| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAWLS INSURANCE GROUP LLC3 Filed as: RAWLS INSURANCE SERVICES | 1292 PRINCE CT HEATHROW, FL 32746 | DELTA DENTAL INSURANCE COMPANY | $123K | — | $123K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 235 HIGHLANDIA DR SUITE 200 BATON ROUGE, LA 70810 | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | $136K | — | $136K | 20.98% |
| RAWLS INSURANCE GROUP LLC3 Filed as: RAWLS INSURANCE SERVICES INC. | 1292 PRINCE CT HEATHROW, FL 32746 | MUTUAL OF OMAHA | $43K | — | $43K | 17.00% |
| PREFERRED BENEFIT ADMINISTRATORS5 | 155 SABAL PALM DRIVE LONGWOOD, FL 32779 | MUTUAL OF OMAHA | $8K | — | $8K | 3.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 2807 CLINTON, IA 527332807 | AMERITAS LIFE INSURANCE COMPANY | $19K | $5K | $24K | 12.74% |
| RAWLS INSURANCE GROUP LLC3 Filed as: RAWLS INSURANCE SERVICES | 1292 PRINCE COURT HEATHROW, FL 32746 | MUTUAL OF OMAHA | $28K | — | $28K | 17.00% |
| PREFERRED BENEFIT ADMINISTRATORS5 | 155 SABAL PALM DRIVE LONGWOOD, FL 32779 | MUTUAL OF OMAHA | $5K | — | $5K | 3.00% |
| SHEMWELL DAVID CLAYTON3 | 2483 TOWER DR UNIT 5 MONROE, LA 71201 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 11.63% |
| SUMMIT FINANCIAL GROUP INC.3 Filed as: SUMMIT FINANCIAL GROUP | 5420 LBJ FREEWAY SUITE 1940 DALLAS, TX 75240 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $331 | — | $331 | 3.39% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF SC EIN 57-0287419 ASO | Claims processing Service code 12 | I-20 AT ALPINE ROAD COLUMBIA, SC 292190001 | $1.2M |
| PAYER MATRIX LLC EIN 81-3946362 MEDICATION REIMB MGMT | Consulting (general) Service code 16 | 1400 N. PROVIDENCE RD MEDIA, PA 19063 | $237K |
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 | 1,809 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,820 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 4,087 | $650K |
| Dental | DELTA DENTAL INSURANCE COMPANY | 4,152 | $1.2M |
| Vision | AMERITAS LIFE INSURANCE COMPANY | 3,264 | $189K |
| Life insurance(3 contracts, 2 carriers) | MUTUAL OF OMAHA | 2,716 | $424K |
| Long-term disability | MUTUAL OF OMAHA | 2,716 | $163K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 4,269 | $650K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 4,087 | $650K |
| Other | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 42 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,269 | — |
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.