401k Plan data: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN plan

HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN
Plan identification number	501

HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN Benefits

401k Plan Type	Welfare 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 Other welfare benefit cover

401k Sponsoring company profile

HANON SYSTEMS USA, LLC has sponsored the creation of one or more 401k plans.

Company Name: HANON SYSTEMS USA, LLC

Employer identification number (EIN): 611697358

NAIC Classification: 336300

Additional information about HANON SYSTEMS USA, LLC

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 2013-11-20

Company Identification Number: 0801886869

Legal Registered Office Address: 39600 LEWIS DR

NOVI
United States of America (USA)
48377

More information about HANON SYSTEMS USA, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01
501 2021-01-01
501 2020-01-01
501 2019-01-01
501 2018-01-01
501 2017-01-01 LAURA PARKS ROBERT BERTRAND 2018-10-12
501 2016-01-01 CHERYL WEILAND ROBERT BERTRAND 2017-10-06
501 2015-08-01 CHERYL WEILAND DAVIDE PICCIRILLI 2016-10-10

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2022-01-01
501	2021-01-01
501	2020-01-01
501	2019-01-01
501	2018-01-01
501	2017-01-01	LAURA PARKS	ROBERT BERTRAND	2018-10-12
501	2016-01-01	CHERYL WEILAND	ROBERT BERTRAND	2017-10-06
501	2015-08-01	CHERYL WEILAND	DAVIDE PICCIRILLI	2016-10-10

Plan Statistics for HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN

401k plan membership statisitcs for HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN

Measure Date Value
2022: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 613
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 635
Number of retired or separated participants receiving benefits 2022-01-01 34
Total of all active and inactive participants 2022-01-01 669
2021: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 590
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 593
Number of retired or separated participants receiving benefits 2021-01-01 20
Total of all active and inactive participants 2021-01-01 613
2020: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 637
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 565
Number of retired or separated participants receiving benefits 2020-01-01 25
Total of all active and inactive participants 2020-01-01 590
2019: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 548
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 622
Number of retired or separated participants receiving benefits 2019-01-01 6
Total of all active and inactive participants 2019-01-01 628
2018: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 437
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 542
Number of retired or separated participants receiving benefits 2018-01-01 17
Total of all active and inactive participants 2018-01-01 559
2017: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 315
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 433
Number of retired or separated participants receiving benefits 2017-01-01 4
Total of all active and inactive participants 2017-01-01 437
2016: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 316
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 311
Number of retired or separated participants receiving benefits 2016-01-01 4
Total of all active and inactive participants 2016-01-01 315
2015: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-08-01 317
Total number of active participants reported on line 7a of the Form 5500 2015-08-01 315
Number of retired or separated participants receiving benefits 2015-08-01 1
Total of all active and inactive participants 2015-08-01 316

Measure	Date	Value
2022: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	613
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	635
Number of retired or separated participants receiving benefits	2022-01-01	34
Total of all active and inactive participants	2022-01-01	669
2021: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	590
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	593
Number of retired or separated participants receiving benefits	2021-01-01	20
Total of all active and inactive participants	2021-01-01	613
2020: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	637
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	565
Number of retired or separated participants receiving benefits	2020-01-01	25
Total of all active and inactive participants	2020-01-01	590
2019: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	548
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	622
Number of retired or separated participants receiving benefits	2019-01-01	6
Total of all active and inactive participants	2019-01-01	628
2018: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	437
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	542
Number of retired or separated participants receiving benefits	2018-01-01	17
Total of all active and inactive participants	2018-01-01	559
2017: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	315
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	433
Number of retired or separated participants receiving benefits	2017-01-01	4
Total of all active and inactive participants	2017-01-01	437
2016: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	316
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	311
Number of retired or separated participants receiving benefits	2016-01-01	4
Total of all active and inactive participants	2016-01-01	315
2015: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-08-01	317
Total number of active participants reported on line 7a of the Form 5500	2015-08-01	315
Number of retired or separated participants receiving benefits	2015-08-01	1
Total of all active and inactive participants	2015-08-01	316

Form 5500 Responses for HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN

2022: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: HANON SYSTEMS USA, LLC HEALTH AND WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-08-01	Type of plan entity	Single employer plan
2015-08-01	First time form 5500 has been submitted	Yes
2015-08-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-08-01	Plan funding arrangement – Insurance	Yes
2015-08-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-08-01	Plan benefit arrangement – Insurance	Yes
2015-08-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )

