| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTOPHER ROSS3 | LAWLEY SERVICE INC. 361 DELAWARE AVENUE BUFFALO, NY 14202 | BLUE CARE NETWORK OF MICHIGAN | $34K | — | $34K | 2.73% |
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY BENEFITS GROUP | — | HIP HEALTH PLANS | $15K | — | $15K | 2.81% |
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY BENEFITS GROUP | — | HIP HEALTH PLANS | $11K | — | $11K | 3.61% |
| CHRISTOPHER ROSS3 | LAWLEY SERVICE INC. 361 DELWARE AVENUE BUFFALO, NY 14202 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $8K | — | $8K | 4.24% |
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY SERVICE INC. | 361 DELAWARE AVENUE BUFFALO, NY 14202 | EMPIRE HEALTH CHOICE HMO, INC.(G1922) | $3K | — | $3K | 1.76% |
| LAWLEY BENEFITS GROUP LLC3 | — | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $839 | $4K | 8.23% |
| FRED DENTINGER3 | 110 THOMAS JEFFERSON LN BUFFALO, NY 14226 | FIRST UNUM LIFE INSURANCE COMPANY | $483 | — | $483 | 1.05% |
| CREATIVE BENEFITS SOLUTIONS3 Filed as: CREATIVE BENEFITS SOLUTIONS LLC | 5435 CORPORATE DRIVE SUITE 260 TROY, MI 480982609 | METROPOLITAN LIFE INSURANCE COMPANY | $928 | — | $928 | 5.64% |
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY SERVICE INC. | — | METROPOLITAN LIFE INSURANCE COMPANY | $273 | $14 | $287 | 1.74% |
| CORNERSTONE BENEFITS LLC3 | 1450 W LONG LAKE RD SUITE 250 TROY, MI 48084 | AMERICAN UNITED LIFE INSURANCE COMPANY | $609 | — | $609 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MATRIX QUALITY CARE, INC. EIN 13-3848923 NONE | Claims processing Service code 12 | — | $1.3M |
| INDEPENDENT HEALTH EIN 16-1237733 NONE | Claims processing Service code 12 | — | $451K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 1,288 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,288 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 195 | $1.4M |
| Dental(2 contracts, 2 carriers) | MIDWESTERN DENTAL PLANS, INC. | 230 | $76K |
| Life insurance(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 1,133 | $52K |
| Prescription drug | BLUE CARE NETWORK OF MICHIGAN | 195 | $1.2M |
| Other(2 contracts) | HIP HEALTH PLANS | 90 | $853K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,133 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.