| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 4064 COLONY ROAD, SUITE 450 CHARLOTTE, NC 28211 | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | $14K | — | $14K | 3.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 15.36% |
| DERRELL B ODOM3 Filed as: DERRELL ODOM | 5082 MARIANA COURT TEGA CAY, SC 29708 | AFLAC | $2K | $237 | $3K | 13.50% |
| DONNA L MATTHEWS3 Filed as: DONNA MATTHEWS | 3152 HITCHING POST LANE ROCK HILL, SC 29732 | AFLAC | $534 | $47 | $581 | 3.07% |
| MJ INSURANCE3 Filed as: LESTER PARK AND VARIOUS AGENTS | 203 CLEARMEADOW DRIVE COLUMBIA, SC 29229 | AFLAC | $348 | — | $348 | 1.84% |
| TERRANCE M LUCZAJ3 Filed as: TERRANCE LUCZAJ | 1201 MAIN STREET, SUITE 2300 COLUMBIA, SC 29201 | AFLAC | $173 | $47 | $220 | 1.16% |
| JEREMY W. CASSIDY AND OTHER AGENTS3 Filed as: JEREMY CASSIDY | 1175 CUSHENDALL TERRACE APARTMENT 202 ROCK HILL, SC 29730 | AFLAC | $114 | — | $114 | 0.60% |
| DAVID C BERRY3 Filed as: DAVID BERRY | 2545 HEATHWAY DRIVE FLORENCE, SC 29501 | AFLAC | $98 | — | $98 | 0.52% |
| MARY JONES3 | 2387 HARBOR VIEW ROAD CAMDEN, SC 29020 | AFLAC | $51 | — | $51 | 0.27% |
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 | 133 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 112 | $415K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 141 | $93K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 141 | $93K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 141 | $112K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 141 | $93K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 112 | $415K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 141 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 141 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.