| 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 | $35K | $0 | $35K | 4.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4250 CONGRESS STREET, SUITE 200 CHARLOTTE, NC 28209 | AMERITAS LIFE INSURANCE CORPORATION | $14K | $0 | $14K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 21ST FLOOR ROLLING MEADOWS, IL 60008 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $1K | $1K | 1.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4250 CONGRESS STREET, SUITE 200 CHARLOTTE, NC 28209 | AMERICAN UNITED LIFE INSURANCE COMPANY | $8K | $2K | $10K | 19.79% |
| DERRELL B ODOM3 Filed as: DERRELL B. ODOM | 5082 MARIANA COURT TEGA CAY, SC 29708 | AFLAC | $4K | $57 | $4K | 10.35% |
| DONNA L MATTHEWS3 Filed as: DONNA L. MATTHEWS | 4089 LINDA DRIVE ROCK HILL, SC 29730 | AFLAC | $3K | $0 | $3K | 7.46% |
| DONALD E. ROLLACK3 | PO BOX 962 FORT MILL, SC 29716 | AFLAC | $684 | $0 | $684 | 1.72% |
| JEREMY W. CASSIDY AND OTHER AGENTS3 | 1833 HOPEWELL ROAD ROCK HILL, SC 29730 | AFLAC | $566 | $23 | $589 | 1.48% |
| CATHERINE D JAMES3 Filed as: CATHERINE D. JAMES | 4531 MEADOWOOD ROA COLUMBIA, SC 29206 | AFLAC | $573 | $0 | $573 | 1.44% |
| DAVID C BERRY3 Filed as: DAVID C. BERRY | 2545 HEATHWAY DRIVE FLORENCE, SC 29501 | AFLAC | $142 | $0 | $142 | 0.36% |
| TERRANCE M LUCZAJ3 Filed as: TERRANCE M. LUCZAJ | 435 HARRODS LANE CHARLESTON, SC 29412 | AFLAC | $103 | $0 | $103 | 0.26% |
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 | 142 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 122 | $860K |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 283 | $97K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 283 | $97K |
| Life insurance(2 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 143 | $90K |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 143 | $50K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 122 | $860K |
| Other(2 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 143 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 283 | — |
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.