| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIPSCOMB & PITTS INSURANCE LLC3 | 2670 UNION AVENUE, SUITE 100 MEMPHIS, TN 38112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | — | $5K | 7.76% |
| LIPSCOMB & PITTS INSURANCE LLC3 | 2670 UNION AVENUE, SUITE 200 MEMPHIS, TN 38112 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | — | $8K | 13.32% |
| LIPSCOMB & PITTS INSURANCE LLC3 | 2670 UNION AVENUE, SUITE 100 MEMPHIS, TN 38112 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 14.85% |
| ROOP, WALTER W3 | 9061 STONE WALK PL GERMANTOWN, TN 38138 | AMERICAN FIDELITY ASSURANCE COMPANY | $137 | — | $137 | 0.66% |
| LIPSCOMB & PITTS INSURANCE LLC3 | 2670 UNION AVENUE, SUITE 200 MEMPHIS, TN 38112 | FIRST CONTINENTAL LIFE AND ACCIDENT INSURANCE CO | $804 | — | $804 | 14.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIPSCOMB & PITTS INSURANCE EIN 62-0533337 NONE | Insurance agents and brokers Service code 22 | 2670 UNION AVE EXT STE 200 MEMPHIS, TN 38112 | $2K |
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 | 209 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 212 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 178 | $250K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 131 | $64K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 131 | $58K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 209 | $57K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 209 | $57K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 178 | $229K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 209 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.