WALBRIDGE/DIG/DFM WELFARE BENEFIT PLAN has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan WALBRIDGE ALDINGER PREMIUM CHOICE PLAN
Measure | Date | Value |
---|
2021: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2021 401k membership |
---|
Total participants, beginning-of-year | 2021-01-01 | 785 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 784 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 40 |
Total of all active and inactive participants | 2021-01-01 | 824 |
2020: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2020 401k membership |
---|
Total participants, beginning-of-year | 2020-01-01 | 773 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 735 |
Number of retired or separated participants receiving benefits | 2020-01-01 | 50 |
Total of all active and inactive participants | 2020-01-01 | 785 |
2019: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2019 401k membership |
---|
Total participants, beginning-of-year | 2019-01-01 | 796 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 739 |
Number of retired or separated participants receiving benefits | 2019-01-01 | 34 |
Total of all active and inactive participants | 2019-01-01 | 773 |
2018: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2018 401k membership |
---|
Total participants, beginning-of-year | 2018-01-01 | 815 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 770 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 26 |
Total of all active and inactive participants | 2018-01-01 | 796 |
2017: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2017 401k membership |
---|
Total participants, beginning-of-year | 2017-01-01 | 549 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 799 |
Number of retired or separated participants receiving benefits | 2017-01-01 | 16 |
Total of all active and inactive participants | 2017-01-01 | 815 |
2016: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2016 401k membership |
---|
Total participants, beginning-of-year | 2016-01-01 | 504 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 529 |
Number of retired or separated participants receiving benefits | 2016-01-01 | 20 |
Total of all active and inactive participants | 2016-01-01 | 549 |
2015: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2015 401k membership |
---|
Total participants, beginning-of-year | 2015-01-01 | 519 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 492 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 12 |
Total of all active and inactive participants | 2015-01-01 | 504 |
2014: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2014 401k membership |
---|
Total participants, beginning-of-year | 2014-01-01 | 513 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 519 |
Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
Total of all active and inactive participants | 2014-01-01 | 519 |
2013: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2013 401k membership |
---|
Total participants, beginning-of-year | 2013-01-01 | 511 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 505 |
Number of retired or separated participants receiving benefits | 2013-01-01 | 8 |
Total of all active and inactive participants | 2013-01-01 | 513 |
2012: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2012 401k membership |
---|
Total participants, beginning-of-year | 2012-01-01 | 865 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 1,164 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 10 |
Total of all active and inactive participants | 2012-01-01 | 1,174 |
2011: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2011 401k membership |
---|
Total participants, beginning-of-year | 2011-01-01 | 818 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 865 |
Total of all active and inactive participants | 2011-01-01 | 865 |
2009: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2009 401k membership |
---|
Total participants, beginning-of-year | 2009-01-01 | 537 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 691 |
Total of all active and inactive participants | 2009-01-01 | 691 |
2021: WALBRIDGE ALDINGER PREMIUM CHOICE 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: WALBRIDGE ALDINGER PREMIUM CHOICE 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: WALBRIDGE ALDINGER PREMIUM CHOICE 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: WALBRIDGE ALDINGER PREMIUM CHOICE 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: WALBRIDGE ALDINGER PREMIUM CHOICE 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: WALBRIDGE ALDINGER PREMIUM CHOICE 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: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2015 form 5500 responses |
---|
2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Plan funding arrangement – Insurance | Yes |
2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-01-01 | Plan benefit arrangement – Insurance | Yes |
2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2014 form 5500 responses |
---|
2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2013 form 5500 responses |
---|
2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Submission has been amended | Yes |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2012: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2012 form 5500 responses |
---|
2012-01-01 | Type of plan entity | Mulitple employer plan |
2012-01-01 | Submission has been amended | Yes |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2011: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2011 form 5500 responses |
---|
2011-01-01 | Type of plan entity | Mulitple employer plan |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2009: WALBRIDGE ALDINGER PREMIUM CHOICE PLAN 2009 form 5500 responses |
---|
2009-01-01 | Type of plan entity | Mulitple employer plan |
2009-01-01 | This submission is the final filing | No |
2009-01-01 | Plan funding arrangement – Insurance | Yes |
2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-01-01 | Plan benefit arrangement – Insurance | Yes |
2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | CID 159430 |
Policy instance | 2 |
Insurance contract or identification number | CID 159430 | Number of Individuals Covered | 1938 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $38,608 | Total amount of fees paid to insurance company | USD $10,719 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,061,103 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $38,608 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 10719 | Additional information about fees paid to insurance broker | ADMIN FEES |
|
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 9272 |
Policy instance | 1 |
Insurance contract or identification number | 9272 | Number of Individuals Covered | 1969 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $18,127 | Total amount of fees paid to insurance company | USD $586 | Dental 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 $18,127 | Amount paid for insurance broker fees | 586 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION - RETENTION BONUS | Insurance broker organization code? | 3 |
|
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | CID 159430 |
Policy instance | 2 |
