IRONWORKERS FENCE ERECTION HEALTH has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan IRONWORKERS FENCE ERECTION HEALTH
| Measure | Date | Value |
|---|
| 2015: IRONWORKERS FENCE ERECTION HEALTH 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 52 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 0 |
| Number of employers contributing to the scheme | 2015-01-01 | 6 |
| 2014: IRONWORKERS FENCE ERECTION HEALTH 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 58 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 52 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| 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 | 52 |
| Number of employers contributing to the scheme | 2014-01-01 | 6 |
| 2013: IRONWORKERS FENCE ERECTION HEALTH 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 62 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 58 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
| 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 | 58 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| 2012: IRONWORKERS FENCE ERECTION HEALTH 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 53 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 62 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
| Total of all active and inactive participants | 2012-01-01 | 62 |
| Number of employers contributing to the scheme | 2012-01-01 | 6 |
| 2011: IRONWORKERS FENCE ERECTION HEALTH 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 53 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 53 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 0 |
| Total of all active and inactive participants | 2011-01-01 | 53 |
| 2009: IRONWORKERS FENCE ERECTION HEALTH 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 37 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 50 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 50 |
| Number of employers contributing to the scheme | 2009-01-01 | 11 |
| Measure | Date | Value |
|---|
| 2015 : IRONWORKERS FENCE ERECTION HEALTH 2015 401k financial data |
|---|
| Transfers to/from the plan | 2015-08-31 | $-307,050 |
| Total plan liabilities at end of year | 2015-08-31 | $0 |
| Total plan liabilities at beginning of year | 2015-08-31 | $28,280 |
| Total income from all sources | 2015-08-31 | $307,600 |
| Expenses. Total of all expenses incurred | 2015-08-31 | $322,935 |
| Benefits paid (including direct rollovers) | 2015-08-31 | $304,399 |
| Total plan assets at end of year | 2015-08-31 | $0 |
| Total plan assets at beginning of year | 2015-08-31 | $350,665 |
| Value of fidelity bond covering the plan | 2015-08-31 | $100,000 |
| Expenses. Other expenses not covered elsewhere | 2015-08-31 | $15,636 |
| Other income received | 2015-08-31 | $13 |
| Net income (gross income less expenses) | 2015-08-31 | $-15,335 |
| Net plan assets at end of year (total assets less liabilities) | 2015-08-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-08-31 | $322,385 |
| Total contributions received or receivable from employer(s) | 2015-08-31 | $307,587 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-08-31 | $2,900 |
| 2014 : IRONWORKERS FENCE ERECTION HEALTH 2014 401k financial data |
|---|
| Transfers to/from the plan | 2014-12-31 | $0 |
| Total plan liabilities at end of year | 2014-12-31 | $28,280 |
| Total plan liabilities at beginning of year | 2014-12-31 | $44,961 |
| Total income from all sources | 2014-12-31 | $401,109 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $437,849 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $408,530 |
| Total plan assets at end of year | 2014-12-31 | $350,665 |
| Total plan assets at beginning of year | 2014-12-31 | $404,086 |
| Value of fidelity bond covering the plan | 2014-12-31 | $100,000 |
| Expenses. Other expenses not covered elsewhere | 2014-12-31 | $25,982 |
| Other income received | 2014-12-31 | $21 |
| Net income (gross income less expenses) | 2014-12-31 | $-36,740 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $322,385 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $359,125 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $401,088 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $3,337 |
| 2013 : IRONWORKERS FENCE ERECTION HEALTH 2013 401k financial data |
|---|
| Transfers to/from the plan | 2013-12-31 | $0 |
| Total plan liabilities at end of year | 2013-12-31 | $44,961 |
| Total plan liabilities at beginning of year | 2013-12-31 | $41,976 |
| Total income from all sources | 2013-12-31 | $384,372 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $461,391 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $431,182 |
| Total plan assets at end of year | 2013-12-31 | $404,086 |
| Total plan assets at beginning of year | 2013-12-31 | $478,120 |
| Value of fidelity bond covering the plan | 2013-12-31 | $100,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $6,913 |
| Expenses. Other expenses not covered elsewhere | 2013-12-31 | $27,559 |
| Other income received | 2013-12-31 | $25 |
| Net income (gross income less expenses) | 2013-12-31 | $-77,019 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $359,125 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $436,144 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $377,434 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $2,650 |
| 2012 : IRONWORKERS FENCE ERECTION HEALTH 2012 401k financial data |
|---|
| Transfers to/from the plan | 2012-12-31 | $0 |
| Total plan liabilities at end of year | 2012-12-31 | $41,976 |
| Total plan liabilities at beginning of year | 2012-12-31 | $33,648 |
| Total income from all sources | 2012-12-31 | $399,413 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $427,190 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $389,292 |
| Total plan assets at end of year | 2012-12-31 | $478,120 |
| Total plan assets at beginning of year | 2012-12-31 | $497,569 |
| Value of fidelity bond covering the plan | 2012-12-31 | $100,000 |
| Total contributions received or receivable from participants | 2012-12-31 | $2,968 |
| Expenses. Other expenses not covered elsewhere | 2012-12-31 | $34,703 |
| Other income received | 2012-12-31 | $32 |
| Net income (gross income less expenses) | 2012-12-31 | $-27,777 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $436,144 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $463,921 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $396,413 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-12-31 | $3,195 |
| 2011 : IRONWORKERS FENCE ERECTION HEALTH 2011 401k financial data |
|---|
| Transfers to/from the plan | 2011-12-31 | $0 |
| Total plan liabilities at end of year | 2011-12-31 | $33,648 |
| Total plan liabilities at beginning of year | 2011-12-31 | $49,423 |
| Total income from all sources | 2011-12-31 | $402,392 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $369,296 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $340,476 |
| Total plan assets at end of year | 2011-12-31 | $497,569 |
| Total plan assets at beginning of year | 2011-12-31 | $480,248 |
| Value of fidelity bond covering the plan | 2011-12-31 | $100,000 |
| Other income received | 2011-12-31 | $778 |
| Net income (gross income less expenses) | 2011-12-31 | $33,096 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $463,921 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $430,825 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $401,614 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-31 | $28,820 |
| 2010 : IRONWORKERS FENCE ERECTION HEALTH 2010 401k financial data |
|---|
| Transfers to/from the plan | 2010-12-31 | $0 |
| Total plan liabilities at end of year | 2010-12-31 | $49,423 |
| Total plan liabilities at beginning of year | 2010-12-31 | $16,959 |
