401k Plan data: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN plan

MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 401k Plan overview

Plan Name	MAXITROL COMPANY EMPLOYEE INSURANCE PLAN
Plan identification number	501

MAXITROL COMPANY EMPLOYEE INSURANCE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

MAXITROL COMPANY has sponsored the creation of one or more 401k plans.

Company Name: MAXITROL COMPANY

Employer identification number (EIN): 381247737

NAIC Classification: 334500

Additional information about MAXITROL COMPANY

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1996-02-26

Company Identification Number: 0010889106

Legal Registered Office Address: 23555 TELEGRAPH RD

SOUTHFIELD
United States of America (USA)
48033

More information about MAXITROL COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MAXITROL COMPANY EMPLOYEE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-01-01 CHRISTOPHER J. KELLY CHRISTOPHER J. KELLY 2017-10-30
501 2016-01-01 CHRISTOPHER J. KELLY CHRISTOPHER J. KELLY 2017-07-27
501 2015-01-01 CHRISTOPHER J. KELLY CHRISTOPHER J. KELLY 2016-09-09
501 2014-01-01 CHRISTOPHER J. KELLY CHRISTOPHER J. KELLY 2015-07-29
501 2013-01-01 CHRISTOPHER J. KELLY CHRISTOPHER J. KELLY 2014-09-30
501 2012-01-01 CHRISTOPHER J. KELLY CHRISTOPHER J. KELLY 2013-09-30
501 2011-01-01 CHRISTOPHER J. KELLY CHRISTOPHER J. KELLY 2012-10-04
501 2009-01-01 CHRISTOPHER J. KELLY CHRISTOPHER J. KELLY 2010-08-19

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2017-01-01	CHRISTOPHER J. KELLY	CHRISTOPHER J. KELLY	2017-10-30
501	2016-01-01	CHRISTOPHER J. KELLY	CHRISTOPHER J. KELLY	2017-07-27
501	2015-01-01	CHRISTOPHER J. KELLY	CHRISTOPHER J. KELLY	2016-09-09
501	2014-01-01	CHRISTOPHER J. KELLY	CHRISTOPHER J. KELLY	2015-07-29
501	2013-01-01	CHRISTOPHER J. KELLY	CHRISTOPHER J. KELLY	2014-09-30
501	2012-01-01	CHRISTOPHER J. KELLY	CHRISTOPHER J. KELLY	2013-09-30
501	2011-01-01	CHRISTOPHER J. KELLY	CHRISTOPHER J. KELLY	2012-10-04
501	2009-01-01	CHRISTOPHER J. KELLY	CHRISTOPHER J. KELLY	2010-08-19

Plan Statistics for MAXITROL COMPANY EMPLOYEE INSURANCE PLAN

401k plan membership statisitcs for MAXITROL COMPANY EMPLOYEE INSURANCE PLAN

Measure Date Value
2017: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 427
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 431
Total of all active and inactive participants 2017-01-01 431
2016: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 414
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 427
Total of all active and inactive participants 2016-01-01 427
2015: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 391
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 414
Total of all active and inactive participants 2015-01-01 414
2014: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 433
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 391
Total of all active and inactive participants 2014-01-01 391
2013: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 445
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 433
Total of all active and inactive participants 2013-01-01 433
2012: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 444
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 445
Total of all active and inactive participants 2012-01-01 445
2011: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 439
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 444
Total of all active and inactive participants 2011-01-01 444
2009: MAXITROL COMPANY EMPLOYEE INSURANCE 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 2009-01-01 486
Total of all active and inactive participants 2009-01-01 486

Measure	Date	Value
2017: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	427
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	431
Total of all active and inactive participants	2017-01-01	431
2016: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	414
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	427
Total of all active and inactive participants	2016-01-01	427
2015: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	391
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	414
Total of all active and inactive participants	2015-01-01	414
2014: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	433
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	391
Total of all active and inactive participants	2014-01-01	391
2013: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	445
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	433
Total of all active and inactive participants	2013-01-01	433
2012: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	444
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	445
Total of all active and inactive participants	2012-01-01	445
2011: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	439
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	444
Total of all active and inactive participants	2011-01-01	444
2009: MAXITROL COMPANY EMPLOYEE INSURANCE 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	486
Total of all active and inactive participants	2009-01-01	486

