| 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 | $33K | — | $33K | 2.90% |
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY BENEFITS GROUP | THOMAS REVELAS 361 DELAWARE AVENUE BUFFALO, NY 14202 | HIP HEALTH PLANS | $14K | — | $14K | 1.96% |
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY BENEFITS GROUP | THOMAS REVELAS 361 DELAWARE AVENUE BUFFALO, NY 14202 | HIP HEALTH PLANS | $6K | — | $6K | 1.96% |
| CHRISTOPHER ROSS3 | LAWLEY SERVICE INC. 361 DELWARE AVENUE BUFFALO, NY 14202 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $2K | — | $2K | 0.96% |
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY SERVICE INC. | 361 DELAWARE AVENUE BUFFALO, NY 14202 | EMPIRE HEALTH CHOICE HMO, INC.(G1922) | $1K | — | $1K | 1.14% |
| LAWLEY BENEFITS GROUP LLC3 | 361 DELAWARE AVE. BUFFALO, NY 142021622 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $773 | $4K | 8.89% |
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY SERVICES, INC. | — | DELTA DENTAL OF MICHIGAN | $1K | — | $1K | 9.11% |
| LAWLEY BENEFITS GROUP LLC3 Filed as: LAWLEY INSURANCE | — | FIDELITY SECURITY LIFE INSURANCE COMPANY | $944 | — | $944 | 9.14% |
| CORNERSTONE BENEFITS LLC3 | 1450 W LONG LAKE RD SUITE 250 TROY, MI 48084 | AMERICAN UNITED LIFE INSURANCE COMPANY | $593 | — | $593 | 10.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MATRIX QUALITY CARE, INC. EIN 13-3848923 NONE | Claims processing Service code 12 | — | $1.2M |
| INDEPENDENT HEALTH EIN 16-1237733 NONE | Claims processing Service code 12 | — | $499K |
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 | 1,285 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,285 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 156 | $1.3M |
| Dental(2 contracts, 2 carriers) | MIDWESTERN DENTAL PLANS, INC. | 167 | $70K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 100 | $10K |
| Life insurance(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 1,143 | $50K |
| Prescription drug | BLUE CARE NETWORK OF MICHIGAN | 156 | $1.1M |
| Other(2 contracts) | HIP HEALTH PLANS | 102 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,143 | — |
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."
No prospect flags tripped on this filing.