Policy contract number

281932

Policy instance

Insurance contract or identification number	281932
Number of Individuals Covered	371
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $25,141
Total amount of fees paid to insurance company	USD $1,749
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,141
Insurance broker organization code?	3
Amount paid for insurance broker fees	1749
Additional information about fees paid to insurance broker	FEES AND OTHER COMMISSIONS

ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )

Policy contract number

18069-0001-001

Policy instance

Insurance contract or identification number	18069-0001-001
Number of Individuals Covered	168
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $2,391
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	LEGAL ASSISTANCE
Welfare Benefit Premiums Paid to Carrier	USD $23,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,391
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )

Policy contract number

281932

Policy instance

Insurance contract or identification number	281932
Number of Individuals Covered	878
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $65,800
Total amount of fees paid to insurance company	USD $4,696
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 $65,800
Insurance broker organization code?	3
Amount paid for insurance broker fees	4696
Additional information about fees paid to insurance broker	FEES AND OTHER COMMISSIONS

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0921946

Policy instance

Insurance contract or identification number	0921946
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

400001000 25584

Policy instance

Insurance contract or identification number	400001000 25584
Number of Individuals Covered	987
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $34,999
Total amount of fees paid to insurance company	USD $6,039
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $269,221
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $34,999
Amount paid for insurance broker fees	6039
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10256777

Policy instance

Insurance contract or identification number	10256777
Number of Individuals Covered	640
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $6,982
Total amount of fees paid to insurance company	USD $2,402
Other welfare benefits provided	WEEKLY INCOME
Welfare Benefit Premiums Paid to Carrier	USD $116,372
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,982
Amount paid for insurance broker fees	2402
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10256807

Policy instance

Insurance contract or identification number	10256807
Number of Individuals Covered	994
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $26,515
Total amount of fees paid to insurance company	USD $4,689
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $220,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $26,515
Amount paid for insurance broker fees	4689
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10256808

Policy instance

Insurance contract or identification number	10256808
Number of Individuals Covered	992
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $13,768
Total amount of fees paid to insurance company	USD $2,490
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $114,730
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,768
Amount paid for insurance broker fees	2490
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

4030007502

Policy instance

Insurance contract or identification number	4030007502
Number of Individuals Covered	847
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $4,126
Total amount of fees paid to insurance company	USD $755
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $31,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,126
Amount paid for insurance broker fees	755
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5996963

Policy instance

Insurance contract or identification number	5996963
Number of Individuals Covered	1160
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $52,750
Total amount of fees paid to insurance company	USD $10,784
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $557,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $52,750
Amount paid for insurance broker fees	10784
Additional information about fees paid to insurance broker	SUPPLEMENTAL AND NON-MONETARY COMPENSATION
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30093393

Policy instance

Insurance contract or identification number	30093393
Number of Individuals Covered	445
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $4,527
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,527
Insurance broker organization code?	3

BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )

Policy contract number

281932

Policy instance

Insurance contract or identification number	281932
Number of Individuals Covered	376
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $27,337
Total amount of fees paid to insurance company	USD $982
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 $27,337
Insurance broker organization code?	3
Amount paid for insurance broker fees	982
Additional information about fees paid to insurance broker	FEES AND OTHER COMMISSIONS

ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )

Policy contract number

18069-0001-001

Policy instance

Insurance contract or identification number	18069-0001-001
Number of Individuals Covered	152
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $2,093
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	LEGAL ASSISTANCE
Welfare Benefit Premiums Paid to Carrier	USD $20,930
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,093
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )

Policy contract number

281932

Policy instance

Insurance contract or identification number	281932
Number of Individuals Covered	789
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $51,001
Total amount of fees paid to insurance company	USD $2,072
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 $51,001
Insurance broker organization code?	3
Amount paid for insurance broker fees	2072
Additional information about fees paid to insurance broker	FEES AND OTHER COMMISSIONS

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10256777

Policy instance

Insurance contract or identification number	10256777
Number of Individuals Covered	565
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $6,404
Total amount of fees paid to insurance company	USD $2,838
Other welfare benefits provided	WEEKLY INCOME
Welfare Benefit Premiums Paid to Carrier	USD $106,734
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,404
Amount paid for insurance broker fees	2838
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10256807