Form 5500 Responses for MAXITROL COMPANY EMPLOYEE INSURANCE PLAN

2017: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: MAXITROL COMPANY EMPLOYEE INSURANCE 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 benefit arrangement – Insurance	Yes
2015: MAXITROL COMPANY EMPLOYEE INSURANCE 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 benefit arrangement – Insurance	Yes
2014: MAXITROL COMPANY EMPLOYEE INSURANCE 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 benefit arrangement – Insurance	Yes
2013: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: MAXITROL COMPANY EMPLOYEE INSURANCE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )

Policy contract number

7615

Policy instance

Insurance contract or identification number	7615
Number of Individuals Covered	414
Insurance policy start date	2014-04-01
Insurance policy end date	2015-03-31
Total amount of commissions paid to insurance broker	USD $6,183
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 $6,183
Insurance broker organization code?	3
Insurance broker name	HYLANT GROUP INC

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

Policy contract number

000010068347

Policy instance

Insurance contract or identification number	000010068347
Number of Individuals Covered	45
Insurance policy start date	2014-04-01
Insurance policy end date	2015-03-31
Total amount of commissions paid to insurance broker	USD $2,277
Total amount of fees paid to insurance company	USD $525
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,182
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,277
Amount paid for insurance broker fees	450
Insurance broker organization code?	3
Insurance broker name	HYLANT GROUP INC

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

Policy contract number

000010068346

Policy instance

Insurance contract or identification number	000010068346
Number of Individuals Covered	220
Insurance policy start date	2014-04-01
Insurance policy end date	2015-03-31
Total amount of commissions paid to insurance broker	USD $1,942
Total amount of fees paid to insurance company	USD $649
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $19,743
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,942
Amount paid for insurance broker fees	556
Insurance broker organization code?	3
Insurance broker name	HYLANT GROUP INC

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

Policy contract number

000010068348

Policy instance

Insurance contract or identification number	000010068348
Number of Individuals Covered	220
Insurance policy start date	2014-04-01
Insurance policy end date	2015-03-31
Total amount of commissions paid to insurance broker	USD $3,949
Total amount of fees paid to insurance company	USD $4,510
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $128,884
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,949
Amount paid for insurance broker fees	3866
Insurance broker organization code?	3
Insurance broker name	HYLANT GROUP INC

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

Policy contract number

147277

Policy instance

Insurance contract or identification number	147277
Number of Individuals Covered	192
Insurance policy start date	2014-04-01
Insurance policy end date	2015-03-31
Total amount of commissions paid to insurance broker	USD $7,552
Total amount of fees paid to insurance company	USD $28,580
Health Insurance Welfare Benefit	Yes
Were dividends or retroactive rate refunds paid in cash?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,552
Amount paid for insurance broker fees	23700
Insurance broker organization code?	3
Insurance broker name	HYLANT GROUP INC

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

Policy contract number

000010068346

Policy instance

Insurance contract or identification number	000010068346
Number of Individuals Covered	217
Insurance policy start date	2013-04-01
Insurance policy end date	2014-03-31
Total amount of commissions paid to insurance broker	USD $1,856
Total amount of fees paid to insurance company	USD $377
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,502
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,314
Insurance broker organization code?	3
Amount paid for insurance broker fees	377
Insurance broker name	AGIS FLORIDA AGENCY

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

Policy contract number

000010068348

Policy instance

Insurance contract or identification number	000010068348
Number of Individuals Covered	217
Insurance policy start date	2013-04-01
Insurance policy end date	2014-03-31
Total amount of commissions paid to insurance broker	USD $3,947
Total amount of fees paid to insurance company	USD $2,604
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $128,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	2604
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $2,172
Insurance broker name	HYLANT GROUP INC

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

Policy contract number

147277

Policy instance

Insurance contract or identification number	147277
Number of Individuals Covered	189
Insurance policy start date	2013-04-01
Insurance policy end date	2014-03-31
Total amount of commissions paid to insurance broker	USD $5,436
Total amount of fees paid to insurance company	USD $30,836
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
Were dividends or retroactive rate refunds paid in cash?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,436
Amount paid for insurance broker fees	23700
Insurance broker organization code?	3
Insurance broker name	AGIS MICHIGAN AGENCY, LLC

DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )

Policy contract number

7615

Policy instance

Insurance contract or identification number	7615
Number of Individuals Covered	391
Insurance policy start date	2013-04-01
Insurance policy end date	2014-03-31
Total amount of commissions paid to insurance broker	USD $5,960
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 $5,960
Insurance broker organization code?	3
Insurance broker name	HYLANT GROUP INC