Insurance contract or identification number | CID 159430 | Number of Individuals Covered | 1825 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $35,200 | Total amount of fees paid to insurance company | USD $5,013 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $983,864 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $35,200 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
|
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 9272 |
Policy instance | 1 |
Insurance contract or identification number | 9272 | Number of Individuals Covered | 1832 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $13,348 | Total amount of fees paid to insurance company | USD $1,242 | Dental 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 $13,348 | Amount paid for insurance broker fees | 1242 | Additional information about fees paid to insurance broker | NEW BUSINESS BONUS, RETENTION BONUS | Insurance broker organization code? | 3 |
|
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 16834 |
Policy instance | 2 |
Insurance contract or identification number | 16834 | Number of Individuals Covered | 1866 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $32,839 | Total amount of fees paid to insurance company | USD $10,186 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $953,771 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $32,839 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
|
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 9272 |
Policy instance | 1 |
Insurance contract or identification number | 9272 | Number of Individuals Covered | 1910 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $17,331 | Total amount of fees paid to insurance company | USD $1,414 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,331 | Amount paid for insurance broker fees | 1414 | Additional information about fees paid to insurance broker | RETENTION BONUS | Insurance broker organization code? | 3 |
|
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 9272 |
Policy instance | 1 |
Insurance contract or identification number | 9272 | Number of Individuals Covered | 1974 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $18,647 | Total amount of fees paid to insurance company | USD $0 | Dental 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 $18,647 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 16834 |
Policy instance | 2 |
Insurance contract or identification number | 16834 | Number of Individuals Covered | 1937 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $31,412 | Total amount of fees paid to insurance company | USD $5,116 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $847,247 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $31,412 | Amount paid for insurance broker fees | 5116 | Additional information about fees paid to insurance broker | OTHER COMPENSATION FOR SERVICES TO CLIENT OR INSURANCE PROVIDER | Insurance broker organization code? | 3 |
|
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 16834 |
Policy instance | 2 |
Insurance contract or identification number | 16834 | Number of Individuals Covered | 1984 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $30,683 | Total amount of fees paid to insurance company | USD $8,574 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $900,776 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $30,683 | Amount paid for insurance broker fees | 8574 | Additional information about fees paid to insurance broker | SERVICES TO CLIENT OR INSURANCE COMPANY | Insurance broker organization code? | 3 | Insurance broker name | KAPNICK & COMPANY, INC. |
|
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 9272 |
Policy instance | 1 |
Insurance contract or identification number | 9272 | Number of Individuals Covered | 2000 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $18,994 | Total amount of fees paid to insurance company | USD $0 | Dental 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 $18,994 | Insurance broker organization code? | 3 | Insurance broker name | KAPNICK & COMPANY, INC. |
|
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 9272 |
Policy instance | 1 |
Insurance contract or identification number | 9272 | Number of Individuals Covered | 1260 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $21,868 | Total amount of fees paid to insurance company | USD $0 | Dental 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 $21,868 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | KAPNICK & COMPANY, INC. |
|
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 16834 |
Policy instance | 2 |
Insurance contract or identification number | 16834 | Number of Individuals Covered | 1275 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $20,559 | Total amount of fees paid to insurance company | USD $10,608 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $588,686 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,559 | Amount paid for insurance broker fees | 10608 | Additional information about fees paid to insurance broker | FEES AND OTHER COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | KAPNICK & COMPANY, INC. |
|
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 16834 |
Policy instance | 2 |
Insurance contract or identification number | 16834 | Number of Individuals Covered | 519 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $20,097 | Total amount of fees paid to insurance company | USD $6,231 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $576,777 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,097 | Amount paid for insurance broker fees | 6231 | Additional information about fees paid to insurance broker | FEES AND OTHER COMP | Insurance broker organization code? | 3 | Insurance broker name | KAPNICK & COMPANY, INC. |
|
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 9272 |
Policy instance | 1 |
Insurance contract or identification number | 9272 | Number of Individuals Covered | 1290 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $20,362 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental 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 $20,362 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | KAPNICK & COMPANY, INC. |
|
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 16834 |
Policy instance | 4 |
Insurance contract or identification number | 16834 | Number of Individuals Covered | 619 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $93,923 | Total amount of fees paid to insurance company | USD $13,872 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $533,224 | 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 | 47147 |
Policy instance | 3 |
Insurance contract or identification number | 47147 | Number of Individuals Covered | 1326 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $54,401 | Total amount of fees paid to insurance company | USD $10,636 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $596,455 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 21 |
Policy instance | 2 |
Insurance contract or identification number | 21 | Number of Individuals Covered | 593 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $4,917 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 9272 |
