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 | Other fees; Insurance services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Direct payment from the plan; Consulting (general) Service code 12 | — | $6.2M |
| CENTRAL STATES SE & SW PENSION FUND EIN 36-6044243 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $1.3M |
| DELTA DENTAL PLAN OF MICHIGAN EIN 38-1791480 NONE KNOWN | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $589K |
| YOUNGSOFT, INC EIN 38-3274599 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $353K |
| TOWERS WATSON DELAWARE, INC. EIN 23-1159360 NONE KNOWN | Consulting fees; Consulting (general); Direct payment from the plan; Actuarial Service code 11 | — | $335K |
| RICHARD BURKER EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $276K |
| HOV SERVICES LLC 9092 EIN 38-3384800 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $185K |
| LAW OFFICES OF MICHAEL J. MILLS EIN 38-3043446 NONE KNOWN | Legal; Direct payment from the plan Service code 29 | — | $154K |
| KYLE STALLMAN EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $147K |
| PATRICIA LAVIGNE EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $140K |
| MDLIVE, INC. EIN 45-4937055 NONE KNOWN | Direct payment from the plan; Other services Service code 49 | — | $128K |
| CVS CAREMARK EIN 95-3382344 NONE KNOWN | Other fees; Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $120K |
| SYED AHMED EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $115K |
| DTE ENERGY EIN 38-3217752 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $115K |
| SANDRA BOWMAN-CLAUS EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $112K |
| BARBARA MCGUIRE EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $101K |
| DOUGLAS JENKINS EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $98K |
| BURHAN TANWEER EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $96K |
| MARK GUENTHER EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $91K |
| KRISTINE ROBERTS EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $90K |
| SUSAN MCGUIRE EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $90K |
| GDI OMNI EIN 39-2079800 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $90K |
| CYNTHIA BOETTNER EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $89K |
| KAREN GLOVER EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $89K |
| STEVEN HARBRON EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $86K |
| PRANAY REDDY EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $83K |
| KIMBERLEE BRATEK EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $81K |
| KALIM RATHUR EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $80K |
| ERICA MILLER EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $79K |
| CORRINE BUCHANAN EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $77K |
| SHERRYLN HALL EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $75K |
| BASELINE DATA SERVICES, LLC EIN 20-5127498 NONE KNOWN | Direct payment from the plan; Other services Service code 49 | — | $75K |
| DAWN LAWRENCE EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $69K |
| LORENE (GAIL) LOWRAN EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $68K |
| RAMONA FRANTZ EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $67K |
| CAROL SHIREY EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $67K |
| RSM US LLP EIN 42-0714325 NONE KNOWN | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $66K |
| KRISTI CRONK EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $65K |
| BRENT DAVID SMITH, D.O. EIN 36-5784581 NONE KNOWN | Consulting (general); Direct payment from the plan Service code 16 | — | $65K |
| WILLIAM KUYK EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $63K |
| TODD GRAHAM EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $62K |
| KELLY MIKOLAJEWSKI EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $62K |
| HONG JIANG EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $60K |
| CYNTHIA MCLAIN EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| JAKE WROBEL EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $58K |
| SHI INTERNATIONAL CORP EIN 22-3009648 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $58K |
| DIANA HUGHES EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $56K |
| GUARDIAN BONDED SECURITY SERVICES EIN 38-2066584 NONE KNOWN | Direct payment from the plan; Other services Service code 49 | — | $55K |
| WILLIAM LAMBROSE EIN 38-1328578 EMPLOYEE OF PLAN | Direct payment from the plan; Employee (plan) Service code 30 | — | $54K |
| AARON TONEY EIN 38-1328578 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $53K |
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 | 15,152 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 15,152 | 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.