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

Policy contract number

000010068347

Policy instance

Insurance contract or identification number	000010068347
Number of Individuals Covered	47
Insurance policy start date	2013-04-01
Insurance policy end date	2014-03-31
Total amount of commissions paid to insurance broker	USD $2,251
Total amount of fees paid to insurance company	USD $295
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,003
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,687
Insurance broker organization code?	3
Amount paid for insurance broker fees	295
Insurance broker name	AGIS FLORIDA AGENCY

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

Policy contract number

000010068347

Policy instance

Insurance contract or identification number	000010068347
Number of Individuals Covered	46
Insurance policy start date	2012-04-01
Insurance policy end date	2013-03-31
Total amount of commissions paid to insurance broker	USD $2,210
Total amount of fees paid to insurance company	USD $491
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,734
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,210
Insurance broker organization code?	3
Amount paid for insurance broker fees	491
Insurance broker name	AGIS FLORIDA AGENCY

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

Policy contract number

000010068346

Policy instance

Insurance contract or identification number	000010068346
Number of Individuals Covered	214
Insurance policy start date	2012-04-01
Insurance policy end date	2013-03-31
Total amount of commissions paid to insurance broker	USD $1,875
Total amount of fees paid to insurance company	USD $623
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,779
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,875
Insurance broker organization code?	3
Amount paid for insurance broker fees	623
Insurance broker name	AGIS FLORIDA AGENCY

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

Policy contract number

147277

Policy instance

Insurance contract or identification number	147277
Number of Individuals Covered	191
Insurance policy start date	2012-04-01
Insurance policy end date	2013-03-31
Total amount of commissions paid to insurance broker	USD $23,748
Total amount of fees paid to insurance company	USD $5,943
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
Were dividends or retroactive rate refunds paid in cash?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $23,748
Insurance broker organization code?	3
Amount paid for insurance broker fees	5943
Insurance broker name	AGIS MICHIGAN AGENCY, LLC

DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )

Policy contract number

7615

Policy instance

Insurance contract or identification number	7615
Number of Individuals Covered	433
Insurance policy start date	2012-04-01
Insurance policy end date	2013-03-31
Total amount of commissions paid to insurance broker	USD $6,587
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 $6,587
Insurance broker organization code?	3
Insurance broker name	AGIS MICHIGAN AGENCY, LLC

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

Policy contract number

000010068348

Policy instance

Insurance contract or identification number	000010068348
Number of Individuals Covered	214
Insurance policy start date	2012-04-01
Insurance policy end date	2013-03-31
Total amount of commissions paid to insurance broker	USD $3,956
Total amount of fees paid to insurance company	USD $4,287
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $129,641
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	4287
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $3,956
Insurance broker name	AGIS MICHIGAN AGENCY, LLC

DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )

Policy contract number

7615

Policy instance

Insurance contract or identification number	7615
Number of Individuals Covered	445
Insurance policy start date	2011-04-01
Insurance policy end date	2012-03-31
Total amount of commissions paid to insurance broker	USD $4,231
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 $4,231
Insurance broker organization code?	3
Insurance broker name	AGIS MICHIGAN AGENCY, LLC

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

Policy contract number

000010068347

Policy instance

Insurance contract or identification number	000010068347
Number of Individuals Covered	48
Insurance policy start date	2011-04-01
Insurance policy end date	2012-03-31
Total amount of commissions paid to insurance broker	USD $2,249
Total amount of fees paid to insurance company	USD $949
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,041
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,249
Insurance broker organization code?	3
Amount paid for insurance broker fees	949
Insurance broker name	AGIS FLORIDA AGENCY

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

Policy contract number

000010068346

Policy instance

Insurance contract or identification number	000010068346
Number of Individuals Covered	222
Insurance policy start date	2011-04-01
Insurance policy end date	2012-03-31
Total amount of commissions paid to insurance broker	USD $1,893
Total amount of fees paid to insurance company	USD $1,236
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $19,049
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,893
Insurance broker organization code?	3
Amount paid for insurance broker fees	1236
Insurance broker name	AGIS FLORIDA AGENCY

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

Policy contract number

000010068348

Policy instance

Insurance contract or identification number	000010068348
Number of Individuals Covered	222
Insurance policy start date	2011-04-01
Insurance policy end date	2012-03-31
Total amount of commissions paid to insurance broker	USD $3,974
Total amount of fees paid to insurance company	USD $8,464
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $131,392
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	8464
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $3,974
Insurance broker name	AGIS MICHIGAN AGENCY, LLC

