| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID KELLY3 | 1 KELLY WAY SPARKS, MN 21152 | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | $94K | $0 | $94K | 1.79% |
| USI INSURANCE SERVICES LLC3 | 235 MAGRATH DARBY BOULEVARD SUITE 325 MOUNT PLEASANT, SC 29464 | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | $41K | $0 | $41K | 0.78% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INS. GROUP, INC. | 1 KELLY WAY SPARKS, MN 21152 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $30K | $0 | $30K | 7.84% |
| USI INSURANCE SERVICES LLC3 | 235 MAGRATH DARBY BOULEVARD SUITE 325 MOUNT PLEASANT, SC 29464 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $18K | $0 | $18K | 4.64% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 2.20% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $155 | $155 | 0.04% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATED INSURANCE GROUP | 1 KELLY WAY SPARKS, MN 21152 | VISION SERVICE PLAN | $4K | $0 | $4K | 6.60% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.41% |
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 | 757 | 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) | 757 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 700 | $5.3M |
| Dental | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 700 | $5.3M |
| Vision | VISION SERVICE PLAN | 688 | $66K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 757 | $380K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 757 | $380K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 757 | $380K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 700 | $5.3M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 757 | $380K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 757 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.