| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES | P.O. BOX 10328 KNOXVILLE, TN 37919 | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | $44K | — | $44K | 4.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES INC | 1900 WINSTON ROAD SUITE 100 KNOXVILLE, TN 37919 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $16K | $5K | $22K | 20.04% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER LLC | 1105 NORTH MARKET STREET SUITE 1300 WILMINGTON, DE 19801 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $55 | — | $55 | 0.05% |
| ANNE SWANSON3 | 123 CENTER PARK DRIVE SUITE 102 KNOXVILLE, TN 37922 | AFLAC | $3K | $265 | $3K | 12.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES INC. | P.O. BOX 10328 KNOXVILLE, TN 37939 | AFLAC | $2K | — | $2K | 6.70% |
| ERIN PEDERSON3 | 8405 VININGS WAY KNOXVILLE, TN 37919 | AFLAC | $1K | $53 | $1K | 5.24% |
| MATTHEW D BUTLER3 Filed as: MATTHEW BUTLER | 123 CENTER PARK DRIVE SUITE 102 KNOXVILLE, TN 37922 | AFLAC | $806 | $53 | $859 | 3.31% |
| JOHN B RAFFIELD IV3 Filed as: JOHN RAFFIELD IV | P.O. BOX 2999 SUMTER, SC 29151 | AFLAC | $272 | — | $272 | 1.05% |
| ASHLEY M MELTON3 Filed as: ASHLEY MELTON | 2230 LLOYD DRIVE SUMTER, SC 29154 | AFLAC | $99 | — | $99 | 0.38% |
| MATTHEW M HACKWORTH3 Filed as: MATTHEW HACKWORTH | 3310 TAMARAH WAY SUMTER, SC 29154 | AFLAC | $99 | — | $99 | 0.38% |
| KRISTI CONNOR3 | 5 HAWTHORNE STREET SUMTER, SC 29150 | AFLAC | $55 | — | $55 | 0.21% |
| ANDREW ARTHUR INC3 Filed as: ANDREW ARTHUR INC. | 103 CHASE STREET SUITE C FLORENCE, SC 29501 | AFLAC | $52 | — | $52 | 0.20% |
| ANETTE G HOOKER3 Filed as: ANETTE HOOKER | 2418 TRILLY LANE FLORENCE, SC 29505 | AFLAC | $34 | — | $34 | 0.13% |
| DON W LYLES3 Filed as: DON LYLES | 2891 BROAD STREET SUMTER, SC 29150 | AFLAC | $33 | — | $33 | 0.13% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: ROGER BROWN | 355 SCOTT FARM DRIVE POWDER SPRINGS, GA 30127 | AFLAC | $30 | — | $30 | 0.12% |
| TERRY SILVERS3 | 100 GREENLEAF DRIVE FLAT ROCK, NC 28731 | AFLAC | $26 | — | $26 | 0.10% |
| LESTER D PARK3 Filed as: LESTER PARK | 203 CLEARMEADOW DRIVE COLUMBIA, SC 29229 | AFLAC | $24 | — | $24 | 0.09% |
| C KING3 | 931-B SOUTH MAIN STREET SUITE 206 KERNERSVILLE, NC 27284 | AFLAC | $17 | — | $17 | 0.07% |
| JENNIFER R EVANS3 Filed as: JENNIFER EVANS | 83 INGLEWOOD CIRCLE SAINT HELENA ISLAND, SC 29920 | AFLAC | $13 | — | $13 | 0.05% |
| JONATHAN W MCCUTCHEON3 Filed as: JONATHAN MCCUTCHEON | 1150 MALLARD LAKE DRIVE BOGART, GA 30622 | AFLAC | $12 | — | $12 | 0.05% |
