| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FALLON BENEFITS GROUP INC.3 Filed as: FALLON BENEFITS GROUP, INC | 3060 PEACHTREE ROAD, NW SUITE 1650 ATLANTA, GA 30305 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | $61K | — | $61K | 4.86% |
| FALLON BENEFITS GROUP INC.3 Filed as: FALLON BENEFITS GROUP | 3060 PEACHTREE ROAD SUITE 1650 ATLANTA, GA 30305 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $36K | — | $36K | 5.52% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 CLAIMS ADMIN FOR ASA | Float revenue; Claims processing; Participant communication; Other services; Named fiduciary; Non-monetary compensation; Direct payment from the plan; Contract Administrator Service code 12 | — | $158K |
| FALLON BENEFITS GROUP EIN 20-8839989 BROKER | Insurance agents and brokers Service code 22 | — | $61K |
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 | 384 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 35 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 422 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH & LIFE INSURANCE COMPANY | 672 | $649K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH & LIFE INSURANCE COMPANY | 672 | $649K |
| Other | CORPCARE ASSOCIATES, INC. | 325 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 672 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.