| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS FLACK3 | 123 E MAIN STREET FOREST CITY, NC 28043 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $4K | $0 | $4K | 0.70% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET INSURANCE GROUP | 22 N TRADE STREET TRYON, NC 28782 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 11.96% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 5.00% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET INSURANCE GROUP | 22 N TRADE STREET TRYON, NC 28782 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $493 | $3K | 18.44% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $718 | $718 | 5.00% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET INSURANCE GROUP | 22 N TRADE STREET TRYON, NC 28782 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $335 | $3K | 22.50% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $669 | $669 | 5.00% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET INSURANCE GROUP | 22 N TRADE STREET TRYON, NC 28782 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $391 | $3K | 23.08% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $635 | $635 | 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 | $713 | $275 | $988 | 13.86% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $356 | $356 | 5.00% |
| MAIN STREET FINANCIAL GROUP3 Filed as: MAIN STREET INSURANCE GROUP | 22 N TRADE STREET TRYON, NC 28782 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $197 | $1K | 23.62% |
| UNITED PRODUCERS GROUP LLC3 | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $272 | $272 | 5.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MAIN STREET INSURANCE GROUP EIN 56-2185489 BROKER | Insurance agents and brokers Service code 22 | — | $10K |
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 | 100 | 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) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 70 | $630K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 80 | $52K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 69 | $7K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 100 | $5K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 24 | $13K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 15 | $13K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 70 | $630K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 100 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 100 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.