| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 115 CENTRAL ISLAND ST., SUITE 100 DANIEL ISLAND, SC 29492 | BLUECROSS BLUESHIELD OF SOUTH CAROLINA | $59K | — | $59K | 3.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2345 GRAND BLVD., SUITE 400 KANSAS CITY, MO 64108 | DELTA DENTAL OF MISSOURI | $11K | — | $11K | 9.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 4064 COLONY ROAD, SUITE 450 CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 15.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 4064 COLONY ROAD, SUITE 450 CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $5K | 16.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 4064 COLONY ROAD, SUITE 450 CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $4K | 15.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 1012 E WALL STREET MT. PLEASANT, SC 29464 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $993 | $3K | 14.80% |
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 | 139 | 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. |
| Total participants (= "Plan participants" tile) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF SOUTH CAROLINA | 128 | $1.6M |
| Dental | DELTA DENTAL OF MISSOURI | 315 | $123K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $21K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 139 | $59K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 139 | $34K |
| Prescription drug | BLUECROSS BLUESHIELD OF SOUTH CAROLINA | 128 | $1.6M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 139 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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."
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.