| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROOKS A. FORET3 | 1048 CANAL BOULEVARD THIBODAUX, LA 70301 | AMERICAN UNITED LIFE INSURANCE COMPANY | $15K | — | $15K | 14.84% |
| BXS INSURANCE INC3 Filed as: BXS INSURANCE | PO BOX 250 GULFPORT, MS 39502 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | $1K | $7K | 13.11% |
| BROOKS A. FORET3 | 1048 CANAL BOULEVARD THIBODAUX, LA 70301 | AMERICAN UNITED LIFE INSURANCE COMPANY | $3K | — | $3K | 14.83% |
| BROOKS A. FORET3 | 1048 CANAL BOULEVARD THIBODAUX, LA 70301 | AMERICAN UNITED LIFE INSURANCE COMPANY | $600 | — | $600 | 14.89% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX EIN 33-0441200 PHARMACY BENEFIT MGMT | Claims processing; Other fees; Float revenue; Direct payment from the plan Service code 12 | PO BOX 509075 SAN DIEGO, CA 92150 | $164K |
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | 115 W WAUSAU AVENUE WAUSAU, WI 54401 | $31K |
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 | 151 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 102 | $52K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 102 | $52K |
| Life insurance(3 contracts) | AMERICAN UNITED LIFE INSURANCE COMPANY | 120 | $125K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 102 | $52K |
| Long-term disability(3 contracts) | AMERICAN UNITED LIFE INSURANCE COMPANY | 120 | $125K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 119 | $291K |
| Other(3 contracts) | AMERICAN UNITED LIFE INSURANCE COMPANY | 120 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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.