Form 5500 · Employee benefit plan · NEW ORLEANS, LA
THE RUBY SLIPPER CAFE
The filing calls this plan THE RUBY SLIPPER CAFE LLC WRAP BENEFIT PLAN.
Public Form 5500 records show how THE RUBY SLIPPER CAFE of NEW ORLEANS, LA, a hospitality and food service employer, structures its employee benefits. Its broker of record is HM BENEFITS LLC. Coverage is written through AETNA LIFE INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in November.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 26-1676429 · plan 502 · plan year 2024, filed Jun 27, 2025
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: 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.
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 AETNA LIFE INSURANCE COMPANY, covers 201 people.
Reported premium across the insured contracts is $968,724, with $51,525 in disclosed broker commissions — about 5.3% of premium.
The most recent policy period ended in November, and the plan year ends November 30. Group contracts typically renew on that annual cycle.
HM BENEFITS LLC is the broker of record on all 3 contracts.
Two carriers split the book: AETNA LIFE INSURANCE COMPANY and THE LINCOLN NATIONAL LIFE INSURANCE COMPANY.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY | Health, Dental, Vision | 201 | Dec 1, 2024 | $944,523 | $47,895 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Disability | 92 | Dec 1, 2024 | $17,821 | $2,673 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 92 | Dec 1, 2024 | $6,380 | $957 |
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.
Other plans filed by this employer
How this plan compares
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