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NORTH AMERICAN BANCARD GROUP HEALTH PLAN 401k Plan overview

Plan NameNORTH AMERICAN BANCARD GROUP HEALTH PLAN
Plan identification number 501

NORTH AMERICAN BANCARD GROUP HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Prepaid legal
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

NAB HOLDINGS, LLC has sponsored the creation of one or more 401k plans.

Company Name:NAB HOLDINGS, LLC
Employer identification number (EIN):453514691
NAIC Classification:522300
NAIC Description: Activities Related to Credit Intermediation

Additional information about NAB HOLDINGS, LLC

Jurisdiction of Incorporation: Michigan Secretary of State
Incorporation Date: 2011-09-14
Company Identification Number: D63759
Legal Registered Office Address: 250 STEPHENSON HWY TROY 480831117


United States of America (USA)

More information about NAB HOLDINGS, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTH AMERICAN BANCARD GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01KIRK HAGGARTY
5012016-01-01KIRK HAGGARTY
5012015-01-01KIRK HAGGARTY
5012014-01-01KIRK HAGGARTY
5012013-01-01KIRK HAGGARTY

Plan Statistics for NORTH AMERICAN BANCARD GROUP HEALTH PLAN

401k plan membership statisitcs for NORTH AMERICAN BANCARD GROUP HEALTH PLAN

Measure Date Value
2022: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01864
Total number of active participants reported on line 7a of the Form 55002022-01-011,095
Number of retired or separated participants receiving benefits2022-01-019
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-011,104
2021: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01855
Total number of active participants reported on line 7a of the Form 55002021-01-01854
Number of retired or separated participants receiving benefits2021-01-0110
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01864
2020: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01872
Total number of active participants reported on line 7a of the Form 55002020-01-01851
Number of retired or separated participants receiving benefits2020-01-014
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01855
2019: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01790
Total number of active participants reported on line 7a of the Form 55002019-01-01871
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01872
2018: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01714
Total number of active participants reported on line 7a of the Form 55002018-01-01779
Number of retired or separated participants receiving benefits2018-01-0111
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01790
2017: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01708
Total number of active participants reported on line 7a of the Form 55002017-01-01709
Number of retired or separated participants receiving benefits2017-01-018
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01717
2016: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01652
Total number of active participants reported on line 7a of the Form 55002016-01-01699
Number of retired or separated participants receiving benefits2016-01-019
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01708
2015: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01504
Total number of active participants reported on line 7a of the Form 55002015-01-01652
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01652
2014: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01508
Total number of active participants reported on line 7a of the Form 55002014-01-01504
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01504
2013: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01500
Total number of active participants reported on line 7a of the Form 55002013-01-01508
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01508
Total participants2013-01-01508

