Logo

MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan NameMOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN
Plan identification number 501

MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

MOBILE MEDICAL RESPONSE INC. has sponsored the creation of one or more 401k plans.

Company Name:MOBILE MEDICAL RESPONSE INC.
Employer identification number (EIN):383198397
NAIC Classification:621900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01MARK THOMPSON
5012016-01-01MARK THOMPSON
5012015-01-01MARK THOMPSON
5012014-01-01MARK THOMPSON
5012013-01-01MARK THOMPSON
5012012-01-01MARK THOMPSON
5012011-01-01MARK THOMPSON
5012010-01-01MARK THOMPSON
5012009-01-01MARK THOMPSON

Plan Statistics for MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN

Measure Date Value
2022: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01566
Total number of active participants reported on line 7a of the Form 55002022-01-01402
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01402
2021: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01714
Total number of active participants reported on line 7a of the Form 55002021-01-01566
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01566
2020: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01733
Total number of active participants reported on line 7a of the Form 55002020-01-01714
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01714
2019: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01781
Total number of active participants reported on line 7a of the Form 55002019-01-01733
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01733
2018: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01725
Total number of active participants reported on line 7a of the Form 55002018-01-01781
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01781
2017: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01767
Total number of active participants reported on line 7a of the Form 55002017-01-01725
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01725
2016: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01766
Total number of active participants reported on line 7a of the Form 55002016-01-01767
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01767
2015: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01769
Total number of active participants reported on line 7a of the Form 55002015-01-01766
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01766
2014: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01748
Total number of active participants reported on line 7a of the Form 55002014-01-01769
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01769
2013: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01337
Total number of active participants reported on line 7a of the Form 55002013-01-01748
Total of all active and inactive participants2013-01-01748
2012: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01351
Total number of active participants reported on line 7a of the Form 55002012-01-01337
Total of all active and inactive participants2012-01-01337
2011: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01327
Total number of active participants reported on line 7a of the Form 55002011-01-01351
Total of all active and inactive participants2011-01-01351
2010: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01613
Total number of active participants reported on line 7a of the Form 55002010-01-01327
Total of all active and inactive participants2010-01-01327
2009: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01613
Total number of active participants reported on line 7a of the Form 55002009-01-01613
Total of all active and inactive participants2009-01-01613

