Form 5500 · Employee benefit plan · ROSMAN, NC
MB INDUSTRIES, INC.
The filing calls this plan MB INDUSTRIES, INC. WELFARE BENEFITS PLAN.
MB INDUSTRIES, INC. of ROSMAN, NC insures health, dental and vision coverage for its employees, per Schedule A of its Form 5500. Its broker of record is PIEDMONT BENEFITS GROUP INC. Coverage is written through CIGNA HEALTH AND LIFE INSURANCE COMPANY and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 21-0515635 · plan 503 · plan year 2025, filed Jul 17, 2026
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 3 insured contracts covering health, dental and vision; the largest, with CIGNA HEALTH AND LIFE INSURANCE COMPANY, covers 30 people.
Reported premium across the insured contracts is $165,162, with $16,906 in disclosed broker commissions — about 10% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
PIEDMONT BENEFITS GROUP INC is the broker of record on 1 of the 3 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including CIGNA HEALTH AND LIFE INSURANCE COMPANY, METROPOLITAN LIFE INSURANCE COMPANY and AFLAC. CIGNA HEALTH AND LIFE INSURANCE COMPANY writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health | 30 | Jan 1, 2026 | $131,691 | $11,730 |
| METROPOLITAN LIFE INSURANCE COMPANY | Dental, Vision | 50 | Jan 1, 2026 | $21,383 | $3,164 |
| AFLAC | — | 10 | Jan 1, 2026 | $12,088 | $2,012 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. The service providers are named on Schedule C of this filing. We publish company names only.
Other plans filed by this employer
How this plan compares
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