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Form 5500 · Employee benefit plan · DETROIT, MI

BLUE CROSS BLUE SHIELD OF MICHIGAN

The filing calls this plan BLUE CROSS BLUE SHIELD OF MICHIGAN GROUP TERM LIFE INSURANCE PLAN.

BLUE CROSS BLUE SHIELD OF MICHIGAN of DETROIT, MI is a 7,804-participant finance and insurance employer whose group benefits are disclosed in its annual Form 5500 filing. Coverage is written through DEARBORN LIFE INSURANCE COMPANY. The plan's most recent policy period ended in December.

Benefits broker of record
Not disclosed
Policy year ends
Decemberas filed for plan year 2024

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 38-2069753 · plan 502 · plan year 2024, filed Oct 10, 2025

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How this plan is funded

Funding not settled by the filing

The filing does not report enough to settle how this plan pays for benefits.

All participants at the start of the year
7,804
Active at start of year
7,804
Active at end of year
7,629
Disclosed commissions
$0
Typical renewal
January 1

Benefits declared on this filing

Healthdeclared under plan 505
Dentaldeclared under plan 508
Visiondeclared under plan 510
Lifeinsured — DEARBORN LIFE INSURANCE COMPANY7,665 of 7,804 participants (98%)
Disabilitynot declared on this filing

Also declared: death benefits.

Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.

Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.

Plan brief

The filing discloses a single insured line, life, through DEARBORN LIFE INSURANCE COMPANY, covering 7,665 people.

Reported premium is $4,720,991; the filing discloses no broker commission on these contracts.

The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.

No broker of record is named on the Schedule A. The contracts may be written directly with the carrier, or the broker fields were left blank on the filing.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
DEARBORN LIFE INSURANCE COMPANYLife7,665Jan 1, 2025$4,720,991$0

Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.

See the filing at the Department of Labor

Administrator and service providers

Plan administrator on the filing
BLUE CROSS BLUE SHIELD OF MICHIGAN
EIN 38-2069753

The plan administrator is from line 3a of the main form. We publish company names only.

Other plans filed by this employer

How this plan compares

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