CHARTER SCHOOL SERVICES OF MICHIGAN, INC. has sponsored the creation of one or more 401k plans.
Additional information about CHARTER SCHOOL SERVICES OF MICHIGAN, INC.
Submission information for form 5500 for 401k plan CHARTER SCHOOL SERVICES OF MICHIGAN, INC. WELFARE BENEFIT PLAN
401k plan membership statisitcs for CHARTER SCHOOL SERVICES OF MICHIGAN, INC. WELFARE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2016: CHARTER SCHOOL SERVICES OF MICHIGAN, INC. WELFARE BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-07-01 | 79 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 90 |
| Number of retired or separated participants receiving benefits | 2016-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-07-01 | 0 |
| Total of all active and inactive participants | 2016-07-01 | 90 |
| 2015: CHARTER SCHOOL SERVICES OF MICHIGAN, INC. WELFARE BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-07-01 | 82 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 79 |
| Number of retired or separated participants receiving benefits | 2015-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-07-01 | 0 |
| Total of all active and inactive participants | 2015-07-01 | 79 |
| 2014: CHARTER SCHOOL SERVICES OF MICHIGAN, INC. WELFARE BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-07-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 82 |
| Number of retired or separated participants receiving benefits | 2014-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-07-01 | 0 |
| Total of all active and inactive participants | 2014-07-01 | 82 |
| 2013: CHARTER SCHOOL SERVICES OF MICHIGAN, INC. WELFARE BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-07-01 | 103 |
| Total of all active and inactive participants | 2013-07-01 | 0 |
| 2012: CHARTER SCHOOL SERVICES OF MICHIGAN, INC. WELFARE BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-07-01 | 113 |
| Total of all active and inactive participants | 2012-07-01 | 0 |
| 2011: CHARTER SCHOOL SERVICES OF MICHIGAN, INC. WELFARE BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-07-01 | 144 |
| Total of all active and inactive participants | 2011-07-01 | 0 |
| 2009: CHARTER SCHOOL SERVICES OF MICHIGAN, INC. WELFARE BENEFIT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-07-01 | 131 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 143 |
| Total of all active and inactive participants | 2009-07-01 | 143 |
| ALLIANCE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60134 ) |
| Policy contract number | 10004813 |
| Policy instance | 4 |
| Insurance contract or identification number | 10004813 | | Number of Individuals Covered | 63 | | Insurance policy start date | 2016-09-01 | | Insurance policy end date | 2017-08-31 | | Welfare Benefit Premiums Paid to Carrier | USD $271,603 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
| Policy contract number | 10004814 |
| Policy instance | 3 |
| Insurance contract or identification number | 10004814 | | Number of Individuals Covered | 66 | | Insurance policy start date | 2016-09-01 | | Insurance policy end date | 2017-08-31 | | Welfare Benefit Premiums Paid to Carrier | USD $355,008 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ADN ADMINISTRATORS, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 502 |
| Policy instance | 2 |
| Insurance contract or identification number | 502 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of fees paid to insurance company | USD $8,040 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 8040 | | Insurance broker organization code? | 3 | | Insurance broker name | ADN ADMINISTRATORS |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 469884 |
| Policy instance | 1 |
| Insurance contract or identification number | 469884 | | Number of Individuals Covered | 24 | | Insurance policy start date | 2016-09-01 | | Insurance policy end date | 2017-09-01 | | Total amount of commissions paid to insurance broker | USD $1,167 | | Total amount of fees paid to insurance company | USD $144 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $5,777 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 144 | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $1,167 | | Insurance broker name | CAMBRIDGE CONSULTING GROUP, LLC |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 001007071100000 |
| Policy instance | 2 |
| Insurance contract or identification number | 001007071100000 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $1,010 | | Other welfare benefits provided | WEEKLY INCOME | | Welfare Benefit Premiums Paid to Carrier | USD $9,331 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $681 | | Insurance broker organization code? | 3 | | Insurance broker name | MOULTHROP CLIFT INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 001007071000000 |
| Policy instance | 3 |
| Insurance contract or identification number | 001007071000000 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $1,045 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,965 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $655 | | Insurance broker organization code? | 3 | | Insurance broker name | MOULTHROP CLIFT INC. |
|
| ADN ADMINISTRATORS, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 502 |
| Policy instance | 5 |
| Insurance contract or identification number | 502 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of fees paid to insurance company | USD $7,701 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 7701 | | Insurance broker organization code? | 3 | | Insurance broker name | ADN ADMINISTRATORS |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 001007070900000 |
