Form 5500 · Employee benefit plan · COLUMBIA, SC
BLUECROSS BLUESHIELD OF SOUTH CAROLINA
The filing calls this plan HOSPITAL AND MEDICAL PLAN FOR BLUECROSS BLUESHIELD OF SC.
BLUECROSS BLUESHIELD OF SOUTH CAROLINA of COLUMBIA, SC is a 11,312-participant finance and insurance employer whose group benefits are disclosed in its annual Form 5500 filing. Coverage is written through BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA and 1 other carrier. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 57-0287419 · plan 503 · plan year 2024, filed Sep 16, 2025
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 2 insured contracts covering health and vision; the largest, with BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA, covers 11,890 people.
The filing declares health, vision and dental. Dental appears with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
Reported premium is $162,861,233; the filing discloses no broker commission on these contracts.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
No broker of record is named on the Schedule A. The contracts may be written directly with the carrier, or the broker fields were left blank on the filing.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | Health | 11,890 | Jan 1, 2025 | $162,093,413 | $0 |
| EYEMED VISION CARE | Vision | 12,208 | Jan 1, 2025 | $767,820 | $0 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Other plans filed by this employer
How this plan compares
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