| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FALLON BENEFITS GROUP INC.3 Filed as: FALLON BENEFITS GROUP INC | 3060 PEACHTREE RD NW STE 1650 ATLANTA, GA 303052258 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 5.00% |
| FALLON BENEFITS GROUP INC.3 Filed as: FALLON BENEFITS GROUP INC | 3060 PEACHTREE RD NW STE 1650 ATLANTA, GA 30305 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 14.99% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 201503, GA LOCKBOX DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 3.30% |
| FALLON BENEFITS GROUP INC.3 Filed as: FALLON BENEFITS GROUP INC | 3060 PEACHTREE RD NW STE 1650 ATLANTA, GA 30305 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 23.37% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 201503 - GA LOCKBOX DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $51 | — | $51 | 0.14% |
| FALLON BENEFITS GROUP INC.3 Filed as: FALLON BENEFITS GROUP INC | 3060 PEACHTREE RD NW STE 1650 ATLANTA, GA 30305 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| FALLON BENEFITS GROUP INC.3 Filed as: FALLON BENEFITS GROUP INC | 3060 PEACHTREE RD NW STE 1650 ATLANTA, GA 30305 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 15.14% |
| WELLS FARGO INSURANCE SERVICES3 | 3475 PIEDMONT RD NE STE 800 ATLANTA, GA 303052258 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | — | $0 | 0.00% |
| FALLON BENEFITS GROUP INC.3 Filed as: FALLON BENEFITS GROUP INC | 3060 PEACHTREE RD NW STE 1650 ATLANTA, GA 30305 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| FALLON BENEFITS GROUP INC. Filed as: FALLON BENEFITS GROUP INC | 3060 PEACHTREE RD NW STE 1650 ATLANTA, GA 30305 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 23.50% |
| FALLON BENEFITS GROUP INC.3 Filed as: FALLON BENEFITS GROUP INC | 3060 PEACHTREE RD NW STE 1650 ATLANTA, GA 30305 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| FALLON BENEFITS GROUP INC.3 Filed as: FALLON BENEFITS GROUP INC | 3060 PEACHTREE RD NW STE 1650 ATLANTA, GA 30305 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.01% |
| FALLON BENEFITS GROUP INC.3 Filed as: FALLON BENEFITS GROUP INC | 3060 PEACHTREE RD NW STE 1650 ATLANTA, GA 30305 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $742 | — | $742 | 21.70% |
No Schedule C service providers reported on this filing.
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 | 195 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 144 | $96K |
| Life insurance(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 195 | $78K |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 195 | $31K |
| Long-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 195 | $69K |
| Other(7 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 195 | $114K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 195 | — |
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.