| Policy instance | 1 |
| Insurance contract or identification number | 001007070900000 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $494 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $3,822 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $323 | | Insurance broker organization code? | 3 | | Insurance broker name | MOULTHROP CLIFT INC. |
|
| EMPLOYEE HEALTH INSURANCE MANAGEMENT (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 50001426-01 |
| Policy instance | 4 |
| Insurance contract or identification number | 50001426-01 | | Number of Individuals Covered | 68 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $15,113 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,113 | | Insurance broker organization code? | 3 | | Insurance broker name | MOULTHROP-CLIFT, INC. |
|
| HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
| Policy contract number | 10004025 |
| Policy instance | 6 |
| Insurance contract or identification number | 10004025 | | Number of Individuals Covered | 66 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $18,863 | | Welfare Benefit Premiums Paid to Carrier | USD $297,768 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,986 | | Insurance broker organization code? | 3 | | Insurance broker name | CAMBRIDGE CONSULTING GROUP LLC |
|
| ALLIANCE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60134 ) |
| Policy contract number | 10004026 |
| Policy instance | 7 |
| Insurance contract or identification number | 10004026 | | Number of Individuals Covered | 70 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $14,799 | | Welfare Benefit Premiums Paid to Carrier | USD $250,043 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,092 | | Insurance broker organization code? | 3 | | Insurance broker name | CAMBRIDGE CONSULTING GROUP LLC |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 001007071100000 |
| Policy instance | 2 |
| Insurance contract or identification number | 001007071100000 | | Number of Individuals Covered | 103 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $1,688 | | Other welfare benefits provided | WEEKLY INCOME | | Welfare Benefit Premiums Paid to Carrier | USD $16,213 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,688 | | Insurance broker organization code? | 3 | | Insurance broker name | MOULTHROP CLIFT INC. |
|
| EMPLOYEE HEALTH INSURANCE MANAGEMENT (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 50001426-01 |
| Policy instance | 4 |
| Insurance contract or identification number | 50001426-01 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2013-09-01 | | Insurance policy end date | 2014-08-31 | | Total amount of commissions paid to insurance broker | USD $635 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $635 | | Insurance broker organization code? | 3 | | Insurance broker name | MOULTHROP-CLIFT, INC. |
|
| ADN ADMINISTRATORS, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 502 |
| Policy instance | 5 |
| Insurance contract or identification number | 502 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of fees paid to insurance company | USD $9,087 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 9087 | | Insurance broker organization code? | 3 | | Insurance broker name | ADN ADMINISTRATORS |
|
| ALLIANCE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60134 ) |
| Policy contract number | 10004026 |
| Policy instance | 6 |
| Insurance contract or identification number | 10004026 | | Number of Individuals Covered | 44 | | Insurance policy start date | 2013-09-01 | | Insurance policy end date | 2014-08-31 | | Total amount of commissions paid to insurance broker | USD $7,927 | | Welfare Benefit Premiums Paid to Carrier | USD $144,018 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,927 | | Insurance broker organization code? | 3 | | Insurance broker name | MOULTHROP-CLIFT, INC. |
|
| HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
| Policy contract number | 10004025 |
| Policy instance | 7 |
| Insurance contract or identification number | 10004025 | | Number of Individuals Covered | 101 | | Insurance policy start date | 2013-09-01 | | Insurance policy end date | 2014-08-31 | | Total amount of commissions paid to insurance broker | USD $27,610 | | Welfare Benefit Premiums Paid to Carrier | USD $481,021 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,610 | | Insurance broker organization code? | 3 | | Insurance broker name | MOULTHROP-CLIFT, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 001007070900000 |
| Policy instance | 1 |
| Insurance contract or identification number | 001007070900000 | | Number of Individuals Covered | 103 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $761 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $5,901 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $761 | | Insurance broker organization code? | 3 | | Insurance broker name | MOULTHROP CLIFT INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 001007071000000 |
| Policy instance | 3 |
| Insurance contract or identification number | 001007071000000 | | Number of Individuals Covered | 103 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $1,709 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,395 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,709 | | Insurance broker organization code? | 3 | | Insurance broker name | MOULTHROP CLIFT INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 001007070900000 |
| Policy instance | 1 |
