Form 5500 · Employee benefit plan · WARREN, MI
MICHIGAN SURGERY SPECIALISTS, P.C.
The filing calls this plan MICHIGAN SURGERY SPECIALISTS, P.C. WELFARE BENEFIT PLAN.
MICHIGAN SURGERY SPECIALISTS, P.C. of WARREN, MI insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is WILLIAM A LEY. Coverage is written through BLUE CROSS BLUE SHIELD OF MICHIGAN and 3 other carriers. The plan's most recent policy period ended in August.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 38-1958736 · plan 501 · plan year 2025, filed Jan 19, 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: other welfare.
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 8 insured contracts covering health, dental, vision, life and disability; the largest, with BLUE CROSS BLUE SHIELD OF MICHIGAN, covers 148 people.
Reported premium across the insured contracts is $1,776,754, with $63,851 in disclosed broker commissions — about 3.6% of premium.
The most recent policy period ended in August, and the plan year ends August 31. Group contracts typically renew on that annual cycle.
WILLIAM A LEY is the broker of record on 2 of the 8 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including BLUE CROSS BLUE SHIELD OF MICHIGAN, BLUE CARE NETWORK OF MICHIGAN, THE LINCOLN NATIONAL LIFE INSURANCE COMPANY and FIDELITY SECURITY LIFE INSURANCE COMPANY. BLUE CROSS BLUE SHIELD OF MICHIGAN writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN | Health | 148 | Aug 31, 2025 | $1,072,215 | $31,855 |
| BLUE CARE NETWORK OF MICHIGAN | Health | 85 | Sep 1, 2025 | $563,695 | $16,765 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Disability | 64 | Sep 1, 2025 | $60,114 | $6,011 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Disability | 29 | Aug 31, 2025 | $22,709 | $3,406 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 27 | Sep 1, 2025 | $15,837 | $2,376 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Dental | 69 | Sep 1, 2025 | $25,493 | $1,785 |
| FIDELITY SECURITY LIFE INSURANCE COMPANY | Vision | 115 | Sep 1, 2025 | $12,789 | $1,263 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 150 | Sep 1, 2025 | $3,902 | $390 |
Premium and claims on these contracts
BLUE CROSS BLUE SHIELD OF MICHIGAN, contract 137657. For the contract year on this filing, the carrier reported $1,072,215 in premium earned and $981,038 in claims incurred. Dividing one by the other gives 91%.
BLUE CARE NETWORK OF MICHIGAN, contract 137657. For the contract year on this filing, the carrier reported $563,695 in premium earned and $470,005 in claims incurred. Dividing one by the other gives 83%.
- BLUE CROSS BLUE SHIELD OF MICHIGAN, contract 137657 reported $269,113 in retention.
- BLUE CARE NETWORK OF MICHIGAN, contract 137657 reported $139,901 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.
Other plans filed by this employer
How this plan compares
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