| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JANET SLOAN3 | PO BOX 70190 MYRTLE BEACH, SC 29572 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 4.66% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BCBS OF SOUTH CAROLINA | I-20 AT ALPINE ROAD COLUMBIA, SC 29219 | COMPANION LIFE | $7K | $0 | $7K | 7.40% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BCBS OF SOUTH CAROLINA | I-20 AT ALPINE ROAD COLUMBIA, SC 29219 | COMPANION LIFE | $2K | $0 | $2K | 2.74% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BCBS OF SOUTH CAROLINA | I-20 AT ALPINE ROAD COLUMBIA, SC 29219 | COMPANION LIFE | $2K | $0 | $2K | 5.00% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BCBS OF SOUTH CAROLINA | I-20 AT ALPINE ROAD COLUMBIA, SC 29219 | COMPANION LIFE | $2K | $0 | $2K | 5.01% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BCBS OF SOUTH CAROLINA | I-20 AT ALPINE ROAD COLUMBIA, SC 29219 | COMPANION LIFE | $544 | $0 | $544 | 2.26% |
| JANET SLOAN3 | PO BOX 70190 MYRTLE BEACH, SC 29572 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BCBS OF SOUTH CAROLINA | I-20 AT ALPINE ROAD COLUMBIA, SC 29219 | COMPANION LIFE | $303 | $0 | $303 | 5.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDCOM EIN 59-2316866 TPA | Contract Administrator; Claims processing Service code 12 | 1061 RIVERSIDE DR JACKSONVILLE, FL 32204 | $8K |
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 | 285 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | 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) | 285 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF SOUTH CAROLINA | 285 | $3.0M |
| Dental(2 contracts) | COMPANION LIFE | 161 | $102K |
| Life insurance(2 contracts) | COMPANION LIFE | 282 | $86K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 193 | $101K |
| Other(3 contracts, 2 carriers) | COMPANION LIFE | 282 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 285 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.