| Total income from all sources | 2010-12-31 | $419,062 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $336,386 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $305,863 |
| Total plan assets at end of year | 2010-12-31 | $480,248 |
| Total plan assets at beginning of year | 2010-12-31 | $365,108 |
| Value of fidelity bond covering the plan | 2010-12-31 | $100,000 |
| Expenses. Other expenses not covered elsewhere | 2010-12-31 | $28,023 |
| Other income received | 2010-12-31 | $3,657 |
| Net income (gross income less expenses) | 2010-12-31 | $82,676 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $430,825 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $348,149 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $415,405 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $2,500 |
| 2015: IRONWORKERS FENCE ERECTION HEALTH 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Multi-employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | Yes |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2015-01-01 | Plan is a collectively bargained plan | Yes |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: IRONWORKERS FENCE ERECTION HEALTH 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Multi-employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | Yes |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: IRONWORKERS FENCE ERECTION HEALTH 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Multi-employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | Yes |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: IRONWORKERS FENCE ERECTION HEALTH 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Multi-employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | Yes |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: IRONWORKERS FENCE ERECTION HEALTH 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Multi-employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | Yes |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: IRONWORKERS FENCE ERECTION HEALTH 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Multi-employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | Yes |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| ASSOCIATED MUTUAL (National Association of Insurance Commissioners NAIC id number: 87882 ) |
| Policy contract number | AM-8002 |
| Policy instance | 1 |
| Insurance contract or identification number | AM-8002 | | Number of Individuals Covered | 51 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare 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 | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $3,278 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00277853/0001 |
| Policy instance | 2 |
| Insurance contract or identification number | 00277853/0001 | | Number of Individuals Covered | 100 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $17,757 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | 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 | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $403,075 | | Commission paid to Insurance Broker | USD $17,757 | | Insurance broker organization code? | 3 | | Insurance broker name | INNOVATIVE BENEFIT SOLUTIONS |
|
| ASSOCIATED MUTUAL (National Association of Insurance Commissioners NAIC id number: 87882 ) |
| Policy contract number | AM-8002 |
| Policy instance | 1 |
| Insurance contract or identification number | AM-8002 | | Number of Individuals Covered | 51 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare 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 | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $5,997 |
|
| ASSOCIATED MUTUAL (National Association of Insurance Commissioners NAIC id number: 87882 ) |
| Policy contract number | AM-8002 |
| Policy instance | 1 |
| Insurance contract or identification number | AM-8002 | | Number of Individuals Covered | 58 | | Insurance policy start date | 2012-08-01 | | Insurance policy end date | 2013-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare 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 | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $6,366 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00277853/0001 |
| Policy instance | 2 |
| Insurance contract or identification number | 00277853/0001 | | Number of Individuals Covered | 94 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $18,169 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | 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 | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $451,224 | | Commission paid to Insurance Broker | USD $18,169 | | Insurance broker organization code? | 3 | | Insurance broker name | INNOVATIVE BENEFIT SOLUTIONS |
|
| ASSOCIATED MUTUAL (National Association of Insurance Commissioners NAIC id number: 87882 ) |
| Policy contract number | AM-8002 |
| Policy instance | 1 |
| Insurance contract or identification number | AM-8002 | | Number of Individuals Covered | 62 | | Insurance policy start date | 2011-08-01 | | Insurance policy end date | 2012-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare 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 | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $6,204 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00277853/0001 |
| Policy instance | 2 |
| Insurance contract or identification number | 00277853/0001 | | Number of Individuals Covered | 103 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $15,587 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | 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 | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $314,375 | | Commission paid to Insurance Broker | USD $15,587 | | Insurance broker organization code? | 3 | | Insurance broker name | INNOVATIVE BENEFIT SOLUTIONS |
|
| ASSOCIATED MUTUAL (National Association of Insurance Commissioners NAIC id number: 87882 ) |
| Policy contract number | AM-8002 |
| Policy instance | 1 |
| Insurance contract or identification number | AM-8002 | | Number of Individuals Covered | 59 | | Insurance policy start date | 2010-08-01 | | Insurance policy end date | 2011-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare 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 | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $7,076 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00277853/0001 |
| Policy instance | 2 |
| Insurance contract or identification number | 00277853/0001 | | Number of Individuals Covered | 106 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $18,413 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | 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 | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No |
|
| ASSOCIATED MUTUAL (National Association of Insurance Commissioners NAIC id number: 87882 ) |
| Policy contract number | AM-8002 |
| Policy instance | 1 |
| Insurance contract or identification number | AM-8002 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2009-08-01 | | Insurance policy end date | 2010-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare 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 | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $5,284 |
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| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00277853/0001 |
| Policy instance | 2 |
| Insurance contract or identification number | 00277853/0001 | | Number of Individuals Covered | 67 | | Insurance policy start date | 2009-03-01 | | Insurance policy end date | 2010-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | 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 | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $185,402 |
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