Policy instance

Insurance contract or identification number	10256807
Number of Individuals Covered	896
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $25,006
Total amount of fees paid to insurance company	USD $8,030
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $208,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,006
Amount paid for insurance broker fees	8030
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30093393

Policy instance

Insurance contract or identification number	30093393
Number of Individuals Covered	423
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $4,333
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,333
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

400001000 25584

Policy instance

Insurance contract or identification number	400001000 25584
Number of Individuals Covered	919
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $34,891
Total amount of fees paid to insurance company	USD $10,146
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $268,389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $34,891
Amount paid for insurance broker fees	10146
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0921946

Policy instance

Insurance contract or identification number	0921946
Number of Individuals Covered	8
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $10,789
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $106,336
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,789
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10256808

Policy instance

Insurance contract or identification number	10256808
Number of Individuals Covered	892
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $13,278
Total amount of fees paid to insurance company	USD $4,466
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $110,348
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,278
Amount paid for insurance broker fees	4466
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

4030007502

Policy instance

Insurance contract or identification number	4030007502
Number of Individuals Covered	789
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $4,361
Total amount of fees paid to insurance company	USD $1,351
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $33,543
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,361
Amount paid for insurance broker fees	1351
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

06885A001

Policy instance

Insurance contract or identification number	06885A001
Number of Individuals Covered	7
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $11,037
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Other welfare benefits provided	EVACUATION
Welfare Benefit Premiums Paid to Carrier	USD $110,370
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,037
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10256807

Policy instance

Insurance contract or identification number	10256807
Number of Individuals Covered	899
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $24,861
Total amount of fees paid to insurance company	USD $11,185
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $207,176
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $24,861
Amount paid for insurance broker fees	11185
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30093393

Policy instance

Insurance contract or identification number	30093393
Number of Individuals Covered	421
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $19,878
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $15,557
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

400001000 25584

Policy instance

Insurance contract or identification number	400001000 25584
Number of Individuals Covered	928
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $34,040
Total amount of fees paid to insurance company	USD $13,163
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $261,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $34,040
Amount paid for insurance broker fees	13163
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10256777

Policy instance

Insurance contract or identification number	10256777
Number of Individuals Covered	563
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $6,591
Total amount of fees paid to insurance company	USD $5,827
Other welfare benefits provided	WEEKLY INCOME
Welfare Benefit Premiums Paid to Carrier	USD $109,850
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,591
Amount paid for insurance broker fees	5827
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0921946

Policy instance

Insurance contract or identification number	0921946
Number of Individuals Covered	10
Insurance policy start date	2020-08-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $5,560
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $55,598
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,560
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

4030007502

Policy instance

Insurance contract or identification number	4030007502
Number of Individuals Covered	809
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $4,533
Total amount of fees paid to insurance company	USD $1,762
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $34,869
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,533
Amount paid for insurance broker fees	1762
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5996963

Policy instance

Insurance contract or identification number	5996963
Number of Individuals Covered	1071
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $62,075
Total amount of fees paid to insurance company	USD $515
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $605,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $62,075
Amount paid for insurance broker fees	515
Additional information about fees paid to insurance broker	NON-MONETARY AND SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )

Policy contract number

281932

Policy instance

Insurance contract or identification number	281932
Number of Individuals Covered	390
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $15,997
Total amount of fees paid to insurance company	USD $2,282
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 $15,997
Insurance broker organization code?	3
Amount paid for insurance broker fees	2282
Additional information about fees paid to insurance broker	FEES AND OTHER COMMISSIONS

ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )

Policy contract number

18069-0001-001

Policy instance

Insurance contract or identification number	18069-0001-001
Number of Individuals Covered	132
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $1,898
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	LEGAL ASSISTANCE
Welfare Benefit Premiums Paid to Carrier	USD $18,975
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,898
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )

Policy contract number

281932

Policy instance

Insurance contract or identification number	281932
Number of Individuals Covered	775
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $39,803
Total amount of fees paid to insurance company	USD $4,150
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 $39,803
Insurance broker organization code?	3
Amount paid for insurance broker fees	4150
Additional information about fees paid to insurance broker	FEES AND OTHER COMMISSIONS

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10256808

Policy instance

Insurance contract or identification number	10256808
Number of Individuals Covered	893
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $13,569
Total amount of fees paid to insurance company	USD $6,026
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $113,075
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,569
Amount paid for insurance broker fees	6026
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )

