No insurance carriers on this filing. Self-funded welfare plans typically pay TPAs and PBMs through Schedule C, not Schedule A.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 NONE KNOWN | Direct payment from the plan; Insurance services; Float revenue; Consulting (general); Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Claims processing Service code 12 | — | $5.7M |
| CENTRAL STATES SE & SW PENSION FUND EIN 36-6044243 NONE KNOWN | Direct payment from the plan; Other services Service code 49 | — | $1.2M |
| DELTA DENTAL PLAN OF MICHIGAN EIN 38-1791480 NONE KNOWN | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $636K |
| YOUNGSOFT, INC. EIN 38-3274599 NONE KNOWN | Direct payment from the plan; Other services Service code 49 | — | $489K |
| THE TRIZETTO CUSTOMER GROUP, INC. EIN 33-0761159 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $369K |
| TOWERS WATSON DELAWARE, INC. EIN 23-1159360 NONE KNOWN | Direct payment from the plan; Consulting (general); Actuarial; Consulting fees Service code 11 | — | $273K |
| RICHARD BURKER EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $258K |
| AON RISK SERVICES EIN 38-0479530 NONE KNOWN | Insurance services; Direct payment from the plan Service code 23 | — | $193K |
| SOURCE HOV EIN 38-3384800 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $171K |
| KYLE STALLMAN EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $144K |
| LAW OFFICES OF MICHAEL J. MILLS EIN 38-3043446 NONE KNOWN | Legal; Direct payment from the plan Service code 29 | — | $138K |
| REHAN AHMED EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $113K |
| SANDIE BOWMAN EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $112K |
| MDLIVE, INC. EIN 45-4937055 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $110K |
| PLANTE & MORAN, PLLC EIN 38-1357951 NONE KNOWN | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $108K |
| CVS CAREMARK EIN 95-3382344 NONE KNOWN | Direct payment from the plan; Claims processing; Other fees; Contract Administrator Service code 12 | — | $105K |
| INTERACTIVE BUSINESS SYSTEMS EIN 36-3152441 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $103K |
| DTE ENERGY COMPANY EIN 38-3217752 NONE KNOWN | Direct payment from the plan; Other services Service code 49 | — | $98K |
| BARB MCGUIRE EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $97K |
| BURHAN TANWEER EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $94K |
| JEFFREY LIU EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $93K |
| SHI INTERNATIONAL CORP EIN 22-3009648 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $91K |
| CYNTHIA BOETTNER EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $87K |
| KRISTINE ROBERTS EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $87K |
| STEVE HARBRON EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $84K |
| PATRICIA LAVIGNE EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $81K |
| PRANAY REDDY EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $81K |
| KAREN GLOVER EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $81K |
| KIM BRATEK EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $79K |
| KALIM RATHUR EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $78K |
| ERICA MILLER EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $77K |
| CORY BUCHANAN EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $76K |
| GDI OMNI INC EIN 39-2079800 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $74K |
| SHERRYLN HALL EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $74K |
| CURTIS BROWN EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $74K |
| BASELINE DATA SERVICES, LLC EIN 20-5127498 NONE KNOWN | Direct payment from the plan; Other services Service code 49 | — | $70K |
| DAWN LAWRENCE EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $68K |
| WILL KUYK EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $66K |
| RAMONA FRANTZ EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $66K |
| RICOH USA, INC. EIN 23-0334400 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $65K |
| DOUGLAS JENKINS EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $65K |
| KRISTI CRONK EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $63K |
| CHERYL VIEREGGE EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $62K |
| CAROL SHIREY EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $62K |
| DEARBORN LITHOGRAPH, INC. EIN 38-1313164 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $59K |
| GUARDIAN BONDED SECURITY SERVICES EIN 38-2066584 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $59K |
| CINDY STORR EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $58K |
| JOE MEIROW EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $56K |
| DIANA HUGHES EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $55K |
| JAKE WROBEL EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $55K |
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 | 14,124 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 14,124 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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."
Self-funded plan with no stop-loss carrier attached. Catastrophic-risk exposure; stop-loss specialist sales target.