| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS C FLACK3 | 307 GREEN MEADOWS DRIVE FOREST CITY, NC 28043 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $16K | $0 | $16K | 2.15% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET FINANCIAL GROUP LLC | 22 N TRADE STREET TRYON, NC 28782 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | $177 | $4K | 10.49% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 4.00% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET FINANCIAL GROUP LLC | 22 N TRADE STREET TRYON, NC 28782 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | $121 | $4K | 15.51% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.00% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET FINANCIAL GROUP LLC | 22 N TRADE STREET TRYON, NC 28782 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $88 | $3K | 15.47% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $933 | $933 | 5.00% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET FINANCIAL GROUP LLC | 22 N TRADE STREET TRYON, NC 28782 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $57 | $2K | 15.49% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $578 | $578 | 5.00% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET FINANCIAL GROUP LLC | 22 N TRADE STREET TRYON, NC 28782 | PRINCIPAL LIFE INSURANCE COMPANY | $801 | $18 | $819 | 10.23% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $400 | $400 | 5.00% |
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 | 93 | 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) | 93 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 78 | $734K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 97 | $36K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 84 | $8K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 79 | $19K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 34 | $12K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 93 | $24K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 78 | $734K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 97 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.