| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENDEAVR INSURANCE SERVICES INC3 | PO BOX 198 GREER, SC 29652 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | — | $6K | 9.68% |
| FORUM BENEFITS INC3 Filed as: FORUM BENEFITS LLC | 1122 S MAIN ST STE B GREENVILLE, SC 29601 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 1.77% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF SOUTH CAROLINA | DBA ENDEAVOR INSURANCE SERVICES 218 TRADE ST STE G GREER, SC 29651 | AMERITAS LIFE INSURANCE CORP | $5K | — | $5K | 8.96% |
| FORUM BENEFITS INC3 Filed as: FORUM BENEFITS LLC | 1122 S MAIN STREET GREENVILLE, SC 29601 | AMERITAS LIFE INSURANCE CORP | $548 | — | $548 | 1.05% |
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 | 114 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECHOICE HEALTHPLAN | 76 | $543K |
| Dental | AMERITAS LIFE INSURANCE CORP | 182 | $52K |
| Vision | AMERITAS LIFE INSURANCE CORP | 182 | $52K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 114 | $58K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 114 | $58K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 114 | $58K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 114 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 182 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.