| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FALLON BENEFIT GROUP INC.3 Filed as: FALLON BENEFIT GROUP | 3060 PEACHTREE STREET, NW #1650 ATLANTA, GA 30305 | UNITED HEALTHCARE INSURANCE COMPANY | $31K | — | $31K | 9.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MGT | Float revenue; Direct payment from the plan; Claims processing; Other fees Service code 12 | 2300 MAIN STREET IRVINE, CA 92614 | $124K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | FIN. SPECIAL SERVICES PO BOX 1087 WAUSAU, WI 544021087 | $92K |
| FALLON BENEFIT GROUP EIN 20-8839989 BROKER | Other commissions Service code 55 | 3060 PEACHTREE RD NW STE 1650 ATLANTA, GA 30305 | $21K |
| MERSEREAU, LAZENBY & ROCKAS LLC EIN 58-2115374 AUDITOR | Accounting (including auditing) Service code 10 | 3469 LAWRENCEVILLE-SUWANEE RD STE B SUWANEE, GA 30024 | $11K |
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 | 182 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 182 | $312K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 182 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.