| DENNIS A SZCZESNY3 Filed as: DENNIS SZCZESNY | 165 INVERNESS DRIVE LEXINGTON, SC 29072 | AFLAC | $9 | — | $9 | 0.03% |
| HAROLD L LYLES3 Filed as: HAROLD L. LYLES | 2750 MOHICAN DRIVE SUMTER, SC 29150 | AFLAC | $8 | — | $8 | 0.03% |
| JOHN TYLER3 | 130 DUCK HAWK WAY MARIETTA, SC 29661 | AFLAC | $6 | — | $6 | 0.02% |
| DAVID H JEFFORDS3 Filed as: DAVID JEFFORDS | P.O. BOX 14132 FLORENCE, SC 29504 | AFLAC | $3 | — | $3 | 0.01% |
| GARY W JOHNSON3 Filed as: GARY JOHNSON | 123 CENTER PARK DRIVE SUITE 102 KNOXVILLE, TN 37922 | AFLAC | $2 | — | $2 | 0.01% |
| DAYTON LLC3 | 324 OLD WOOD DRIVE COLUMBIA, SC 29212 | AFLAC | $2 | — | $2 | 0.01% |
| DEBORAH B SMITH3 Filed as: DEBORAH SMITH | 4720 TWIN OAKS DRIVE NORTHWEST KENNESAW, GA 30152 | AFLAC | $2 | — | $2 | 0.01% |
| PATRICIA A PARK3 Filed as: PATRICIA PARK | 5000 THURMOND MALL SUITE 103 COLUMBIA, SC 29201 | AFLAC | $2 | — | $2 | 0.01% |
| LINDA CAMPBELL3 | 174 PALMETTO GREEN DRIVE LONGS, SC 29568 | AFLAC | $1 | — | $1 | 0.00% |
| FRANCES SANDRA BOND3 Filed as: FRANCES BOND | 480 HOLLY SPRINGS CHURCH ROAD INMAN, SC 29349 | AFLAC | $1 | — | $1 | 0.00% |
| CANDACE H SAMS3 Filed as: CANDACE SAMS | P.O. BOX 1815 LAURENS, SC 29360 | AFLAC | $2K | $136 | $2K | 12.63% |
| WILLIAM KEITH PRINCE3 Filed as: WILLIAM PRINCE | 4 QUEENS WAY GREENVILLE, SC 29615 | AFLAC | $454 | $136 | $590 | 3.02% |
| JUSTIN M GUIDI3 Filed as: JUSTIN GUIDI | 555 NORTH PLEASANTBURG DRIVE SUITE 200 GREENVILLE, SC 29607 | AFLAC | $419 | $54 | $473 | 2.42% |
| JOSEPH BERNABEI3 | 7 SINGLE OAK COURT FOUNTAIN INN, SC 29644 | AFLAC | $330 | $54 | $384 | 1.97% |
| BISHOP INSURANCE, LLC3 Filed as: BISHOP INSURANCE LLC | 113 HOMESTEAD DRIVE BOILING SPRINGS, SC 29316 | AFLAC | $369 | — | $369 | 1.89% |
| VERNA C JENKINS3 Filed as: VERNA JENKINS | 4202 POPLAR GROVE DRIVE CHARLOTTE, NC 28269 | AFLAC | $230 | — | $230 | 1.18% |
| DONALD L ETHIER3 Filed as: DONALD ETHIER | 481 GRANADA DRIVE SPARTANBURG, SC 29303 | AFLAC | $84 | — | $84 | 0.43% |
| DONALD P KREDENSOR3 Filed as: DONALD KREDENSOR | 1112 RIVER WALK DRIVE SIMPSONVILLE, SC 29681 | AFLAC | $48 | — | $48 | 0.25% |
| DENNIS C LINDEY3 Filed as: DENNIS LINDEY | P.O. BOX 1082 GOODLETTSVILLE, TN 37070 | AFLAC | $41 | — | $41 | 0.21% |
| ASSUREDPARTNERS3 Filed as: MARKEE SHEPHERD | 29 ROYAL GATE DRIVE COLUMBIA, SC 29223 | AFLAC | $25 | — | $25 | 0.13% |
| AMY SISK CUNNINGHAM3 Filed as: AMY CUNNINGHAM | 141 SUGAR HILL COURT BOILING SPRINGS, SC 29316 | AFLAC | $23 | — | $23 | 0.12% |
| FRANCES SANDRA BOND3 Filed as: FRANCES BOND | 480 HOLLY SPRINGS CHURCH ROAD INMAN, SC 29349 | AFLAC | $18 | — | $18 | 0.09% |
