| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MAX & SIERRA INC DBA ALTA BENEFITS3 Filed as: MAX & SIERRA, INC DBA ALTA BENEFITS | 201 WEST MAIN STREET SUITE 100, PMB 310 DURHAM, NC 27701 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | — | $2K | 2.53% |
| HIGHSTREET INSURANCE SERVICES SOUTH3 Filed as: HIGHSTREET INS SVCS SOUTHEAST INC | PO BOX 2205 HICKORY, NC 28603 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | — | $2K | 2.41% |
| MAX & SIERRA INC3 Filed as: MAX & SIERRA, INC | 201 WEST MAIN STREET SUITE 100 DURHAM, NC 27701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $285 | $6K | 12.04% |
| HIGHSTREET INSURANCE SERVICES SOUTH3 | PO BOX 2205 HICKORY, NC 28603 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 3.52% |
| MAX & SIERRA INC3 Filed as: MAX & SIERRA, INC | 201 WEST MAIN STREET SUITE 100 DURHAM, NC 27701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $289 | $6K | 12.25% |
| HIGHSTREET INSURANCE SERVICES SOUTH3 | PO BOX 2205 HICKORY, NC 28603 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 3.32% |
| MAX & SIERRA INC3 | 201 WEST MAIN STREET SUITE 100 DURHAM, NC 27701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $172 | $1K | 4.38% |
| HIGHSTREET INSURANCE SERVICES SOUTH3 | PO BOX 2205 HICKORY, NC 28603 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $375 | — | $375 | 1.14% |
| MAX & SIERRA INC3 Filed as: MAX & SIERRA, INC | 201 WEST MAIN STREET SUITE 100 DURHAM, NC 27701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $153 | $4K | 16.00% |
| HIGHSTREET INSURANCE SERVICES SOUTH3 | PO BOX 2205 HICKORY, NC 28603 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 4.62% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF TENNESSEE INC | 6 CADILLAC DRIVE #200 BRENTWOOD, TN 37027 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 9.32% |
| MAX & SIERRA INC3 Filed as: MAX & SIERRA, INC | 201 WEST MAIN STREET SUITE 100 DURHAM, NC 27701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $88 | $3K | 15.84% |
| HIGHSTREET INSURANCE SERVICES SOUTH3 | PO BOX 2205 HICKORY, NC 28603 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $755 | — | $755 | 4.71% |
| MAX & SIERRA INC3 Filed as: MAX & SIERRA, INC | 201 WEST MAIN STREET SUITE 100 DURHAM, NC 27701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $86 | $2K | 16.09% |
| HIGHSTREET INSURANCE SERVICES SOUTH3 | PO BOX 2205 HICKORY, NC 28603 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $676 | — | $676 | 4.47% |
| MAX & SIERRA INC3 Filed as: MAX & SIERRA, INC | 201 WEST MAIN STREET SUITE 100 DURHAM, NC 27701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $550 | $76 | $626 | 4.40% |
| HIGHSTREET INSURANCE SERVICES SOUTH3 | PO BOX 2205 HICKORY, NC 28603 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $162 | — | $162 | 1.14% |
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 | 158 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 159 | $461K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 131 | $96K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 131 | $96K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 152 | $65K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 77 | $50K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 152 | $33K |
| Other(6 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 152 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 159 | — |
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.