| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIBERTY BENEFITS GROUP LLC3 | 17610 WOODINVILLE SNOHOMISH RD WOODINVILLE, WA 98072 | THE STANDARD | $25K | $25K | $50K | 4.00% |
| LIBERTY BENEFITS GROUP LLC3 | 17610 WOODINVILLE SNOHOMISH RD WOODINVILLE, WA 98072 | THE STANDARD | $0 | $0 | $0 | 0.00% |
| LIBERTY BENEFITS GROUP LLC3 | PO BOX 691 WOODINVILLE, WA 98072 | THE STANDARD | $27K | $4K | $31K | 14.76% |
| LIBERTY BENEFITS GROUP LLC3 | 17610 WOODINVILLE SNOHOMISH RD WOODINVILLE, WA 98072 | THE STANDARD | $18K | $3K | $21K | 13.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIBERTY BENEFITS GROUP LLC EIN 92-0193732 NONE | Insurance agents and brokers Service code 22 | PO BOX 691 WOODINVILLE, WA 98072 | $339K |
| TRUSTEED PLANS SERVICES CORPORATION EIN 91-0780588 NONE | Contract Administrator Service code 13 | PO BOX 1894 TACOMA, WA 98401 | $46K |
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 | 0 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | THE STANDARD | 2,086 | $371K |
| Long-term disability(2 contracts) | THE STANDARD | 2,101 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,101 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.