| TONIA LANE HUNTER3 Filed as: TONIA HUNTER | P.O. BOX 126 WILLIAMSTON, SC 29697 | AFLAC | $15 | — | $15 | 0.08% |
| JOHN TYLER3 | 130 DUCK HAWK WAY MARIETTA, SC 29661 | AFLAC | $14 | — | $14 | 0.07% |
| C KING3 | 931-B SOUTH MAIN STREET SUITE 206 KERNERSVILLE, NC 27284 | AFLAC | $12 | — | $12 | 0.06% |
| BETTY A BLACKERBY3 Filed as: BETTY BLACKERBY | 107 WILD IRIS LANE HENDERSONVILLE, NC 28739 | AFLAC | $10 | — | $10 | 0.05% |
| JANET S BATES3 Filed as: JANET BATES | 12008 HARMON LANE PINEVILLE, NC 28134 | AFLAC | $10 | — | $10 | 0.05% |
| H CANDLER3 | 1363 HEADQUARTERS PLANTATION DRIVE JOHNS ISLAND, SC 29455 | AFLAC | $9 | — | $9 | 0.05% |
| JUDITH A POTWORA3 Filed as: JUDITH POTWORA | 7 BIRCHSTONE COURT SIMPSONVILLE, SC 29681 | AFLAC | $7 | — | $7 | 0.04% |
| ALMA CUNNINGHAM3 | 1120 VALENTINE LANE GREER, SC 29651 | AFLAC | $6 | — | $6 | 0.03% |
| DANNY DANIELS3 | 1931 SHARON ROAD WOODRUFF, SC 29388 | AFLAC | $5 | — | $5 | 0.03% |
| MARK P ENSLEY3 Filed as: MARK ENSLEY | 317 WEATHERSTONE LANE SIMPSONVILLE, SC 29680 | AFLAC | $4 | — | $4 | 0.02% |
| DENNIS A SZCZESNY3 Filed as: DENNIS SZCZESNY | 165 INVERNESS DRIVE LEXINGTON, SC 29072 | AFLAC | $3 | — | $3 | 0.02% |
| LARA CARLSON3 | 106 LAUREL VIEW DRIVE ST. SIMONS ISLAND, GA 31522 | AFLAC | $3 | — | $3 | 0.02% |
| DAYTON LLC3 | 324 OLD WOOD DRIVE COLUMBIA, SC 29212 | AFLAC | $2 | — | $2 | 0.01% |
| TRULUCK & ASSOCIATES INC3 Filed as: TRULUCK & ASSOCIATES INC. | 1934 PANTHEON DRIVE WINTER GARDEN, FL 34787 | AFLAC | $2 | — | $2 | 0.01% |
| DEBORAH B SMITH3 Filed as: DEBORAH SMITH | 4720 TWIN OAKS DRIVE NORTHWEST KENNESAW, GA 30152 | AFLAC | $1 | — | $1 | 0.01% |
| YVONNE ENSLEY3 | 3714 GRANDVIEW DRIVE APARTMENT 182K SIMPSONVILLE, SC 29680 | AFLAC | $1 | — | $1 | 0.01% |
| LINDA CAMPBELL3 | 174 PALMETTO GREEN DRIVE LONGS, SC 29568 | AFLAC | $1 | — | $1 | 0.01% |
| GARY W JOHNSON3 Filed as: GARY JOHNSON | 123 CENTER PARK DRIVE SUITE 102 KNOXVILLE, TN 37922 | AFLAC | $1 | — | $1 | 0.01% |
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 | 143 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 117 | $1.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 143 | $108K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 143 | $108K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 143 | $108K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 143 | $108K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 143 | $108K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 117 | $1.1M |
| Other(2 contracts) | AFLAC | 34 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 143 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.