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

Policy contract number

147277

Policy instance

Insurance contract or identification number	147277
Number of Individuals Covered	198
Insurance policy start date	2011-04-01
Insurance policy end date	2012-03-31
Total amount of commissions paid to insurance broker	USD $24,396
Total amount of fees paid to insurance company	USD $1,667
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
Were dividends or retroactive rate refunds paid in cash?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $24,396
Insurance broker organization code?	3
Amount paid for insurance broker fees	1667
Insurance broker name	AGIS MICHIGAN AGENCY, LLC

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

Policy contract number

000010068346

Policy instance

Insurance contract or identification number	000010068346
Number of Individuals Covered	228
Insurance policy start date	2010-04-01
Insurance policy end date	2011-03-31
Total amount of commissions paid to insurance broker	USD $1,926
Total amount of fees paid to insurance company	USD $978
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $19,509
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

000010068348

Policy instance

Insurance contract or identification number	000010068348
Number of Individuals Covered	228
Insurance policy start date	2010-04-01
Insurance policy end date	2011-03-31
Total amount of commissions paid to insurance broker	USD $4,004
Total amount of fees paid to insurance company	USD $6,649
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $134,379
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

08898

Policy instance

Insurance contract or identification number	08898
Number of Individuals Covered	212
Insurance policy start date	2010-04-01
Insurance policy end date	2011-03-31
Total amount of commissions paid to insurance broker	USD $18,130
Total amount of fees paid to insurance company	USD $1,721
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
Were dividends or retroactive rate refunds paid in cash?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )

Policy contract number

7615

Policy instance

Insurance contract or identification number	7615
Number of Individuals Covered	444
Insurance policy start date	2010-04-01
Insurance policy end date	2011-03-31
Total amount of commissions paid to insurance broker	USD $4,287
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

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

Policy contract number

000010068347

Policy instance

Insurance contract or identification number	000010068347
Number of Individuals Covered	52
Insurance policy start date	2010-04-01
Insurance policy end date	2011-03-31
Total amount of commissions paid to insurance broker	USD $2,264
Total amount of fees paid to insurance company	USD $718
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,094
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

000010068347

Policy instance

Insurance contract or identification number	000010068347
Number of Individuals Covered	49
Insurance policy start date	2009-04-01
Insurance policy end date	2010-03-31
Total amount of commissions paid to insurance broker	USD $2,225
Total amount of fees paid to insurance company	USD $192
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,905
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,225
Insurance broker organization code?	3
Amount paid for insurance broker fees	192
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker name	AGIS FLORIDA AGENCY

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

Policy contract number

000010068348

Policy instance

Insurance contract or identification number	000010068348
Number of Individuals Covered	234
Insurance policy start date	2009-04-01
Insurance policy end date	2010-03-31
Total amount of commissions paid to insurance broker	USD $4,044
Total amount of fees paid to insurance company	USD $1,859
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $136,655
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,044
Insurance broker organization code?	3
Amount paid for insurance broker fees	1859
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker name	AGIS FLORIDA AGENCY

BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 120 )

Policy contract number

08898

Policy instance

Insurance contract or identification number	08898
Number of Individuals Covered	478
Insurance policy start date	2009-04-01
Insurance policy end date	2010-03-31
Total amount of commissions paid to insurance broker	USD $19,835
Total amount of fees paid to insurance company	USD $3,072
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
Were dividends or retroactive rate refunds paid as a credit?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $19,835
Insurance broker organization code?	3
Amount paid for insurance broker fees	3072
Insurance broker name	AGIS MICHIGAN AGENCY

DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )

Policy contract number

0003038-0001

Policy instance

Insurance contract or identification number	0003038-0001
Number of Individuals Covered	439
Insurance policy start date	2009-04-01
Insurance policy end date	2010-03-31
Total amount of commissions paid to insurance broker	USD $4,814
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
Welfare Benefit Premiums Paid to Carrier	USD $1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,814
Insurance broker organization code?	3
Insurance broker name	AGIS MICHIGAN AGENCY

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

Policy contract number

000010068346

Policy instance

Insurance contract or identification number	000010068346
Number of Individuals Covered	234
Insurance policy start date	2009-04-01
Insurance policy end date	2010-03-31
Total amount of commissions paid to insurance broker	USD $1,963
Total amount of fees paid to insurance company	USD $273
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,143
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,963
Insurance broker organization code?	3
Amount paid for insurance broker fees	273
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker name	AGIS FLORIDA AGENCY

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Company Name:	MAXITROL COMPANY
Employer identification number (EIN):	381247737
NAIC Classification:	334500

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1996-02-26
Company Identification Number:	0010889106
Legal Registered Office Address:	23555 TELEGRAPH RD SOUTHFIELD United States of America (USA) 48033