Form 5500 Responses for MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN

2022: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: MOBILE MEDICAL RESPONSE, INC. WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number040000100025667
Policy instance 7
Insurance contract or identification number040000100025667
Number of Individuals Covered217
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $8,119
Total amount of fees paid to insurance companyUSD $1,628
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,125
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,119
Amount paid for insurance broker fees1628
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number001025740100000
Policy instance 3
Insurance contract or identification number001025740100000
Number of Individuals Covered69
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,915
Total amount of fees paid to insurance companyUSD $485
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,436
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,915
Amount paid for insurance broker fees485
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number100341
Policy instance 4
Insurance contract or identification number100341
Number of Individuals Covered268
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $39,433
Total amount of fees paid to insurance companyUSD $1,573
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,433
Insurance broker organization code?3
Amount paid for insurance broker fees1573
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number001025740200000
Policy instance 5
Insurance contract or identification number001025740200000
Number of Individuals Covered403
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,435
Total amount of fees paid to insurance companyUSD $878
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $29,568
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,435
Amount paid for insurance broker fees878
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number001025740300000
Policy instance 6
Insurance contract or identification number001025740300000
Number of Individuals Covered387
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $17,735
Total amount of fees paid to insurance companyUSD $3,035
Other welfare benefits providedWEEKLY INCOME
Welfare Benefit Premiums Paid to CarrierUSD $118,233
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,735
Amount paid for insurance broker fees3035
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number004030075340000
Policy instance 8
Insurance contract or identification number004030075340000
Number of Individuals Covered210
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,307
Total amount of fees paid to insurance companyUSD $285
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOL SPOUSE AD&D
Welfare Benefit Premiums Paid to CarrierUSD $8,715
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,307
Amount paid for insurance broker fees285
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number100341
Policy instance 9
Insurance contract or identification number100341
Number of Individuals Covered440
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $60,979
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $58,522
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12049684-0062
Policy instance 1
Insurance contract or identification number12049684-0062
Number of Individuals Covered283
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,595
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,595
Insurance broker organization code?3
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number0001753
Policy instance 2
Insurance contract or identification number0001753
Number of Individuals Covered714
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $13,563
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,563
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number004030075340000
Policy instance 8
Insurance contract or identification number004030075340000
Number of Individuals Covered246
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,522
Total amount of fees paid to insurance companyUSD $24
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOL SPOUSE AD&D
Welfare Benefit Premiums Paid to CarrierUSD $10,147
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,522
Amount paid for insurance broker fees24
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12049684-0062
Policy instance 1
Insurance contract or identification number12049684-0062
Number of Individuals Covered286
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,718
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,718
Insurance broker organization code?3
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number0001753
Policy instance 2
Insurance contract or identification number0001753
Number of Individuals Covered728
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $14,256
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,256
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number001025740100000
Policy instance 3
Insurance contract or identification number001025740100000
Number of Individuals Covered48
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,587
Total amount of fees paid to insurance companyUSD $24
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,247
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,587
Amount paid for insurance broker fees24
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number100341
Policy instance 4
Insurance contract or identification number100341
Number of Individuals Covered298
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $41,271
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,271
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number001025740200000
Policy instance 5
Insurance contract or identification number001025740200000
Number of Individuals Covered373
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,683
Total amount of fees paid to insurance companyUSD $24
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $31,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,683
Amount paid for insurance broker fees24
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number001025740300000
Policy instance 6
Insurance contract or identification number001025740300000
Number of Individuals Covered358
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $16,184
Total amount of fees paid to insurance companyUSD $24
Other welfare benefits providedWEEKLY INCOME
Welfare Benefit Premiums Paid to CarrierUSD $107,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,184
Amount paid for insurance broker fees24
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number040000100025667
Policy instance 7
Insurance contract or identification number040000100025667
Number of Individuals Covered248
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $8,683
Total amount of fees paid to insurance companyUSD $24
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $57,887
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,683
Amount paid for insurance broker fees24
Insurance broker organization code?3
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number100341
Policy instance 9
Insurance contract or identification number100341
Number of Individuals Covered452
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $61,673
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $61,673
Insurance broker organization code?3
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number0001753
Policy instance 2
Insurance contract or identification number0001753
Number of Individuals Covered711
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $14,056
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,056
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number001025740100000
Policy instance 3
Insurance contract or identification number001025740100000
Number of Individuals Covered59
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $2,171
Total amount of fees paid to insurance companyUSD $748
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,171
Amount paid for insurance broker fees748
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12049684-0062
Policy instance 1
Insurance contract or identification number12049684-0062
Number of Individuals Covered259
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $2,632