| Insurance contract or identification number | 001007070900000 | | Number of Individuals Covered | 113 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $753 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $5,853 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $753 | | Insurance broker organization code? | 3 | | Insurance broker name | MOULTHROP CLIFT INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 001007071100000 |
| Policy instance | 2 |
| Insurance contract or identification number | 001007071100000 | | Number of Individuals Covered | 113 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $1,700 | | Other welfare benefits provided | WEEKLY INCOME | | Welfare Benefit Premiums Paid to Carrier | USD $16,394 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,700 | | Insurance broker organization code? | 3 | | Insurance broker name | MOULTHROP CLIFT INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 001007071000000 |
| Policy instance | 3 |
| Insurance contract or identification number | 001007071000000 | | Number of Individuals Covered | 113 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $1,641 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,937 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,641 | | Insurance broker organization code? | 3 | | Insurance broker name | MOULTHROP CLIFT INC. |
|
| EMPLOYEE HEALTH INSURANCE MANAGEMENT (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 50001426-01 |
| Policy instance | 4 |
| Insurance contract or identification number | 50001426-01 | | Number of Individuals Covered | 89 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Total amount of commissions paid to insurance broker | USD $720 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $720 | | Insurance broker organization code? | 3 | | Insurance broker name | MOULTHROP-CLIFT, INC. |
|
| ASSOCIATED MUTUAL (National Association of Insurance Commissioners NAIC id number: 87882 ) |
| Policy contract number | 3170 |
| Policy instance | 5 |
| Insurance contract or identification number | 3170 | | Number of Individuals Covered | 94 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Total amount of commissions paid to insurance broker | USD $1,527 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,649 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,527 | | Insurance broker organization code? | 3 | | Insurance broker name | JOHN DENTON |
|
| HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
| Policy contract number | 10004026 |
| Policy instance | 6 |
| Insurance contract or identification number | 10004026 | | Number of Individuals Covered | 64 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Total amount of commissions paid to insurance broker | USD $10,053 | | Welfare Benefit Premiums Paid to Carrier | USD $197,625 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,053 | | Insurance broker organization code? | 3 | | Insurance broker name | MOULTHROP-CLIFT, INC. |
|
| HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
| Policy contract number | 10004025 |
| Policy instance | 7 |
| Insurance contract or identification number | 10004025 | | Number of Individuals Covered | 64 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Total amount of commissions paid to insurance broker | USD $18,653 | | Welfare Benefit Premiums Paid to Carrier | USD $356,426 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,653 | | Insurance broker organization code? | 3 | | Insurance broker name | MOULTHROP-CLIFT, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 001007070900000 |
| Policy instance | 1 |
| Insurance contract or identification number | 001007070900000 | | Number of Individuals Covered | 144 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $847 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $6,708 | | 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 | 001007071100000 |
| Policy instance | 2 |
| Insurance contract or identification number | 001007071100000 | | Number of Individuals Covered | 144 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $1,937 | | Other welfare benefits provided | WEEKLY INCOME | | Welfare Benefit Premiums Paid to Carrier | USD $19,868 | | 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 | 001007071000000 |
| Policy instance | 3 |
| Insurance contract or identification number | 001007071000000 | | Number of Individuals Covered | 144 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $1,958 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,051 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 004011760001 |
| Policy instance | 4 |
| Insurance contract or identification number | 004011760001 | | Number of Individuals Covered | 108 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-10-31 | | Total amount of commissions paid to insurance broker | USD $17,984 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $343,665 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | CID 401176 |
| Policy instance | 5 |
| Insurance contract or identification number | CID 401176 | | Number of Individuals Covered | 92 | | Insurance policy start date | 2011-08-01 | | Insurance policy end date | 2012-07-31 | | Total amount of commissions paid to insurance broker | USD $25,061 | | Total amount of fees paid to insurance company | USD $1,094 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMPLOYEE HEALTH INSURANCE MANAGEMENT (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 50001426-01 |
| Policy instance | 6 |
| Insurance contract or identification number | 50001426-01 | | Number of Individuals Covered | 103 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $2,731 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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