Policy contract number

18069-0001-001

Policy instance

Insurance contract or identification number	18069-0001-001
Number of Individuals Covered	140
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $1,950
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	LEGAL ASSISTANCE
Welfare Benefit Premiums Paid to Carrier	USD $19,504
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,950
Insurance broker organization code?	3

BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )

Policy contract number

281932

Policy instance

Insurance contract or identification number	281932
Number of Individuals Covered	440
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $23,677
Total amount of fees paid to insurance company	USD $2,159
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 $23,677
Insurance broker organization code?	3
Amount paid for insurance broker fees	2159
Additional information about fees paid to insurance broker	FEES AND OTHER COMMISSIONS

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

06885A

Policy instance

Insurance contract or identification number	06885A
Number of Individuals Covered	5
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $14,494
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Other welfare benefits provided	EVACUATION
Welfare Benefit Premiums Paid to Carrier	USD $144,941
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,494
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5996963

Policy instance

Insurance contract or identification number	5996963
Number of Individuals Covered	1108
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $63,305
Total amount of fees paid to insurance company	USD $-969
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $650,820
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $63,305
Amount paid for insurance broker fees	88
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

12049684 0773

Policy instance

Insurance contract or identification number	12049684 0773
Number of Individuals Covered	428
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
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 number

00544357

Policy instance

Insurance contract or identification number	00544357
Number of Individuals Covered	611
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $80,346
Total amount of fees paid to insurance company	USD $13,349
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $660,314
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $80,346
Amount paid for insurance broker fees	13349
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )

Policy contract number

281932

Policy instance

Insurance contract or identification number	281932
Number of Individuals Covered	777
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $33,047
Total amount of fees paid to insurance company	USD $3,397
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 $33,047
Insurance broker organization code?	3
Amount paid for insurance broker fees	3397
Additional information about fees paid to insurance broker	FEES AND OTHER COMMISSIONS

BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )

Policy contract number

281932

Policy instance

Insurance contract or identification number	281932
Number of Individuals Covered	709
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $29,192
Total amount of fees paid to insurance company	USD $2,519
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 $29,192
Insurance broker organization code?	3
Amount paid for insurance broker fees	2519
Additional information about fees paid to insurance broker	FEES AND OTHER COMMISSIONS

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00544357

Policy instance

Insurance contract or identification number	00544357
Number of Individuals Covered	537
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $72,875
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $598,525
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $72,875
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

12049684 0773

Policy instance

Insurance contract or identification number	12049684 0773
Number of Individuals Covered	371
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5996963

Policy instance

Insurance contract or identification number	5996963
Number of Individuals Covered	1014
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $58,280
Total amount of fees paid to insurance company	USD $10,903
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $549,385
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $58,280
Amount paid for insurance broker fees	73
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

06885A

Policy instance

Insurance contract or identification number	06885A
Number of Individuals Covered	5
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $10,169
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Other welfare benefits provided	EVACUATION
Welfare Benefit Premiums Paid to Carrier	USD $101,690
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,169
Insurance broker organization code?	3

ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )

Policy contract number

18069-0001-001

Policy instance

Insurance contract or identification number	18069-0001-001
Number of Individuals Covered	120
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $1,694
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	LEGAL ASSISTANCE
Welfare Benefit Premiums Paid to Carrier	USD $16,944
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,694
Insurance broker organization code?	3

BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )

Policy contract number

281932

Policy instance

Insurance contract or identification number	281932
Number of Individuals Covered	433
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $21,566
Total amount of fees paid to insurance company	USD $1,849
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 $21,566
Insurance broker organization code?	3
Amount paid for insurance broker fees	1849
Additional information about fees paid to insurance broker	FEES AND OTHER COMMISSIONS

ULLIANCE, INC. (National Association of Insurance Commissioners NAIC id number: 62419 )

Policy contract number

NONE

Policy instance

Insurance contract or identification number	NONE
Number of Individuals Covered	403
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $11,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )

Policy contract number

281932

Policy instance

Insurance contract or identification number	281932
Number of Individuals Covered	547
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $23,287
Total amount of fees paid to insurance company	USD $1,908
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 $23,287
Insurance broker organization code?	3
Amount paid for insurance broker fees	1908
Additional information about fees paid to insurance broker	OTHER FEES
Insurance broker name	HYLANT GROUP, INC.