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,632
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number100341
Policy instance 4
Insurance contract or identification number100341
Number of Individuals Covered714
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $41,555
Total amount of fees paid to insurance companyUSD $2,070
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,555
Insurance broker organization code?3
Amount paid for insurance broker fees2070
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number001025740300000
Policy instance 6
Insurance contract or identification number001025740300000
Number of Individuals Covered357
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $15,178
Total amount of fees paid to insurance companyUSD $5,311
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $101,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,178
Amount paid for insurance broker fees5311
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number040000100025667
Policy instance 7
Insurance contract or identification number040000100025667
Number of Individuals Covered180
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $6,301
Total amount of fees paid to insurance companyUSD $2,163
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,008
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,301
Amount paid for insurance broker fees2163
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number001025740200000
Policy instance 5
Insurance contract or identification number001025740200000
Number of Individuals Covered359
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,796
Total amount of fees paid to insurance companyUSD $1,358
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,307
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,796
Amount paid for insurance broker fees1358
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12049684-0062
Policy instance 1
Insurance contract or identification number12049684-0062
Number of Individuals Covered265
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Vision Insurance Welfare BenefitYes
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 number0001480
Policy instance 2
Insurance contract or identification number0001480
Number of Individuals Covered71
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,152
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,152
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number3U7128
Policy instance 3
Insurance contract or identification number3U7128
Number of Individuals Covered70
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $13,203
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $347,990
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,203
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberEAB1000033
Policy instance 4
Insurance contract or identification numberEAB1000033
Number of Individuals Covered364
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $33,965
Total amount of fees paid to insurance companyUSD $9,621
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedLIFSUP1
Welfare Benefit Premiums Paid to CarrierUSD $226,429
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,965
Amount paid for insurance broker fees9621
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number51810
Policy instance 5
Insurance contract or identification number51810
Number of Individuals Covered65
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $197
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $197
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number0001753
Policy instance 6
Insurance contract or identification number0001753
Number of Individuals Covered719
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $13,906
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,906
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number100341
Policy instance 7
Insurance contract or identification number100341
Number of Individuals Covered733
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $92,162
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $87,902
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12049684-0062
Policy instance 1
Insurance contract or identification number12049684-0062
Number of Individuals Covered274
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Vision Insurance Welfare BenefitYes
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 number0001480
Policy instance 2
Insurance contract or identification number0001480
Number of Individuals Covered55
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,306
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,306
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number3U7128
Policy instance 3
Insurance contract or identification number3U7128
Number of Individuals Covered60
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $19,818
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $258,887
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,818
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0396499
Policy instance 4
Insurance contract or identification numberR0396499
Number of Individuals Covered47
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,265
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,111
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,265
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberEAB1000033
Policy instance 5
Insurance contract or identification numberEAB1000033
Number of Individuals Covered467
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $36,213
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedLIFSUP1
Welfare Benefit Premiums Paid to CarrierUSD $242,186
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,213
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number51810
Policy instance 6
Insurance contract or identification number51810
Number of Individuals Covered49
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $193
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,931
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $193
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12049684-1099
Policy instance 7
Insurance contract or identification number12049684-1099
Number of Individuals Covered1
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Vision Insurance Welfare BenefitYes
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 number100341
Policy instance 9
Insurance contract or identification number100341
Number of Individuals Covered781
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $53,703
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,407
Insurance broker organization code?3
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number0001753
Policy instance 8
Insurance contract or identification number0001753
Number of Individuals Covered782
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $7,134
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,134
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number51810
Policy instance 7
Insurance contract or identification number51810
Number of Individuals Covered66
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $232
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,318
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $232
Insurance broker nameADVANCED BENEFIT SOLUTIONS, INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberEAB1000033
Policy instance 6
Insurance contract or identification numberEAB1000033
Number of Individuals Covered416
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $54,945
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedLIFSUP1
Welfare Benefit Premiums Paid to CarrierUSD $232,506
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $54,945
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0396499
Policy instance 5
Insurance contract or identification numberR0396499
Number of Individuals Covered47
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Total amount of commissions paid to insurance brokerUSD $1,284
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,369
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,284
Insurance broker organization code?3
Insurance broker nameUNITED BENEFIT ADVISORS INC - HQ
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number674640
Policy instance 4
Insurance contract or identification number674640
Number of Individuals Covered65
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $13,230
