| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET FINANCIAL GROUP INC | 22 N TRADE STREET TRYON, NC 28782 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $528 | $4K | 11.33% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.00% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET FINANCIAL GROUP INC | 22 N TRADE STREET TRYON, NC 28782 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $706 | $4K | 17.88% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.00% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET FINANCIAL GROUP INC | 22 N TRADE STREET TRYON, NC 28782 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $703 | $4K | 17.89% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.00% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET FINANCIAL GROUP INC | 22 N TRADE STREET TRYON, NC 28782 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $347 | $2K | 17.75% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $631 | $631 | 5.00% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET FINANCIAL GROUP INC | 22 N TRADE STREET TRYON, NC 28782 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $292 | $2K | 17.94% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $496 | $496 | 5.00% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET FINANCIAL GROUP INC | 22 N TRADE STREET TRYON, NC 28782 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $498 | $139 | $637 | 12.80% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $249 | $249 | 5.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHGRAM, INC. EIN 56-1449504 TPA | Claims processing Service code 12 | — | $37K |
| CIGNA CORPORATION EIN 59-1031071 NETWORK | Claims processing Service code 12 | — | $8K |
| ADMIN AMERICA, INC. FSA/HRA ADMIN | Claims processing Service code 12 | 1720 WINDWARD CONCOURSE SUITE 290 ALPHARETTA, GA 30005 | $3K |
| HEALTHGRAM - TELADOCINC EIN 47-4591265 TELADOC | Contract Administrator Service code 13 | — | $942 |
| CAREOPERATIVE, LLC EIN 20-8981027 N/A | Claims processing Service code 12 | — | $888 |
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 | 54 | 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) | 54 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 43 | $40K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 41 | $5K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 54 | $24K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 46 | $10K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 54 | $25K |
| Stop-loss / reinsurancereinsurance | SWISS RE CORPORATE SOLUTIONS AMERICA INS. CORP. | 43 | $268K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 54 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 54 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.