Form 5500 Responses for NORTH AMERICAN BANCARD GROUP HEALTH PLAN

2022: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: NORTH AMERICAN BANCARD GROUP HEALTH PLAN 2013 form 5500 responses
2013-01-01Type of plan entityMulitple employer plan
2013-01-01First time form 5500 has been submittedYes
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00939702
Policy instance 4
Insurance contract or identification number00939702
Number of Individuals Covered53
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $613
Total amount of fees paid to insurance companyUSD $53
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $613
Amount paid for insurance broker fees53
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number302207
Policy instance 3
Insurance contract or identification number302207
Number of Individuals Covered128
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,924
Other welfare benefits providedLEGAL SERVICES PLAN MEMBERSHIPS
Welfare Benefit Premiums Paid to CarrierUSD $20,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,103
Insurance broker organization code?4
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00481908
Policy instance 2
Insurance contract or identification number00481908
Number of Individuals Covered1095
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $25,414
Total amount of fees paid to insurance companyUSD $45,287
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, ACCIDENT, VOLUNTARY: CI, HI
Welfare Benefit Premiums Paid to CarrierUSD $1,259,520
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,414
Amount paid for insurance broker fees45287
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number280283
Policy instance 1
Insurance contract or identification number280283
Number of Individuals Covered1775
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $37,520
Total amount of fees paid to insurance companyUSD $8,495
Welfare Benefit Premiums Paid to CarrierUSD $1,072,003
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,520
Amount paid for insurance broker fees8495
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number302207
Policy instance 3
Insurance contract or identification number302207
Number of Individuals Covered72
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,890
Other welfare benefits providedLEGAL SERVICES PLAN MEMBERSHIPS
Welfare Benefit Premiums Paid to CarrierUSD $10,378
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,277
Insurance broker organization code?4
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00481908
Policy instance 2
Insurance contract or identification number00481908
Number of Individuals Covered854
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $15,848
Total amount of fees paid to insurance companyUSD $16,431
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, ACCIDENT, VOLUNTARY CI
Welfare Benefit Premiums Paid to CarrierUSD $1,149,795
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,848
Amount paid for insurance broker fees16431
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number280283
Policy instance 1
Insurance contract or identification number280283
Number of Individuals Covered1405
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $29,822
Total amount of fees paid to insurance companyUSD $4,146
Welfare Benefit Premiums Paid to CarrierUSD $832,067
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,822
Amount paid for insurance broker fees4146
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number280283
Policy instance 1
Insurance contract or identification number280283
Number of Individuals Covered1379
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $30,433
Total amount of fees paid to insurance companyUSD $8,520
Welfare Benefit Premiums Paid to CarrierUSD $869,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,433
Amount paid for insurance broker fees8520
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00481908
Policy instance 2
Insurance contract or identification number00481908
Number of Individuals Covered851
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of fees paid to insurance companyUSD $21,114
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $887,455
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees21114
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00481908
Policy instance 2
Insurance contract or identification number00481908
Number of Individuals Covered871
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of fees paid to insurance companyUSD $13,314
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $948,180
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees13314
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract numberGROUP 58670
Policy instance 1
Insurance contract or identification numberGROUP 58670
Number of Individuals Covered713
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $26,547
Welfare Benefit Premiums Paid to CarrierUSD $757,828
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,547
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 751902
Policy instance 7
Insurance contract or identification numberLK 751902
Number of Individuals Covered691
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $73,511
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 964817
Policy instance 6
Insurance contract or identification numberLK 964817
Number of Individuals Covered691
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,975
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00481908
Policy instance 5
Insurance contract or identification number00481908
Number of Individuals Covered595
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of fees paid to insurance companyUSD $13,688
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $507,232
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees13688
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX967014
Policy instance 4
Insurance contract or identification numberFLX967014
Number of Individuals Covered829
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,170
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 number00280283/0001
Policy instance 3
Insurance contract or identification number00280283/0001
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $90,893
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 numberGROUP 58670
Policy instance 2
Insurance contract or identification numberGROUP 58670
Number of Individuals Covered595
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $21,206
Total amount of fees paid to insurance companyUSD $7,224
Welfare Benefit Premiums Paid to CarrierUSD $606,242
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,206
Amount paid for insurance broker fees7224
Additional information about fees paid to insurance brokerFEES NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 968525
Policy instance 1
Insurance contract or identification numberOK 968525
Number of Individuals Covered799
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $10,999
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00481908
Policy instance 5
Insurance contract or identification number00481908
Number of Individuals Covered613
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $28,403
Total amount of fees paid to insurance companyUSD $3,725
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $469,845
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,416
Insurance broker organization code?3
Amount paid for insurance broker fees3725
Insurance broker nameLOCKTON COMPANIES, LLC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number211994
Policy instance 4
Insurance contract or identification number211994
Number of Individuals Covered652
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $9,638
Total amount of fees paid to insurance companyUSD $2,753
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $137,758
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,638
Amount paid for insurance broker fees2753
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number0280283/001
Policy instance 3
Insurance contract or identification number0280283/001
Number of Individuals Covered403
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $35,044
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $973,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,044
Insurance broker organization code?3
Insurance broker nameJAY SCHREIBMAN
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract numberGROUP 58670
Policy instance 2
Insurance contract or identification numberGROUP 58670
Number of Individuals Covered791
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $54,557
Total amount of fees paid to insurance companyUSD $3,013
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $54,557
Insurance broker organization code?3
Amount paid for insurance broker fees3013
Additional information about fees paid to insurance brokerFEES
Insurance broker nameLSG INSURANCE PARTNERS
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number211995
Policy instance 1
Insurance contract or identification number211995
Number of Individuals Covered69
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,707
Total amount of fees paid to insurance companyUSD $361
Other welfare benefits providedLIFESTYLE LIFE AND AD&D
Welfare Benefit Premiums Paid to CarrierUSD $21,438
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,707
Amount paid for insurance broker fees361
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number211995
Policy instance 1
Insurance contract or identification number211995
Number of Individuals Covered49
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,015
Total amount of fees paid to insurance companyUSD $308
Other welfare benefits providedLIFESTYLE LIFE AND AD&D
Welfare Benefit Premiums Paid to CarrierUSD $20,101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,877
Amount paid for insurance broker fees156
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract numberGROUP 58670
Policy instance 2
Insurance contract or identification numberGROUP 58670
Number of Individuals Covered463
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $39,038
Total amount of fees paid to insurance companyUSD $4,160
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,638
Insurance broker organization code?3
Amount paid for insurance broker fees4160
Additional information about fees paid to insurance brokerFEES
Insurance broker nameLSG INSURANCE PARTNERS
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number0280283/001
Policy instance 3
Insurance contract or identification number0280283/001
Number of Individuals Covered378
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $32,563
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $863,524
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,563
Insurance broker organization code?3
Insurance broker nameJAY SCHREIBMAN
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number211994
Policy instance 4
Insurance contract or identification number211994
Number of Individuals Covered504
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $8,915
Total amount of fees paid to insurance companyUSD $1,758
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $114,305
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,501
Amount paid for insurance broker fees881
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00481908
Policy instance 5
Insurance contract or identification number00481908
Number of Individuals Covered439
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $23,792
Total amount of fees paid to insurance companyUSD $8,371
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $378,731
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,909
Amount paid for insurance broker fees8371
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number211995
Policy instance 6
Insurance contract or identification number211995
Number of Individuals Covered47
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,890
Total amount of fees paid to insurance companyUSD $312
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $16,597
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,890
Amount paid for insurance broker fees312
Insurance broker organization code?3
Insurance broker nameLUBIN SCHWARTZ & GOLDMAN
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number211994
Policy instance 5
Insurance contract or identification number211994
Number of Individuals Covered508
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $10,241
Total amount of fees paid to insurance companyUSD $2,112
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $111,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,241
Amount paid for insurance broker fees2112
Insurance broker organization code?3
Insurance broker nameLUBIN SCHWARTZ & GOLDMAN
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number0280283/002
Policy instance 4
Insurance contract or identification number0280283/002
Number of Individuals Covered17
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,604
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $64,591
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 number0280283/001
Policy instance 3
Insurance contract or identification number0280283/001
Number of Individuals Covered394
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $35,527
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $1,380,615
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 numberGROUP 58670
Policy instance 2
Insurance contract or identification numberGROUP 58670
Number of Individuals Covered367
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $38,041
Total amount of fees paid to insurance companyUSD $422
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees422
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $38,041
Insurance broker nameJAY R SCHREIBMAN
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00481908
Policy instance 1
Insurance contract or identification number00481908
Number of Individuals Covered438
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $20,448
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $317,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,448
Insurance broker organization code?3
Insurance broker nameLUBIN SCHWARTZ & GOLDMAN INC

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