Filings through .
History & trajectory Charts need 2 or more years. This plan has 10 years on file. Pro shows premium, premium per covered life, covered lives and carrier and broker share for every year.
See pricingThe filing reports zero broker compensation on a plan over 100 participants. The plan likely buys direct or does not report its broker. Give it a call.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
| Carrier | Coverage | Premium |
|---|---|---|
HealthRxHMO | HealthRxHMO | |
Stop-loss | Stop-loss | |
HealthRxDentalOther | HealthRxDentalOther |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 3 contracts with Pro. Pro is free for 7 days and then costs $49 a month.
These benefits are declared on the Form 5500 main form. A ✓ means the benefit also has a Schedule A insurance contract. Without one, plan assets or a Schedule C TPA fund the benefit.
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,203 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,203 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH ALLIANCE PLAN | 16 | $139K |
| Dental | GREEN SHIELD CANADA INSURANCE SERVICES | 6 | $5K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH ALLIANCE PLAN | 16 | $139K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 2,405 | $66K |
| Other | GREEN SHIELD CANADA INSURANCE SERVICES | 6 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,405 | - |
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 instead of this filer's headcount. We show the row, but it does not count the people in this plan.
Brokers paid through Schedule A and service providers paid through Schedule C.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 NONE KNOWN | Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Insurance services; Contract Administrator; Direct payment from the plan; Consulting (general); Claims processing Service code 12 | — | $1.0M |
| CENTRAL DATA SERVICES EIN 25-1352803 NONE KNOWN | Direct payment from the plan; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $399K |
| PRUDENTIAL TRUST CO. EIN 81-6705696 NONE KNOWN | Investment management fees paid indirectly by plan; Investment management; Direct payment from the plan; Investment management fees paid directly by plan; Securities brokerage commissions and fees Service code 28 | — | $239K |
| MILLIMAN, INC. EIN 91-0675641 NONE KNOWN | Consulting (general); Consulting fees; Actuarial; Direct payment from the plan Service code 11 | — | $224K |
| STATE STREET GLOBAL ADVISORS EIN 81-4017137 NONE KNOWN | Investment management; Direct payment from the plan; Investment management fees paid directly by plan; Custodial (securities); Custodial (other than securities); Investment management fees paid indirectly by plan Service code 18 | — | $118K |
| PLANTE & MORAN, PLLC EIN 33-1498605 NONE KNOWN | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $113K |
| SEGAL MARCO ADVISORS EIN 13-2646110 NONE KNOWN | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $105K |
| DELTA DENTAL OF MICHIGAN EIN 38-1791480 NONE KNOWN | Claims processing; Contract Administrator; Direct payment from the plan; Insurance services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $68K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE KNOWN | Contract Administrator; Direct payment from the plan; Claims processing; Other services; Insurance services Service code 12 | — | $47K |
| PNC BANK, NATIONAL ASSOCIATION EIN 22-1146430 NONE KNOWN | Direct payment from the plan; Custodial (securities); Other investment fees and expenses Service code 19 | — | $41K |
| GROOM LAW GROUP, CHARTERED EIN 52-1219029 NONE KNOWN | Legal; Direct payment from the plan Service code 29 | — | $37K |
| PARKER BUSINESS SOLUTIONS LLC TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | 1701 PENNSYLVANIA AVE. NW SUITE 1200 WASHINGTON, DC 20006 | $30K |
| SCOTT ANDREWS TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | 1701 PENNSYLVANIA AVE. NW SUITE 1200 WASHINGTON, DC 20006 | $26K |
| GARY MANN TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | 1701 PENNSYLVANIA AVE. NW SUITE 1200 WASHINGTON, DC 20006 | $26K |
| JAMES LEE KING TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | 1701 PENNSYLVANIA AVE. NW SUITE 1200 WASHINGTON, DC 20006 | $25K |
| GARY PETRONI TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | 1701 PENNSYLVANIA AVE. NW SUITE 1200 WASHINGTON, DC 20006 | $24K |
| JANICE CARUSO TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | 1701 PENNSYLVANIA AVE. NW SUITE 1200 WASHINGTON, DC 20006 | $24K |
| JESSICA GUBING TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | 1701 PENNSYLVANIA AVE. NW SUITE 1200 WASHINGTON, DC 20006 | $24K |
| DIALOG DIRECT EIN 46-1570786 NONE KNOWN | Direct payment from the plan; Other services Service code 49 | — | $21K |
| FIFTH THIRD NATIONAL BANK EIN 31-0281170 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $15K |
| SEGAL SELECT INSURANCE SERVICES | Insurance brokerage commissions and fees Service code 53 | — | $10K |
| SEGAL SELECT INSURANCE SERVICES INC EIN 46-0619194 NONE KNOWN | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $0 |
This section shows how the plan is funded and what that means for risk.
Welfare charges, retention and retention rate (the carrier margin on this plan) are on Pro.
1 contact
11 filings · 2015 to 2025