| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS C FLACK3 | 123 E MAIN STREET FOREST CITY, NC 28043 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $13K | $0 | $13K | 2.19% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET INSURANCE GROUP | 22 N TRADE STREET TRYON, NC 28782 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | $2K | $10K | 15.14% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | PO BOX 2291 DURHAM, NC 27702 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 4.75% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET FINANCIAL GROUP INC | 22 N TRADE STREET TRYON, NC 28782 | USABLE LIFE | $2K | $0 | $2K | 14.70% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $783 | $0 | $783 | 6.86% |
| MAIN STREET FINANCIAL GROUP3 | 22 N TRADE ST TRYON, NC 28782 | USABLE LIFE | $2K | $0 | $2K | 23.61% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $1K | $0 | $1K | 20.30% |
| MAIN STREET FINANCIAL GROUP3 | 22 N TRADE ST TRYON, NC 28782 | USABLE LIFE | $777 | $0 | $777 | 15.00% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $363 | $0 | $363 | 7.01% |
| MAIN STREET FINANCIAL GROUP3 | 22 N TRADE ST TRYON, NC 28782 | USABLE LIFE | $338 | $0 | $338 | 24.64% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $298 | $0 | $298 | 21.72% |
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 | 141 | 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) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 88 | $598K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 165 | $63K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 165 | $63K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 165 | $63K |
| Short-term disability | USABLE LIFE | 48 | $11K |
| Long-term disability | USABLE LIFE | 38 | $5K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 88 | $598K |
| Other(3 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 88 | $607K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 165 | — |
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.