| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET INSURANCE GROUP | 22 N TRADE STREET TRYON, NC 28782 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $980 | $7K | 12.25% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | PO BOX 2291 DURHAM, NC 27702 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 4.17% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET FINANCIAL GROUP INC | 22 N TRADE STREET TRYON, NC 28782 | COMMUNITY EYE CARE | $1K | $0 | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF NC EIN 56-0894904 CLAIMS | Claims processing Service code 12 | — | $30K |
| THOMAS C FLACK BROKER | Claims processing Service code 12 | 123 E MAIN STREET FOREST CITY, NC 28043 | $13K |
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 | 70 | 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) | 70 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 120 | $59K |
| Vision | COMMUNITY EYE CARE | 72 | $10K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 120 | $59K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 82 | $197K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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.