Policy instance | 1 |
Insurance contract or identification number | 9272 | Number of Individuals Covered | 1262 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $21,530 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental 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 $21,530 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | FEES & OTHER COMMISSIONS PAID | Insurance broker organization code? | 3 | Insurance broker name | KAPNICK & COMPANY, INC. |
|
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 16834 |
Policy instance | 2 |
Insurance contract or identification number | 16834 | Number of Individuals Covered | 619 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $93,923 | Total amount of fees paid to insurance company | USD $13,872 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $533,224 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $93,923 | Amount paid for insurance broker fees | 13872 | Additional information about fees paid to insurance broker | FEES & OTHER COMMISSIONS PAID | Insurance broker organization code? | 3 | Insurance broker name | KAPNICK & COMPANY, INC. |
|
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 9272 |
Policy instance | 1 |
Insurance contract or identification number | 9272 | Number of Individuals Covered | 1241 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $22,570 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental 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 $22,570 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | KAPNICK & COMPANY, INC. |
|
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 47147 |
Policy instance | 3 |
Insurance contract or identification number | 47147 | Number of Individuals Covered | 1319 | Insurance policy start date | 2011-11-01 | Insurance policy end date | 2012-10-31 | Total amount of commissions paid to insurance broker | USD $39,744 | Total amount of fees paid to insurance company | USD $5,452 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $494,937 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 21 |
Policy instance | 2 |
Insurance contract or identification number | 21 | Number of Individuals Covered | 641 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $5,609 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental 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 | 16834 |
Policy instance | 4 |
Insurance contract or identification number | 16834 | Number of Individuals Covered | 1296 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $52,716 | Total amount of fees paid to insurance company | USD $12,724 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $451,736 | 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 | 16834 |
Policy instance | 2 |
Insurance contract or identification number | 16834 | Number of Individuals Covered | 1296 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $52,716 | Total amount of fees paid to insurance company | USD $12,724 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $451,736 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $52,716 | Amount paid for insurance broker fees | 12724 | Additional information about fees paid to insurance broker | FEES & OTHER COMMISSIONS PAID | Insurance broker organization code? | 3 | Insurance broker name | KAPNICK & COMPANY, INC. |
|
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 9272 |
Policy instance | 1 |
Insurance contract or identification number | 9272 | Number of Individuals Covered | 1483 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $24,535 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 21 |
Policy instance | 2 |
Insurance contract or identification number | 21 | Number of Individuals Covered | 583 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $4,939 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental 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 | 47147 |
Policy instance | 3 |
Insurance contract or identification number | 47147 | Number of Individuals Covered | 572 | Insurance policy start date | 2010-11-01 | Insurance policy end date | 2011-10-31 | Total amount of commissions paid to insurance broker | USD $36,868 | Total amount of fees paid to insurance company | USD $966 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $264,991 | 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 | 16834 |
Policy instance | 4 |
Insurance contract or identification number | 16834 | Number of Individuals Covered | 1508 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $78,813 | Total amount of fees paid to insurance company | USD $4,001 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $540,969 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 9272 |
Policy instance | 1 |
Insurance contract or identification number | 9272 | Number of Individuals Covered | 1517 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $23,104 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental 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 $23,104 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | KAPNICK & COMPANY, INC. |
|
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 16834 |
Policy instance | 2 |
Insurance contract or identification number | 16834 | Number of Individuals Covered | 1402 | Insurance policy start date | 2009-07-01 | Insurance policy end date | 2010-06-30 | Total amount of commissions paid to insurance broker | USD $91,545 | Total amount of fees paid to insurance company | USD $2 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $284,615 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $91,545 | Amount paid for insurance broker fees | 2 | Additional information about fees paid to insurance broker | MISCELLANEOUS | Insurance broker organization code? | 3 | Insurance broker name | KAPNICK INSURANCE GROUP |
|
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 47147 |
Policy instance | 4 |
Insurance contract or identification number | 47147 | Number of Individuals Covered | 154 | Insurance policy start date | 2009-11-01 | Insurance policy end date | 2010-10-31 | Total amount of commissions paid to insurance broker | USD $34,416 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $160,102 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $34,416 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | KAPNICK & COMPANY, INC. |
|
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
Policy contract number | 16834 |
Policy instance | 5 |
Insurance contract or identification number | 16834 | Number of Individuals Covered | 1539 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $42,995 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $196,168 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $42,995 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | KAPNICK & COMPANY, INC. |
|
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 21 |
Policy instance | 3 |
Insurance contract or identification number | 21 | Number of Individuals Covered | 377 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $3,286 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental 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 $3,286 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | KAPNICK & COMPANY, INC. |
|