| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIBERTY BENEFITS GROUP LLC3 Filed as: LIBERTY BENEFITS GROUP, LLC | 4100 194TH STREET SW, SUITE 380 LYNNWOOD, WA 98036 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $4K | $0 | $4K | 5.03% |
| LIBERTY BENEFITS GROUP LLC3 Filed as: LIBERTY BENEFITS GROUP, LLC | 17610 WOODINVILLE SNOHOMISH ROAD WOODINVILLE, WA 98072 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | $0 | $14K | 20.00% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES, INC. | 1250 SOUTH CAPITAL OF TEXAS HIGHWAY SUITE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $852 | $852 | 1.19% |
| LIBERTY BENEFITS GROUP LLC3 Filed as: LIBERTY BENEFITS GROUP, LLC | 17610 WOODINVILLE SNOHOMISH ROAD WOODINVILLE, WA 98072 | WILLAMETTE DENTAL INSURANCE INC. | $1K | $0 | $1K | 4.58% |
| LIBERTY BENEFITS GROUP LLC3 Filed as: LIBERTY BENEFITS GROUP | 4100 194TH STREET SW, SUITE 380 LYNNWOOD, WA 98036 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $894 | — | $894 | 9.89% |
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 | 158 | 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) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 194 | $103K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 168 | $9K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 58 | $72K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 58 | $72K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 58 | $72K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 58 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 194 | — |
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.