| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANIEL ROBERSON3 | 2670 UNION AVENUE SUITE 100 MEMPHIS, TN 38112 | BLUE CROSS BLUE SHIELD OF TENNESSEE, INC. | $32K | — | $32K | 6.51% |
| JOHN P WEBBER3 Filed as: JOHN WEBBER | 5050 POPLAR AVENUE #1200 MEMPHIS, TN 38157 | BLUE CROSS BLUE SHIELD OF TENNESSEE, INC. | $31K | — | $31K | 6.28% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS-SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $19K | $924 | $20K | 31.45% |
| LIPSCOMB & PITTS INSURANCE LLC3 Filed as: LIPSCOMB & PITTS INSURANCE | 2670 UNION AVENUE EXT SUITE 100 MEMPHIS, TN 38112 | DELTA DENTAL OF TENNESSEE | $3K | — | $3K | 7.66% |
| TOWER INSURANCE CENTER INC3 Filed as: TOWER INSURANCE CENTER | 5050 POPLAR AVENUE MEMPHIS, TN 38157 | DELTA DENTAL OF TENNESSEE | $1K | — | $1K | 2.34% |
| JOHN P WEBBER3 | 5050 POPLAR AVENUE #1200 MEMPHIS, TN 38157 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 11.13% |
| US NATIONAL BENEFIT PARTNERS WEST3 Filed as: US NATIONAL BENEFIT PARTNERS/B.JUND | 99 WOOD AVENUE SOUTH SUITE 500 ISELIN, CA 08830 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| SUNSTAR INSURANCE GROUP LLC3 | 9201 WATSON ROAD SUITE 300 ST. LOUIS, MO 63126 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 4.15% |
| LIPSCOMB & PITTS INSURANCE LLC3 | 2670 UNION AVENUE EXT SUITE 200 MEMPHIS, TN 38112 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $676 | — | $676 | 2.54% |
| JOHN P WEBBER3 | 5050 POPLAR AVENUE #1200 MEMPHIS, TN 38157 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 12.37% |
| SUNSTAR INSURANCE GROUP LLC3 | 9201 WATSON ROAD SUITE 300 ST. LOUIS, MO 63126 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $536 | — | $536 | 4.13% |
| US NATIONAL BENEFIT PARTNERS WEST3 Filed as: US NATIONAL BENEFIT PARTNERS/B.JUND | 99 WOOD AVENUE SOUTH SUITE 500 ISELIN, CA 08830 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $536 | $536 | 4.13% |
| LIPSCOMB & PITTS INSURANCE LLC3 | 2670 UNION AVENUE EXT SUITE 200 MEMPHIS, TN 38112 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $342 | — | $342 | 2.63% |
| LIPSCOMB & PITTS INSURANCE LLC3 | 2670 UNION AVENUE EXT SUITE 200 MEMPHIS, TN 38112 | VISION SERVICE PLAN | $98 | — | $98 | 0.84% |
| JOHN P WEBBER3 | 5050 POPLAR AVENUE MEMPHIS, TN 38157 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $412 | — | $412 | 9.21% |
| SUNSTAR INSURANCE GROUP LLC3 | 9201 WATSON ROAD SUITE 300 ST. LOUIS, MO 63126 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $224 | — | $224 | 5.01% |
| US NATIONAL BENEFIT PARTNERS WEST3 Filed as: US NATIONAL BENEFIT PARTNERS/B.JUND | 99 WOOD AVENUE SOUTH SUITE 500 ISELIN, CA 08830 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $187 | $187 | 4.18% |
| LIPSCOMB & PITTS INSURANCE LLC3 | 2670 UNION AVENUE EXT SUITE 200 MEMPHIS, TN 38112 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $80 | — | $80 | 1.79% |
| JOHN P WEBBER3 | 5050 POPLAR AVENUE #1200 MEMPHIS, TN 38157 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $549 | — | $549 | 16.53% |
| SUNSTAR INSURANCE GROUP LLC3 | 9201 WATSON ROAD SUITE 300 ST. LOUIS, MO 63126 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $137 | — | $137 | 4.12% |
| US NATIONAL BENEFIT PARTNERS WEST3 Filed as: US NATIONAL BENEFIT PARTNERS/B.JUND | 99 WOOD AVENUE SOUTH SUITE 500 ISELIN, CA 08830 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $137 | $137 | 4.12% |
| LIPSCOMB & PITTS INSURANCE LLC3 | 2670 UNION AVENUE EXT SUITE 200 MEMPHIS, TN 38112 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $115 | — | $115 | 3.46% |
| JP WEBBER3 | 5050 POPLAR AVENUE #1200 MEMPHIS, TN 38157 | PETERSEN INTERNATIONAL UNDERWRITERS | $268 | — | $268 | 9.50% |
| JOHN P WEBBER3 Filed as: JOHN PAUL WEBBER | 5050 POPLAR AVENUE #1200 MEMPHIS, TN 38157 | PRINCIPAL LIFE INSURANCE COMPANY | — | $18 | $18 | 0.96% |
| JOHN P WEBBER3 | 5050 POPLAR AVENUE #1200 MEMPHIS, TN 38157 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $213 | — | $213 | 12.76% |
| SUNSTAR INSURANCE GROUP LLC3 | 9201 WATSON ROAD SUITE 300 ST. LOUIS, MO 63126 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $83 | — | $83 | 4.97% |
| US NATIONAL BENEFIT PARTNERS WEST3 Filed as: US NATIONAL BENEFIT PARTNERS/B.JUND | 99 WOOD AVENUE SOUTH SUITE 500 ISELIN, CA 08830 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $71 | $71 | 4.25% |
| LIPSCOMB & PITTS INSURANCE LLC3 | 2670 UNION AVENUE EXT SUITE 200 MEMPHIS, TN 38112 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $38 | — | $38 | 2.28% |
No Schedule C service providers reported on this filing.
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 | 119 | 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) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TENNESSEE, INC. | 128 | $498K |
| Dental | DELTA DENTAL OF TENNESSEE | 135 | $45K |
| Vision | VISION SERVICE PLAN | 87 | $12K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 119 | $8K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 20 | $13K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 118 | $27K |
| Other(6 contracts, 4 carriers) | AFLAC | 119 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 135 | — |
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.