# OX PAPERBOARD MICHIGAN LLC HEALTH CARE PLAN

Health and welfare plan sponsored by **OX PAPERBOARD MICHIGAN LLC**. Form 5500 filing for plan year 2024.

| Field | Value |
|---|---|
| Sponsor | OX PAPERBOARD MICHIGAN LLC |
| EIN | 454440302 |
| Plan number | 501 |
| Plan year | 2024 |
| Location | NORTHVILLE, MI |
| Industry | paper & forest products |
| Funding | fully insured |
| Total premiums | $2.6M |
| Participants | 181 |
| Persons covered | 342 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| BCBS OF MICHIGAN | Health, Rx, PPO |
| SUN LIFE FINANCIAL | Life, STD, LTD, Indemnity, Other |
| DELTA DENTAL OF MICHIGAN | Dental |
| VISION SERVICE PLAN (VSP) | Vision |
| BRONSON BATTLE CREEK DBA HELPNET EAP | Other |

## Brokers

| Broker | Placed with |
|---|---|
| PATRICIA SULLIVAN FORLETTA | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| GALLAGHER BENEFIT SERVICES, INC. | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| GALLAGHER BENEFIT SERVICES, INC. | SUN LIFE ASSURANCE COMPANY OF CANADA |
| GALLAGHER BENEFIT SERVICES, INC. | DELTA DENTAL OF MICHIGAN |
| GALLAGHER BENEFIT SERVICES, INC. | VISION SERVICE PLAN |

## About this data

- Source: public Form 5500 filings from the U.S. Department of Labor (EBSA), rebuilt on each DOL release.
- Full page (charts, history, peer benchmarks, fees, contacts): https://planoptica.com/welfare/454440302-501
- Cite as: PlanOptica, https://planoptica.com/welfare/454440302-501
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