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $258,373
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,230
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS INC
ALLIANCE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60134 )
Policy contract number10004906
Policy instance 3
Insurance contract or identification number10004906
Number of Individuals Covered725
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $107,885
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,509,309
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $107,885
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number0001480
Policy instance 2
Insurance contract or identification number0001480
Number of Individuals Covered73
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,710
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,710
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS, INC.
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12049684-0062
Policy instance 1
Insurance contract or identification number12049684-0062
Number of Individuals Covered289
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Vision Insurance Welfare BenefitYes
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 number000010196990
Policy instance 4
Insurance contract or identification number000010196990
Number of Individuals Covered380
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $20,037
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $133,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,037
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number40000100018911
Policy instance 6
Insurance contract or identification number40000100018911
Number of Individuals Covered156
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $6,024
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $40,159
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,024
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010196988
Policy instance 5
Insurance contract or identification number000010196988
Number of Individuals Covered404
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,283
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $35,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,283
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS INC
CONSUMER'S MUTUAL INSURANCE OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 15128 )
Policy contract numberMILG0181
Policy instance 1
Insurance contract or identification numberMILG0181
Number of Individuals Covered319
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $127,710
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,533,322
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $127,710
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number0001753
Policy instance 3
Insurance contract or identification number0001753
Number of Individuals Covered766
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,423
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,423
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS, INC.
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12049684-0062
Policy instance 2
Insurance contract or identification number12049684-0062
Number of Individuals Covered245
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0AN24
Policy instance 6
Insurance contract or identification numberGLTD0AN24
Number of Individuals Covered60
Insurance policy start date2013-12-01
Insurance policy end date2014-12-01
Total amount of commissions paid to insurance brokerUSD $2,564
Total amount of fees paid to insurance companyUSD $600
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,094
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,564
Amount paid for insurance broker fees600
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AN24
Policy instance 7
Insurance contract or identification numberGVTL0AN24
Number of Individuals Covered161
Insurance policy start date2013-12-01
Insurance policy end date2014-12-01
Total amount of commissions paid to insurance brokerUSD $6,957
Total amount of fees paid to insurance companyUSD $1,716
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D - VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $46,379
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,957
Amount paid for insurance broker fees1716
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUG0AN24
Policy instance 5
Insurance contract or identification numberGUG0AN24
Number of Individuals Covered350
Insurance policy start date2013-12-01
Insurance policy end date2014-12-01
Total amount of commissions paid to insurance brokerUSD $10,958
Total amount of fees paid to insurance companyUSD $2,563
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $73,053
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,958
Amount paid for insurance broker fees2563
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AN24
Policy instance 4
Insurance contract or identification numberGLUG0AN24
Number of Individuals Covered372
Insurance policy start date2013-12-01
Insurance policy end date2014-12-01
Total amount of commissions paid to insurance brokerUSD $4,020
Total amount of fees paid to insurance companyUSD $939
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $26,798
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,020
Amount paid for insurance broker fees939
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS INC
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number0001753
Policy instance 3
Insurance contract or identification number0001753
Number of Individuals Covered769
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS, INC.
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12049684-0062
Policy instance 2
Insurance contract or identification number12049684-0062
Number of Individuals Covered236
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Vision Insurance Welfare BenefitYes
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 number45627
Policy instance 1
Insurance contract or identification number45627
Number of Individuals Covered768
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $33,903
Total amount of fees paid to insurance companyUSD $9,522
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,903
Insurance broker organization code?3
Amount paid for insurance broker fees9522
Insurance broker nameADVANCED BENEFIT SOLUTIONS
DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )
Policy contract number0001753
Policy instance 3
Insurance contract or identification number0001753
Number of Individuals Covered750
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Dental Insurance Welfare BenefitYes
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 number45627
Policy instance 1
Insurance contract or identification number45627
Number of Individuals Covered748
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $76,728
Total amount of fees paid to insurance companyUSD $8,484
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,772
Insurance broker organization code?3
Amount paid for insurance broker fees502
Insurance broker nameBROWN & BROWN OF CENTRAL MI
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AN24
Policy instance 7
Insurance contract or identification numberGVTL0AN24
Number of Individuals Covered175
Insurance policy start date2012-12-01
Insurance policy end date2013-12-01
Total amount of commissions paid to insurance brokerUSD $6,749
Total amount of fees paid to insurance companyUSD $161
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D - VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $44,993
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,749
Amount paid for insurance broker fees161
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AN24
Policy instance 4
Insurance contract or identification numberGLUG0AN24
Number of Individuals Covered347
Insurance policy start date2012-12-01
Insurance policy end date2013-12-01
Total amount of commissions paid to insurance brokerUSD $3,707
Total amount of fees paid to insurance companyUSD $71
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $24,713
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,707
Amount paid for insurance broker fees71
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0AN24
Policy instance 6
Insurance contract or identification numberGLTD0AN24
Number of Individuals Covered53
Insurance policy start date2012-12-01
Insurance policy end date2013-12-01
