| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RISK SERVICES OF LOUISIANA INC3 Filed as: RISK SERVICES OF LOUISIANA | 400 TEXAS STREET SUITE 100 SHREVEPORT, LA 71101 | PRINCIPAL LIFE INSURANCE COMPANY | $13K | — | $13K | 12.55% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP AGENCY ASSOCIATION | PO BOX 130 CEDAR CITY, UT 84721 | PRINCIPAL LIFE INSURANCE COMPANY | — | $1K | $1K | 1.00% |
| BAC AGENCY, INC.5 | 6331 EAST LIVINGSTON AVENUE REYNOLDSBURG, OH 43068 | UNITED HEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 9.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BUSINESS ADMINISTRATORS & CONS. INC THIRD PARTY ADMIN. | Contract Administrator Service code 13 | 6331 EAST LIVINGSTON AVE. REYNOLDSBURG, OH 43068 | $96K |
| LEAVITT GROUP INSURANCE AGENT | Insurance agents and brokers Service code 22 | HEAVIN OTTO LEAVITT 4717 GOLLIHAR ROAD CORPUS CHRISTI, TX 78411 | $43K |
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 NETWORK PROVIDER | Insurance services Service code 23 | — | $26K |
| COLLIER, JOHNSON & WOODS, P.C. EIN 74-2520265 AUDITOR | Accounting (including auditing) Service code 10 | — | $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 | 308 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 308 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPANION LIFE INSURANCE COMPANY | 137 | $273K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 308 | $100K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 308 | $100K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 308 | $100K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 308 | $100K |
| Prescription drug | COMPANION LIFE INSURANCE COMPANY | 137 | $273K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 137 | $273K |
| Other | UNITED HEALTHCARE INSURANCE COMPANY | 137 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 308 | — |
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."
No prospect flags tripped on this filing.