| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT ADMINISTRATION COMPANY LLC3 Filed as: BENEFIT ADMINISTRATION SERVICES LTD | P. O. BOX 14208 JACKSON, MS 39236 | HCC LIFE INSURANCE COMPANY | $35K | $3K | $37K | 9.20% |
| PHCS3 | C/O MULTI PLANS P. O. BOX 29380 NEW YORK, NY 100879380 | HCC LIFE INSURANCE COMPANY | — | $12K | $12K | 3.06% |
| CORVEL3 | DEPARTMENT 6984 LOS ANGELES, CA 900846984 | HCC LIFE INSURANCE COMPANY | $0 | $10K | $10K | 2.48% |
| INSURANCE RESOURCE GROUP INC3 Filed as: INSURANCE RESOURCE GROUP, INC. | 106 OIL CENTER DRIVE 250 LAFAYETTE, LA 705032459 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $13K | $2K | $15K | 17.09% |
| INSURANCE RESOURCE GROUP INC3 | 106 OIL CENTER DRIVE 250 LAFAYETTE, LA 705032459 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $815 | $7K | 17.00% |
| SCOTT D LAGRANGE3 | 107 CHASE DRIVE LAFAYETTE, LA 70507 | AFLAC | $731 | $39 | $770 | 3.54% |
| BLAKE CHARLES ADAMS3 | 200 CREEKWOOD DRIVE LAFAYETTE, LA 70503 | AFLAC | $625 | — | $625 | 2.88% |
| CHRISTOPHER GERALD HEBERT3 | 111 SUMMER MORNING CT LAFAYETTE, LA 70508 | AFLAC | $404 | $8 | $412 | 1.90% |
| KEITH WILLIAM BELLE3 | 302 LA RUE FRANCE STE 100 LAFAYETTE, LA 70508 | AFLAC | $182 | $8 | $190 | 0.87% |
| MICHAEL E BENSON3 Filed as: MICHAEL T. DOMINGUE | 300 RUE BEAUREGARD LAFAYETTE, LA 70508 | AFLAC | $113 | — | $113 | 0.52% |
| BLAZE J FREMIN3 Filed as: BLAZE J. FREMIN | P. O. BOX 53871 LAFAYETTE, LA 70505 | AFLAC | $107 | — | $107 | 0.49% |
| BLAKE S. DUBROC3 | 213 BELLE DAME DRIVE LAFAYETTE, LA 70506 | AFLAC | $31 | — | $31 | 0.14% |
| WILLA DEAN MORRIS3 | 1375 HELMS ROAD LAKE CHARLES, LA 70607 | AFLAC | $26 | — | $26 | 0.12% |
| TROY JAMES LEBLANC3 | 201 PRESCOTT BLVD #1136 YOUNGSVILLE, LA 70592 | AFLAC | $23 | — | $23 | 0.11% |
| BETSY E BELLARD3 | 201 MARIE ANTOINETTE STREET LAFAYETTE, LA 70506 | AFLAC | $21 | — | $21 | 0.10% |
| RAYMOND H ZIMMERMAN3 | 2512 TYLER ST LAKE CHARLES, LA 70605 | AFLAC | $10 | — | $10 | 0.05% |
| ROGER A PISANI3 Filed as: ROGER PISANI | P. O. BOX 11136 NEW IBERIA, LA 70562 | AFLAC | $9 | — | $9 | 0.04% |
| JEREMY HEBERT3 | 201 KNOLLWOOD DRIVE LAFAYETTE, LA 70506 | AFLAC | $8 | — | $8 | 0.04% |
| DAVID LAVIGNE3 Filed as: DAVID M LAVIGNE | 210 ELYSIAN FIELDS DR LAFAYETTE, LA 70508 | AFLAC | $8 | — | $8 | 0.04% |
| JAMES VERGENAL3 Filed as: JAMES A VERGENAL | 911 DARTEZ DRIVE NEW IBERIA, LA 70563 | AFLAC | $8 | — | $8 | 0.04% |
| NATIONAL UNDERWRITERS AGENCY INC3 Filed as: NATIONAL UNDERWRITERS AGENCY, INC. | 4245 MILGEN ROAD COLUMBUS, GA 31907 | AFLAC | $6 | — | $6 | 0.03% |
| PAUL JACK PRIMEAUX3 | 1239 MAGNOLIA ST SLIDELL, LA 70460 | AFLAC | $6 | — | $6 | 0.03% |
| ALANA SONNIER ADAMS3 | 6765 CORPORATE BLVD APT 5308 BATON ROUGE, LA 70809 | AFLAC | $5 | — | $5 | 0.02% |
| RICKY C PISANI3 Filed as: RICKY PISANI | P. O. BOX 13757 NEW IBERIA, LA 70562 | AFLAC | $5 | — | $5 | 0.02% |
| CRUSER MARKETING INC3 Filed as: CRUSER MARKETING INC. | 7516 BLUEBONNET BLVD #116 BATON ROUGE, LA 70810 | AFLAC | $2 | — | $2 | 0.01% |
| INSURANCE RESOURCE GROUP INC3 Filed as: INSURANCE RESOURCE GROUP, INC. | 106 OIL CENTER DRIVE 250 LAFAYETTE, LA 705032459 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $664 | $3K | 19.21% |
| INSURANCE RESOURCE GROUP INC3 Filed as: INSURANCE RESOURCE GROUP INC. | 106 OIL CENTER DRIVE, #250 LAFAYETTE, LA 705032459 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $265 | $3K | 16.77% |
| BLAKE CHARLES ADAMS3 Filed as: BLAKE ADAMS | 200 CREEKWOOD DRIVE LAFAYETTE, LA 70503 | AFLAC | $10 | — | $10 | 5.08% |
| KEITH WILLIAM BELLE3 Filed as: KEITH BELLE | 302 LA RUE FRANCE STE 100 LAFAYETTE, LA 70508 | AFLAC | $3 | — | $3 | 1.52% |
| MICHAEL E BENSON3 Filed as: MICHAEL DOMINGUE | 300 RUE BEAUREGARD LAFAYETTE, LA 70508 | AFLAC | $1 | — | $1 | 0.51% |
| BLAZE FREMIN3 | P. O. BOX 53871 LAFAYETTE, LA 70508 | AFLAC | $1 | — | $1 | 0.51% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT ADMINISTRATION SERVICES LTD EIN 64-0687636 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | P. O. BOX 14208 JACKSON, MS 392364208 | $52K |
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 | 223 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 223 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 190 | $404K |
| Dental | HCC LIFE INSURANCE COMPANY | 190 | $404K |
| Vision | HCC LIFE INSURANCE COMPANY | 190 | $404K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 220 | $104K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 223 | $16K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 223 | $41K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 190 | $404K |
| Other(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 220 | $111K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 223 | — |
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.