Form 5500 · Employee benefit plan · SUMTER, SC
CALHOUN GROCERY INC.
The filing calls this plan CALHOUN GROCERY, INC. EMPLOYEE BENEFIT PLAN.
CALHOUN GROCERY INC. of SUMTER, SC files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is HILB GROUP OF SOUTH CAROLINA. Coverage is written through BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA and 2 other carriers. The plan's most recent policy period ended in February.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 82-5507692 · plan 501 · plan year 2026, filed Aug 7, 2026
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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
Also declared: other welfare.
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.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
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 5 insured contracts covering health, dental, vision and life; the largest, with BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA, covers 127 people.
Reported premium across the insured contracts is $1,782,924, with $122,869 in disclosed broker commissions — about 6.9% of premium.
The most recent policy period ended in February, and the plan year ends February 28. Group contracts typically renew on that annual cycle.
HILB GROUP OF SOUTH CAROLINA is the broker of record on 4 of the 5 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA, TRANSAMERICA LIFE INSURANCE COMPANY and COMPANION LIFE. BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | Health | 127 | Mar 1, 2026 | $1,678,968 | $75,882 |
| TRANSAMERICA LIFE INSURANCE COMPANY | Life | 113 | Mar 1, 2026 | $41,905 | $39,809 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | Dental | 130 | Mar 1, 2026 | $55,582 | $5,549 |
| COMPANION LIFE | Life | 125 | Mar 1, 2026 | $5,542 | $1,113 |
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | Vision | 130 | Mar 1, 2026 | $927 | $516 |
Premium and claims on these contracts
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA, contract 66-17658-00 01. For the contract year on this filing, the carrier reported $1,678,968 in premium earned and $1,159,198 in claims incurred. Dividing one by the other gives 69%.
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA, contract 25-87587. For the contract year on this filing, the carrier reported $55,582 in premium earned and $42,391 in claims incurred. Dividing one by the other gives 76%.
- BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA, contract 66-17658-00 01 reported $519,769 in retention.
- BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA, contract 25-87587 reported $13,191 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
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.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
How this plan compares
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