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ILLINOIS-CHICAGO
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BOOK NO. 21
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BILLINGSLY CONTAINER CORP.
1265 S. Foster Ave.
Chicago, IL 60624-1079
County: Cook
(773)999-9999
Ms. Judy Hart, Director of Human Resources
Mr. Dave Bly, CFO
Plan Name: Employee Health and Welfare Benefit Plan
Benefits: Health, Life, Disability
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Bus. Code
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322200
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Plan Year End
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5/31/2006
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Funding
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Insured
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Eff Date
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6/1/1984
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Active Participants
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179
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Ret-Sep Future Bens
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0
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Ret-Sep Receiving Bens
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1
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Deceased
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0
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Approx. Employees
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273
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Total Participants
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180
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Insurance Carrier
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Metropolitan Life
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Carrier Code
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65978
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Benefits
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Life Insurance
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Participants
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187
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Policy Year End
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5/31/06
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Non-experience Rated Premiums
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$15,287
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Agent-Broker
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Westin Insurance Consultants
1400 N. Clark St., Chicago, IL 60610-4700
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Commission
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$1,198
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Insurance Carrier
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Unicare Health Plans
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Carrier Code
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95505
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Benefits
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Health, Prescription Drug, HMO Contract, PPO Contract
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Participants
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178
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Policy Year End
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6/30/06
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Non-experience Rated Premiums
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$848,034
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Agent-Broker
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Westin Insurance Consultants
1400 N. Clark St., Chicago, IL 60610-4700
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Commission
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$33,890
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Insurance Carrier
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Prudential Health Care
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Carrier Code |
95040 |
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Benefits
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Health, Prescription Drug, PPO Contract
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Participants
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2
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Policy Year End
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12/31/05
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Non-experience Rated Premiums
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$6,624
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Agent-Broker
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Westin Insurance Consultants
1400 N. Clark St., Chicago, IL 60610-4700
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Commission
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$265
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Insurance Carrier
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Sun Life of Canada
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Carrier Code
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79065
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Benefits
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Long-term disability
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Participants
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49
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Policy Year End
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5/31/06
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Non-experience Rated Premiums
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$12,596
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Agent-Broker
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Westin Insurance Consultants
1400 N. Clark St., Chicago, IL 60610-4700
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Commission
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$1,868
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Provider(s)
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Fees
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Delta Dental Plan of Illinois
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Contract Administrator
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$5,864
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NOTE:
- Voluntary benefits are offered
- Current primary health carrier (2006) is Unicare Health Plans
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OHIO-NORTHERN
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BOOK NO. 59
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ADVANCE TECHNO GROUP
1800 Buford Avenue
Toledo, OH 43624-1428
County: Lucas
(419)999-9999
Mr. Ted Larkin, VP, Human Resources
Mr. Thomas Dunn, CFO
Ms. Joy Matthews, Benefits Manager
Plan Name: Group Insurance Trust
Benefits: Health, Life, Dental
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Bus. Code
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921100
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Plan Year End |
12/31/2005 |
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Funding
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Insurance, Trust, Spon. assets
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Eff Date
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1/1/1982
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| |
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Active Participants
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985
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Ret-Sep Future Bens
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0
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Ret-Sep Receiving Bens
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0
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Deceased
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0
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Approx. Employees
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958
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Total Participants
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985
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Contributors
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Benefits Paid
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Employer Contribs
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$3,383,544
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Direct to Participants
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0
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Participant Contribs
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0
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To Insurance Carriers
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$3,287,735
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Other Contribs
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0
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Other
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$24,180
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Non-Cash Contribs
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0
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Total Benefits
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$3,311,915
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Total Contribs
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$3,383,544
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Total Income
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$3,392,262
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Total Adm. Expenses
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$80,122
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Total Expense
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$3,392,037
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Total Assets
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$188,193
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Net Income
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$225
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Insurance Carrier
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Medical Life
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Carrier Code
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86991
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Benefits
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Life Insurance
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Participants
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985
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Policy Year End
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12/31/05
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Non-experience Rated Premiums
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$53,307
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Insurance Carrier
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Medical Mutual Insurance
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Carrier Code
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29076
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Benefits
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Dental
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| Participants
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861
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Policy Year End
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12/31/05
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Non-experience Rated Premiums
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$352,769
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Insurance Carrier
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Paramount Health Care
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Carrier Code
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95189
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Benefits
|
Health
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Participants
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674
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Policy Year End
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12/31/05
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Non-experience Rated Premiums
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$2,473,672
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Insurance Carrier
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Family Health Insurance
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Carrier Code
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96865
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Benefits
|
Health
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Participants
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139
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Policy Year End
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12/31/05
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Non-experience Rated Premiums
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$407,855
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Provider(s)
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Fees
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S.A.S.I.
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Contract Administrator
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$50,982
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Brooks Insurance
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Consulting
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$18,000
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NOTE:
- Current primary health carrier (2005) is United Healthcare
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