Form 5500 · Employee benefit plan · LORIS, SC
EBTRON, INC.
The filing calls this plan EBTRON, INC. HEALTH AND WELFARE PLAN.
EBTRON, INC. of LORIS, SC is a 122-participant manufacturing employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is UNITED PRODUCERS GROUP, LLC. Coverage is written through BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA and 1 other carrier. The plan's most recent policy period ended in April.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 22-2455232 · plan 501 · plan year 2025, filed Nov 18, 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
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.
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, dental, vision, life and disability; the largest, with BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA, covers 106 people.
Reported premium across the insured contracts is $1,532,366, with $76,378 in disclosed broker commissions — about 5% of premium.
The most recent policy period ended in April, and the plan year ends April 30. Group contracts typically renew on that annual cycle.
UNITED PRODUCERS GROUP, LLC is the broker of record on 1 of the 2 contracts; the rest name a different broker or none.
Two carriers split the book: BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA and THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | Health, Life | 106 | May 1, 2025 | $1,431,900 | $48,951 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Dental, Vision, Disability | 119 | May 1, 2025 | $100,466 | $27,427 |
Premium and claims on this contract
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA, contract 66-17254-00. For the contract year on this filing, the carrier reported $1,431,900 in premium earned and $934,481 in claims incurred. Dividing one by the other gives 65%.
- BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA, contract 66-17254-00 reported $497,418 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.
Other plans filed by this employer
How this plan compares
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