| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HIBBETS INSURANCE INC3 Filed as: HIBBETS INSURANCE INCORPORATED | PO BOX 2369 ORANGEBURG, SC 29116 | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | $54K | — | $54K | 3.94% |
| MCLAUGHLIN & SMOAK LLC3 | 710 JOHNNIE DODDS BLVD MT PLEASANT, SC 29464 | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | $2K | — | $2K | 0.29% |
| JOHN HIBBITS3 | P. O. BOX 2369 ORANGEBURG, SC 29118 | AMFIRST INSURANCE COMPANY | $25K | $0 | $25K | 10.00% |
| MWL3 | P. O. BOX 14067 JACKSON, MS 392364067 | AMFIRST INSURANCE COMPANY | $13K | $0 | $13K | 5.00% |
| GIBSON & ASSOCIATES INCORPORATED3 Filed as: GIBSON & ASSOC. | 7139 BROADRIVER ROAD IRMO, SC 29063 | AMFIRST INSURANCE COMPANY | $8K | $0 | $8K | 3.00% |
| HIBBITS INSURANCE INC3 Filed as: HIBBITS INSURANCE, INC. | P. O. BOX 2369 ORANGEBURG, SC 29116 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | $9K | $22K | 9.03% |
| DIANA L BIANCA3 | PO BOX 8528 MYRTLE BEACH, SC 29578 | AFLAC | $575 | — | $575 | 5.66% |
| DONNA G SMITH3 Filed as: DONNA G. SMITH | PO BOX 2207 MYRTLE BEACH, SC 29578 | AFLAC | $161 | — | $161 | 1.58% |
| TONY B. ANDERSON3 Filed as: TONY B ANDERSON | PO BOX 1061 CONWAY, SC 29528 | AFLAC | $147 | — | $147 | 1.45% |
| THOMAS BLAKELY, III3 | 174 CHANNEL BLUFF AVE. PAWLEYS ISLAND, SC 29585 | AFLAC | $42 | — | $42 | 0.41% |
| C HARVEY KING9 Filed as: C. HARVEY KING | PO BOX 1370 MT PLEASANT, SC 29465 | AFLAC | $39 | — | $39 | 0.38% |
| JAMES B LEE3 | 640 WHISPERING PINES COURT MURRELLS INLET, SC 29576 | AFLAC | $28 | — | $28 | 0.28% |
| JUSTIN M GUIDI3 Filed as: JUSTIN M. GUIDI | 555 N. PLEASANTBURG DR., STE 200 GREENVILLE, SC 29607 | AFLAC | $16 | — | $16 | 0.16% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: WILLIAM A MARSH | 317 WELLNESS COURT MYRTLE BEACH, SC 29577 | AFLAC | $15 | — | $15 | 0.15% |
| JONATHAN W MCCUTCHEON3 | 1150 MALLARD LAKE DRIVE BOGART, GA 30622 | AFLAC | $14 | — | $14 | 0.14% |
| DAYTON LLC3 Filed as: DAYTON, LLC | 221 SERENITY DRIVE PICKENS, SC 29671 | AFLAC | $10 | — | $10 | 0.10% |
| JOHN D TYLER3 | 130 DUCK HAWK WAY MARIETTA, GA 29661 | AFLAC | $9 | — | $9 | 0.09% |
| JAMES M BOYLE3 | 1325 DAIRY GLEN DRIVE FUQUAY VARINA, NC 27526 | AFLAC | $8 | — | $8 | 0.08% |
| C HARVEY KING3 Filed as: C. HARVEY KING | PO BOX 45 WEST JEFFERSON, NC 28694 | AFLAC | $4 | — | $4 | 0.04% |
No Schedule C service providers reported on this filing.
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 | 194 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 197 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 197 | $2.4M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 223 | $1.0M |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 223 | $246K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 223 | $246K |
| Short-term disability(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 223 | $256K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 223 | $246K |
| Prescription drug(2 contracts) | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 197 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 223 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.