MICHIGAN HEALTHCARE PROFESSIONALS, P.C. has sponsored the creation of one or more 401k plans.
Additional information about MICHIGAN HEALTHCARE PROFESSIONALS, P.C.
Submission information for form 5500 for 401k plan MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS
401k plan membership statisitcs for MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS
| Measure | Date | Value |
|---|
| 2022: MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 974 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 997 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 997 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 1,994 |
| 2021: MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 903 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 974 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 974 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 1,948 |
| 2020: MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 935 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 903 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 903 |
| 2019: MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 920 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 935 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 935 |
| 2018: MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 920 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 920 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 920 |
| 2015: MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 855 |
| 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 | 855 |
| 2014: MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 0 |
| 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 | 0 |
| Measure | Date | Value |
|---|
| 2022 : MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 2022 401k financial data |
|---|
| Total income from all sources | 2022-12-31 | $0 |
| Total plan assets at end of year | 2022-12-31 | $0 |
| Total plan assets at beginning of year | 2022-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $0 |
| 2021 : MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 2021 401k financial data |
|---|
| Total income from all sources | 2021-12-31 | $0 |
| Total plan assets at end of year | 2021-12-31 | $0 |
| Total plan assets at beginning of year | 2021-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $0 |
| 2020 : MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 2020 401k financial data |
|---|
| Total income from all sources | 2020-12-31 | $0 |
| Total plan assets at end of year | 2020-12-31 | $0 |
| Total plan assets at beginning of year | 2020-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $0 |
| 2019 : MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 2019 401k financial data |
|---|
| Total income from all sources | 2019-12-31 | $11,175,161 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $11,175,161 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $9,653,235 |
| Total plan assets at end of year | 2019-12-31 | $0 |
| Total plan assets at beginning of year | 2019-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2019-12-31 | $852,852 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $11,175,161 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $669,074 |
| 2018 : MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 2018 401k financial data |
|---|
| Total income from all sources | 2018-12-31 | $10,248,429 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $10,248,429 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $8,833,854 |
| Total plan assets at end of year | 2018-12-31 | $0 |
| Total plan assets at beginning of year | 2018-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2018-12-31 | $764,256 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $10,248,429 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $650,319 |
| 2015 : MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $7,098,555 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $7,098,555 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $5,916,149 |
| Total plan assets at end of year | 2015-12-31 | $0 |
| Total plan assets at beginning of year | 2015-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2015-12-31 | $609,706 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $7,098,555 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $572,700 |
| 2014 : MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 2014 401k financial data |
|---|
| Total income from all sources | 2014-12-31 | $0 |
| Total plan assets at end of year | 2014-12-31 | $0 |
| Total plan assets at beginning of year | 2014-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $0 |
| 2022: MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 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: MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 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: MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 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: MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 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: MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 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 |
| 2015: MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 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: MICHIGAN HEALTHCARE PROFESSIONALS, P.C. SEC 125 BENEFITS 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 benefit arrangement – Insurance | Yes |
| PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 ) |
| Policy contract number | 796928 |
| Policy instance | 8 |
| Insurance contract or identification number | 796928 | | Number of Individuals Covered | 309 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $35,996 | | 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 $35,996 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 280004 |
| Policy instance | 1 |
| Insurance contract or identification number | 280004 | | Number of Individuals Covered | 997 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $208,821 | | Total amount of fees paid to insurance company | USD $6,979 | | Health Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | 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 $208,821 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 6979 |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 280004 |
| Policy instance | 2 |
| Insurance contract or identification number | 280004 | | Number of Individuals Covered | 289 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $34,433 | | Total amount of fees paid to insurance company | USD $1,792 | | Health Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | 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 $34,433 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1792 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010264609 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010264609 | | Number of Individuals Covered | 1455 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $76 | | Total amount of fees paid to insurance company | USD $2,071 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability 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 $76 | | Amount paid for insurance broker fees | 1812 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00472964 |
| Policy instance | 4 |
| Insurance contract or identification number | 00472964 | | Number of Individuals Covered | 1034 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | BASE COMMISSION |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010264610 |
| Policy instance | 5 |
| Insurance contract or identification number | 000010264610 | | Number of Individuals Covered | 776 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $22,767 | | Total amount of fees paid to insurance company | USD $11,207 | | Other welfare benefits provided | WEEKLY INCOME | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,990 | | Amount paid for insurance broker fees | 9754 | | Additional information about fees paid to insurance broker | FEES | | 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 | 6 |
| Insurance contract or identification number | 000400001000 | | Number of Individuals Covered | 464 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $25,634 | | Total amount of fees paid to insurance company | USD $12,950 | | Life 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 $21,440 | | Amount paid for insurance broker fees | 11337 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010264619 |
| Policy instance | 7 |
