Form 5500 · Employee benefit plan · NOVI, MI
CAMELOT VENTURE GROUP, LLC
The filing calls this plan CAMELOT VENTURE GROUP WRAP BENEFIT PLAN.
CAMELOT VENTURE GROUP, LLC of NOVI, MI insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is KATHERINE HENRY - NFP CORPORATE. Coverage is written through BLUE CROSS BLUE SHIELD OF MICHIGAN and 1 other carrier. The plan's most recent policy period ended in October.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 26-3390928 · plan 501 · plan year 2025, filed Mar 27, 2026
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits 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.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
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
Schedule A lists 2 insured contracts covering health, dental, vision, life and disability; the largest, with BLUE CROSS BLUE SHIELD OF MICHIGAN, covers 259 people.
Reported premium across the insured contracts is $1,714,924, with $46,481 in disclosed broker commissions — about 2.7% of premium.
The most recent policy period ended in October, and the plan year ends October 31. Group contracts typically renew on that annual cycle.
KATHERINE HENRY - NFP CORPORATE is the broker of record on 1 of the 2 contracts; the rest name a different broker or none.
Two carriers split the book: BLUE CROSS BLUE SHIELD OF MICHIGAN and EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN | Health | 259 | Nov 1, 2025 | $1,539,960 | $46,481 |
| EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | Health, Dental, Vision, Life, Disability | 153 | Nov 1, 2025 | $174,964 | $0 |
Premium and claims on this contract
BLUE CROSS BLUE SHIELD OF MICHIGAN, contract 290788. For the contract year on this filing, the carrier reported $1,539,960 in premium earned and $1,721,780 in claims incurred. Dividing one by the other gives 112%.
- BLUE CROSS BLUE SHIELD OF MICHIGAN, contract 290788 reported $427,424 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
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.
Administrator and service providers
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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