01 | Plan is a collectively bargained plan | No |
| 2009-09-01 | Plan funding arrangement – Insurance | Yes |
| 2009-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2008 form 5500 responses |
|---|
| 2008-09-01 | Type of plan entity | Single employer plan |
| 2008-09-01 | Submission has been amended | No |
| 2008-09-01 | This submission is the final filing | No |
| 2008-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-09-01 | Plan is a collectively bargained plan | No |
| 2008-09-01 | Plan funding arrangement – Insurance | Yes |
| 2008-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2007 form 5500 responses |
|---|
| 2007-09-01 | Type of plan entity | Single employer plan |
| 2007-09-01 | Submission has been amended | No |
| 2007-09-01 | This submission is the final filing | No |
| 2007-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-09-01 | Plan is a collectively bargained plan | No |
| 2007-09-01 | Plan funding arrangement – Insurance | Yes |
| 2007-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2006: GRUPO ANTOLIN PRIMERA AUTOMOTIVE SYSTEMS HEALTH 2006 form 5500 responses |
|---|
| 2006-09-01 | Type of plan entity | Single employer plan |
| 2006-09-01 | First time form 5500 has been submitted | Yes |
| 2006-09-01 | Submission has been amended | No |
| 2006-09-01 | This submission is the final filing | No |
| 2006-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2006-09-01 | Plan is a collectively bargained plan | No |
| 2006-09-01 | Plan funding arrangement – Insurance | Yes |
| 2006-09-01 | Plan benefit arrangement – Insurance | Yes |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 953602 |
| Policy instance | 5 |
| Insurance contract or identification number | 953602 | | Number of Individuals Covered | 141 | | Insurance policy start date | 2023-09-01 | | Insurance policy end date | 2024-08-31 | | Total amount of commissions paid to insurance broker | USD $7,904 | | Total amount of fees paid to insurance company | USD $1,447 | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $77,884 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 447 |
| Policy instance | 4 |
| Insurance contract or identification number | 447 | | Number of Individuals Covered | 200 | | Insurance policy start date | 2023-09-01 | | Insurance policy end date | 2024-08-31 | | Total amount of commissions paid to insurance broker | USD $5,385 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 | 264689 |
| Policy instance | 3 |
| Insurance contract or identification number | 264689 | | Number of Individuals Covered | 134 | | Insurance policy start date | 2023-09-01 | | Insurance policy end date | 2024-08-31 | | Total amount of commissions paid to insurance broker | USD $32,205 | | Total amount of fees paid to insurance company | USD $840 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10071451001 |
| Policy instance | 2 |
| Insurance contract or identification number | 10071451001 | | Number of Individuals Covered | 193 | | Insurance policy start date | 2023-09-01 | | Insurance policy end date | 2024-08-31 | | Total amount of commissions paid to insurance broker | USD $1,191 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,831 | | 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 | 264689 |
| Policy instance | 1 |
| Insurance contract or identification number | 264689 | | Number of Individuals Covered | 56 | | Insurance policy start date | 2023-09-01 | | Insurance policy end date | 2024-08-31 | | Total amount of commissions paid to insurance broker | USD $14,523 | | Total amount of fees paid to insurance company | USD $425 | | Health Insurance Welfare Benefit | Yes | | 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 | 264689 |
| Policy instance | 1 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 8208 |
| Policy instance | 2 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10071451001 |
| Policy instance | 3 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 447 |
| Policy instance | 4 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 264689 |
| Policy instance | 5 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 953602 |
| Policy instance | 6 |
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 264689 |
| Policy instance | 1 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10071451001 |
| Policy instance | 2 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 264689 |
| Policy instance | 3 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 953602 |
| Policy instance | 4 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 8208 |
| Policy instance | 5 |
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 264689 |
| Policy instance | 1 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10071451001 |
| Policy instance | 2 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 264689 |
| Policy instance | 3 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 8208 |
| Policy instance | 4 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 953602 |
| Policy instance | 5 |
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 264689 |
| Policy instance | 1 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 953602 |
| Policy instance | 3 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10071451001 |
| Policy instance | 2 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 264689 |
| Policy instance | 4 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 8208 |
| Policy instance | 5 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 8208 |
| Policy instance | 5 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 10244487 |
| Policy instance | 4 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 264689 |
| Policy instance | 3 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10071451001 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 7031707 |
| Policy instance | 1 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 8208 |
| Policy instance | 6 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 8208 |
| Policy instance | 5 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 264689 |
| Policy instance | 4 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 498235 |
| Policy instance | 3 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10071451001 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 264689 |
| Policy instance | 1 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 447/8208 |
| Policy instance | 1 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 498235 |
| Policy instance | 2 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 264689/0001 |
| Policy instance | 3 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 8606 |
| Policy instance | 3 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 447/8208 |
| Policy instance | 1 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 8606 |
| Policy instance | 2 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 264689/0001 |
| Policy instance | 4 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 264689/0001 |
| Policy instance | 3 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 447/8208 |
| Policy instance | 1 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 8606 |
| Policy instance | 2 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 447/8208 |
| Policy instance | 1 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 10094272 |
| Policy instance | 2 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 8606 |
| Policy instance | 3 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 264689/0001 |
| Policy instance | 4 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 264689/0001 |
| Policy instance | 3 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 10094272 |
| Policy instance | 2 |
| GOLDEN DENTAL PLAN (National Association of Insurance Commissioners NAIC id number: 11113 ) |
| Policy contract number | 00 |
| Policy instance | 1 |
| GOLDEN DENTAL PLAN (National Association of Insurance Commissioners NAIC id number: 11113 ) |
| Policy contract number | 00 |
| Policy instance | 1 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 10094272 |
| Policy instance | 2 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 264689/0001 |
| Policy instance | 3 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 10094272 |
| Policy instance | 3 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 401043 |
| Policy instance | 2 |
| GOLDEN DENTAL PLAN (National Association of Insurance Commissioners NAIC id number: 11113 ) |
| Policy contract number | 00 |
| Policy instance | 1 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 264689/0001 |
| Policy instance | 4 |
| GOLDEN DENTAL PLAN (National Association of Insurance Commissioners NAIC id number: 11113 ) |
| Policy contract number | 00 |
| Policy instance | 1 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 264689/0001 |
| Policy instance | 3 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 401043 |
| Policy instance | 2 |