ULLIANCE, INC. (National Association of Insurance Commissioners NAIC id number: 62419 )

Policy contract number

NONE

Policy instance

Insurance contract or identification number	NONE
Number of Individuals Covered	343
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $8,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )

Policy contract number

18069-0001-001

Policy instance

Insurance contract or identification number	18069-0001-001
Number of Individuals Covered	110
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,306
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	LEGAL ASSISTANCE
Welfare Benefit Premiums Paid to Carrier	USD $14,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,306
Insurance broker organization code?	3
Insurance broker name	HYLANT GROUP, INC.

BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )

Policy contract number

281932

Policy instance

Insurance contract or identification number	281932
Number of Individuals Covered	447
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $23,078
Total amount of fees paid to insurance company	USD $1,905
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 $23,078
Insurance broker organization code?	3
Amount paid for insurance broker fees	1905
Additional information about fees paid to insurance broker	OTHER FEES
Insurance broker name	HYLANT GROUP, INC.

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5996963

Policy instance

Insurance contract or identification number	5996963
Number of Individuals Covered	887
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $93,681
Total amount of fees paid to insurance company	USD $9,450
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $930,569
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $93,681
Amount paid for insurance broker fees	82
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION FOR MEALS
Insurance broker organization code?	3
Insurance broker name	HYLANT GROUP, INC.

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

06885A

Policy instance

Insurance contract or identification number	06885A
Number of Individuals Covered	4
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $7,925
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Other welfare benefits provided	EVACUATION
Welfare Benefit Premiums Paid to Carrier	USD $79,248
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,925
Insurance broker organization code?	3
Insurance broker name	HYLANT GROUP, INC.

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

12049684 0773

Policy instance

Insurance contract or identification number	12049684 0773
Number of Individuals Covered	284
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )

Policy contract number

63096

Policy instance

Insurance contract or identification number	63096
Number of Individuals Covered	128
Insurance policy start date	2015-08-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $30,093
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $30,093
Insurance broker organization code?	3
Insurance broker name	HYLANT GROUP, INC.

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

12049684 0773

Policy instance

Insurance contract or identification number	12049684 0773
Number of Individuals Covered	183
Insurance policy start date	2015-08-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5996963

Policy instance

Insurance contract or identification number	5996963
Number of Individuals Covered	718
Insurance policy start date	2015-08-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $20,159
Total amount of fees paid to insurance company	USD $7,091
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $387,844
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $20,159
Amount paid for insurance broker fees	36
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3
Insurance broker name	HYLANT GROUP, INC.

BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )

Policy contract number

00281932/0001

Policy instance

Insurance contract or identification number	00281932/0001
Number of Individuals Covered	450
Insurance policy start date	2015-08-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $30,830
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $738,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $30,830
Insurance broker organization code?	3
Insurance broker name	HYLANT GROUP, INC.

ARAG INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 34738 )

Policy contract number

18069-0001-001

Policy instance

Insurance contract or identification number	18069-0001-001
Number of Individuals Covered	102
Insurance policy start date	2015-08-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	LEGAL ASSISTANCE
Welfare Benefit Premiums Paid to Carrier	USD $6,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ULLIANCE, INC. (National Association of Insurance Commissioners NAIC id number: 62419 )

Policy contract number

NONE

Policy instance

Insurance contract or identification number	NONE
Number of Individuals Covered	300
Insurance policy start date	2015-08-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $3,225
Other welfare benefits provided	EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $3,225
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	3225
Additional information about fees paid to insurance broker	SALES AND SERVICES
Insurance broker organization code?	3
Insurance broker name	HYLANT GROUP, INC.

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

06885A

Policy instance

Insurance contract or identification number	06885A
Number of Individuals Covered	6
Insurance policy start date	2015-08-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $5,551
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Other welfare benefits provided	EVACUATION
Welfare Benefit Premiums Paid to Carrier	USD $55,509
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	5551
Additional information about fees paid to insurance broker	SALES AND SERVICES
Insurance broker organization code?	3
Insurance broker name	HYLANT GROUP, INC.

Potentially related plans

Was this data useful?

If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us. Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer

The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Company Name:	HANON SYSTEMS USA, LLC
Employer identification number (EIN):	611697358
NAIC Classification:	336300

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	2013-11-20
Company Identification Number:	0801886869
Legal Registered Office Address:	39600 LEWIS DR NOVI United States of America (USA) 48377