| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FALLON BENEFITS GROUP INC.3 Filed as: FALLON BENEFITS GROUP | 3060 PEACHTREE ROAD SUITE 1650 ATLANTA, GA 30305 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $1K | $70K | $71K | 5.13% |
| FALLON BENEFITS GROUP INC.3 Filed as: FALLON BENEFITS GROUP | 3060 PEACHTREE ROAD SUITE 1650 ATLANTA, GA 30305 | SYMETRA LIFE INSURANCE COMPANY | $22K | $3K | $26K | 23.42% |
| FALLON BENEFITS GROUP INC.3 Filed as: FALLON BENEFITS GROUP | 3060 PEACHTREE ROAD, NW SUITE 1650 ATLANTA, GA 30305 | SUN LIFE ASSURANCE COMPANY OF CANADA | $14K | — | $14K | 14.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE COMPA EIN 59-1031071 CLAIM ADMIN | Participant communication; Other services; Contract Administrator; Non-monetary compensation; Named fiduciary; Float revenue; Direct payment from the plan; Claims processing Service code 12 | — | $4K |
| CIGNA | Contract Administrator; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation; Direct payment from the plan; Float revenue; Other services Service code 12 | — | $0 |
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 | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 128 | $1.4M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 134 | $96K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 128 | $1.4M |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 141 | $110K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 141 | $110K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 141 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 141 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.