Total amount of commissions paid to insurance brokerUSD $2,379
Total amount of fees paid to insurance companyUSD $47
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,861
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,379
Amount paid for insurance broker fees47
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUG0AN24
Policy instance 5
Insurance contract or identification numberGUG0AN24
Number of Individuals Covered325
Insurance policy start date2012-12-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $10,128
Total amount of fees paid to insurance companyUSD $197
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $67,518
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,128
Amount paid for insurance broker fees197
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12049684-0062
Policy instance 2
Insurance contract or identification number12049684-0062
Number of Individuals Covered215
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Vision Insurance Welfare BenefitYes
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 number45627
Policy instance 1
Insurance contract or identification number45627
Number of Individuals Covered295
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $33,953
Total amount of fees paid to insurance companyUSD $7,317
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,165
Amount paid for insurance broker fees7317
Insurance broker organization code?3
Insurance broker nameRUSSELL MANZ
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12049684-0062
Policy instance 2
Insurance contract or identification number12049684-0062
Number of Individuals Covered221
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number000000225225
Policy instance 3
Insurance contract or identification number000000225225
Number of Individuals Covered337
Insurance policy start date2012-05-01
Insurance policy end date2012-12-01
Total amount of commissions paid to insurance brokerUSD $6,170
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,686
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,196
Insurance broker organization code?3
Insurance broker nameLIEBESKIND, MICHAEL B.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number000000225226
Policy instance 4
Insurance contract or identification number000000225226
Number of Individuals Covered96
Insurance policy start date2012-05-01
Insurance policy end date2012-12-01
Total amount of commissions paid to insurance brokerUSD $2,910
Other welfare benefits providedLIFESTYLE AD&D & LIFESTYLE LIFE
Welfare Benefit Premiums Paid to CarrierUSD $18,227
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,315
Insurance broker organization code?3
Insurance broker nameADVANCED BENEFIT SOLUTIONS
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 964984
Policy instance 3
Insurance contract or identification numberOK 964984
Number of Individuals Covered295
Insurance policy start date2011-01-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $30
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $296
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 750788
Policy instance 5
Insurance contract or identification numberLK 750788
Number of Individuals Covered295
Insurance policy start date2011-01-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $970
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,703
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number000000225226
Policy instance 8
Insurance contract or identification number000000225226
Number of Individuals Covered109
Insurance policy start date2011-05-01
Insurance policy end date2012-05-11
Total amount of commissions paid to insurance brokerUSD $6,223
Other welfare benefits providedLIFESTYLE ADD LIFESTYLE LIFE
Welfare Benefit Premiums Paid to CarrierUSD $34,251
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12049684-0062
Policy instance 6
Insurance contract or identification number12049684-0062
Number of Individuals Covered167
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 962389
Policy instance 4
Insurance contract or identification numberLK 962389
Number of Individuals Covered29
Insurance policy start date2011-01-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $98
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $976
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX963330
Policy instance 2
Insurance contract or identification numberFLX963330
Number of Individuals Covered295
Insurance policy start date2011-01-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $1,129
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,288
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 number45627
Policy instance 1
Insurance contract or identification number45627
Number of Individuals Covered278
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $37,741
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number000000225225
Policy instance 7
Insurance contract or identification number000000225225
Number of Individuals Covered351
Insurance policy start date2011-05-01
Insurance policy end date2012-05-01
Total amount of commissions paid to insurance brokerUSD $11,571
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $104,842
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12049684-0062
Policy instance 6
Insurance contract or identification number12049684-0062
Number of Individuals Covered116
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 750788
Policy instance 5
Insurance contract or identification numberLK 750788
Number of Individuals Covered327
Insurance policy start date2010-01-01
Insurance policy end date2011-01-01
Total amount of commissions paid to insurance brokerUSD $8,062
Total amount of fees paid to insurance companyUSD $1,629
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,620
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,062
Amount paid for insurance broker fees1629
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
Insurance broker nameNATIONAL EMPLOYEE BENEFIT
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 962389
Policy instance 4
Insurance contract or identification numberLK 962389
Number of Individuals Covered21
Insurance policy start date2010-01-01
Insurance policy end date2011-01-01
Total amount of commissions paid to insurance brokerUSD $855
Total amount of fees paid to insurance companyUSD $171
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,548
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $855
Amount paid for insurance broker fees171
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
Insurance broker nameNATIONAL EMPLOYEE BENEFIT
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX963330
Policy instance 2
Insurance contract or identification numberFLX963330
Number of Individuals Covered306
Insurance policy start date2010-01-01
Insurance policy end date2011-01-01
Total amount of commissions paid to insurance brokerUSD $3,505
Total amount of fees paid to insurance companyUSD $709
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,053
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,505
Amount paid for insurance broker fees709
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
Insurance broker nameNATIONAL EMPLOYEE BENEFIT
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number45627
Policy instance 1
Insurance contract or identification number45627
Number of Individuals Covered257
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $39,356
Total amount of fees paid to insurance companyUSD $1,635
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,448
Insurance broker organization code?3
Amount paid for insurance broker fees1635
Insurance broker nameEDWARD BECKER, JR.
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 964984
Policy instance 3
Insurance contract or identification numberOK 964984
Number of Individuals Covered306
Insurance policy start date2010-01-01
Insurance policy end date2011-01-01
Total amount of commissions paid to insurance brokerUSD $262
Total amount of fees paid to insurance companyUSD $54
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $2,618
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $262
Amount paid for insurance broker fees54
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
Insurance broker nameNATIONAL EMPLOYEE BENEFIT

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

Copyright © Market Footprint Ltd
Contact us   Datalog Company Directory
401k Lookup     VAT Lookup S1