Form 5500 · Employee benefit plan · ALPHARETTA, GA
TM RESTAURANT GROUP, LLC
The filing calls this plan TSRG INC HEALTH AND WELFARE PLAN.
Public Form 5500 records show how TM RESTAURANT GROUP, LLC of ALPHARETTA, GA, a hospitality and food service employer, structures its employee benefits. Its broker of record is FALLON BENEFITS GROUP INC.. Coverage is written through UNITEDHEALTHCARE INSURANCE COMPANY. The plan's most recent policy period ended in October.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 90-0850479 · plan 501 · plan year 2025, filed May 5, 2026
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
Also declared: death benefits, 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.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
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, vision, life and disability; the largest, with UNITEDHEALTHCARE INSURANCE COMPANY, covers 569 people.
Reported premium across the insured contracts is $1,107,643, with $23,179 in disclosed broker commissions — about 2.1% of premium.
The most recent policy period ended in October, and the plan year ends October 31. Group contracts typically renew on that annual cycle.
FALLON BENEFITS GROUP INC. is the broker of record on all 3 contracts.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNITEDHEALTHCARE INSURANCE COMPANY | Life, Disability | 119 | Nov 1, 2025 | $64,254 | $9,638 |
| UNITEDHEALTHCARE INSURANCE COMPANY | Health | 207 | Nov 1, 2025 | $382,375 | $9,249 |
| UNITEDHEALTHCARE INSURANCE COMPANY | Health, Dental, Vision | 569 | Nov 1, 2025 | $661,014 | $4,292 |
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. We publish company names only.
Other plans filed by this employer
How this plan compares
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