| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CREATIVE BENEFITS, INC.3 Filed as: CREATIVE BENEFIT SOLUTIONS | 5435 CORPORATE DR, STE 260 TROY, MI 48098 | BLUE CARE NETWORK OF MICHIGAN | $41K | $0 | $41K | 2.15% |
| CREATIVE BENEFITS, INC.3 Filed as: CREATIVE BENEFIT SOLUTIONS | 5435 CORPORATE DR, STE 260 TROY, MI 48098 | GUARDIAN | $28K | $0 | $28K | 6.69% |
| CREATIVE BENEFITS, INC.3 Filed as: CREATIVE BENEFIT SOLUTIONS | 5435 CORPORATE DR, STE 260 TROY, MI 48098 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $9K | $0 | $9K | 3.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE HEALTH INSURANCE MGMT INC. EIN 38-2776173 HEALTH/FLEX ADMIN | Contract Administrator Service code 13 | — | $71K |
| TOTAL ADMINISTRATIVE SERVICES CORP. EIN 39-1561025 FLEX/HSA VENDOR | Contract Administrator Service code 13 | 2302 INTERNATIONAL LANE MADISON, WI 53704 | $12K |
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 | 405 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 29 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 434 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 545 | $2.2M |
| Dental | GUARDIAN | 414 | $418K |
| Vision | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | 32 | $243K |
| Life insurance | GUARDIAN | 414 | $418K |
| Short-term disability | GUARDIAN | 414 | $418K |
| Long-term disability | GUARDIAN | 414 | $418K |
| Other(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 545 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 545 | — |
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.