| Insurance contract or identification number | 000010264619 | | Number of Individuals Covered | 413 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $79,653 | | Total amount of fees paid to insurance company | USD $37,198 | | Life 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 $66,367 | | Amount paid for insurance broker fees | 32453 | | Additional information about fees paid to insurance broker | FESS | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | ACC-0000001839 |
| Policy instance | 2 |
| Insurance contract or identification number | ACC-0000001839 | | 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 $11,012 | | Total amount of fees paid to insurance company | USD $1,652 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,012 | | Amount paid for insurance broker fees | 1652 | | Additional information about fees paid to insurance broker | SUBSIDY | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010264609 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010264609 | | Number of Individuals Covered | 1416 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of fees paid to insurance company | USD $1,341 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1208 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00472964 |
| Policy instance | 4 |
| Insurance contract or identification number | 00472964 | | Number of Individuals Covered | 1034 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT INSURANCE | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | BASE COMMISSION |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010264610 |
| Policy instance | 5 |
| Insurance contract or identification number | 000010264610 | | Number of Individuals Covered | 652 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $18,199 | | Total amount of fees paid to insurance company | USD $7,528 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,199 | | Amount paid for insurance broker fees | 6999 | | Additional information about fees paid to insurance broker | FEES | | 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 | 6 |
| Insurance contract or identification number | 000400001000 | | Number of Individuals Covered | 1146 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $22,959 | | Total amount of fees paid to insurance company | 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 $22,959 | | Amount paid for insurance broker fees | 8830 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010264619 |
| Policy instance | 7 |
| Insurance contract or identification number | 000010264619 | | Number of Individuals Covered | 430 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $70,295 | | Total amount of fees paid to insurance company | USD $27,044 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $70,295 | | Amount paid for insurance broker fees | 25105 | | Additional information about fees paid to insurance broker | FESS | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | |
| Policy instance | 1 |
| Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00472964 |
| Policy instance | 4 |
| Insurance contract or identification number | 00472964 | | Number of Individuals Covered | 1034 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $44,534 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT INSURANCE | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $44,534 | | Additional information about fees paid to insurance broker | BASE COMMISSION |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 000000407671 |
| Policy instance | 3 |
| Insurance contract or identification number | 000000407671 | | Number of Individuals Covered | 1396 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $102,507 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability 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 $102,507 | | Additional information about fees paid to insurance broker | BASE COMMISSION |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 000000407672 |
| Policy instance | 2 |
| Insurance contract or identification number | 000000407672 | | Number of Individuals Covered | 475 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $17,215 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,215 | | Additional information about fees paid to insurance broker | BASE COMMISSION |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | |
| Policy instance | 1 |
| Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $30,304 | | Total amount of fees paid to insurance company | USD $5,646 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $30,304 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 5646 |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | |
| Policy instance | 1 |
| Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 000000407672 |
| Policy instance | 2 |
| Insurance contract or identification number | 000000407672 | | Number of Individuals Covered | 522 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $20,344 | | Total amount of fees paid to insurance company | USD $1,174 | | 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 $156,494 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,344 | | Additional information about fees paid to insurance broker | BASE COMMISSION | | Amount paid for insurance broker fees | 1174 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 000000407671 |
| Policy instance | 3 |
| Insurance contract or identification number | 000000407671 | | Number of Individuals Covered | 1535 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $104,632 | | Total amount of fees paid to insurance company | USD $6,036 | | 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 $804,859 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $104,632 | | Additional information about fees paid to insurance broker | BASE COMMISSION | | Amount paid for insurance broker fees | 6036 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00472964 |
| Policy instance | 4 |
| Insurance contract or identification number | 00472964 | | Number of Individuals Covered | 1082 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $36,463 | | Total amount of fees paid to insurance company | USD $10,387 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $882,544 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $36,463 | | Additional information about fees paid to insurance broker | BASE COMMISSION | | Amount paid for insurance broker fees | 10387 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 000000407672 |
| Policy instance | 2 |
| Insurance contract or identification number | 000000407672 | | Number of Individuals Covered | 544 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | BASE COMMISSION |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | |
| Policy instance | 1 |
| Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 000000407671 |
| Policy instance | 3 |
| Insurance contract or identification number | 000000407671 | | Number of Individuals Covered | 1419 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | BASE COMMISSION |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00472964 |
| Policy instance | 4 |
| Insurance contract or identification number | 00472964 | | Number of Individuals Covered | 1031 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $35,110 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $851,538 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | BASE COMMISSION |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | |
| Policy instance | 1 |
| Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | 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 | 00280004/0001 |
| Policy instance | 2 |
| Insurance contract or identification number | 00280004/0001 | | Number of Individuals Covered | 610 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $43,292 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,561,912 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $43,292 | | Additional information about fees paid to insurance broker | COMMISSIONS PAID | | Insurance broker name | |
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| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | GROUP 55520 |
| Policy instance | 1 |
| Insurance contract or identification number | GROUP 55520 | | Number of Individuals Covered | 754 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $50,387 | | Total amount of fees paid to insurance company | USD $6,161 | | Health Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid in cash? | 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 $50,387 | | Additional information about fees paid to insurance broker | SALES AND BASE COMMISSION | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 6161 | | Insurance broker name | GRACE & PORTA BENEFITS |
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