| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FORTIPHI LLC3 Filed as: FORTIPHI | PO BOX 1547 MOUNT VERNON, WA 98273 | UNITEDHEALTHCARE INSURANCE COMPANY | $43K | $0 | $43K | 3.29% |
| PCF INSURANCE SERVICES OF THE WEST3 | DBA FORTIPHI MOUNT VERNON, WA 98273 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $942 | $0 | $942 | 4.06% |
| RYAN G YOUNG3 | 801 N NURSERY RD IRVING, TX 75061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $261 | $0 | $261 | 1.13% |
| ESSENTIAL OIL JOY3 | 2909 S HARPER VALLEY WAY RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $173 | $0 | $173 | 0.75% |
| MEGAN ELIZABETH CASTO3 | 10340 CARNEY DRIVE SE OLYUMPIA, WA 98501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $138 | $17 | $155 | 0.67% |
| RONALD JONES3 | 320 NANCY CT MOSCOW, ID 83843 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $98 | $0 | $98 | 0.42% |
| STEPHANIE SHEPPA3 Filed as: STEPHANIE JO HANSEN | 20144 GINA MARIE LANE BURLINGTON, WA 98233 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $97 | $1 | $98 | 0.42% |
| G SCOTT COOKE3 Filed as: SCOTT PETERSON | 21926 43RD DR SE BOTHELL, WA 98021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $64 | $0 | $64 | 0.28% |
| RICH IN BENEFITS INC3 | 13109 NE 123RD ST KIRKLAND, WA 98034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $60 | $0 | $60 | 0.26% |
| DANIEL SHARP3 | 11622 50TH DR SE EVERETT, WA 98208 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $57 | $0 | $57 | 0.25% |
| ALCYON MOSCHOGIANIS3 | 2904 139TH PL SE MILL CREEK, WA 98012 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $43 | $0 | $43 | 0.19% |
| JOEL N NEWMAN AGENCY LLC3 | 924-B NW 52ND ST RIDGEFIELD, WA 98107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | $0 | $29 | 0.13% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 Filed as: DOUGLAS EDWARD VIESELMEYER | 14405 115TH AVE CT E PUYALLUP, WA 98374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 0.11% |
| BRIAN T MURPHY LLC3 | 5002 47TH AVE SW SEATTLE, WA 98136 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | $0 | $24 | 0.10% |
| ROXANA BUSCHMAN3 | 400 NORTHEAST 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 0.09% |
| CARYL ESTES3 | 15907 ASH WAY UNIT C609 LYNNWOOD, WA 98087 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $0 | $20 | 0.09% |
| PAMELA COPLE SMITH3 | 411 HIGHLAND DR SEATTLE, WA 98109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | $0 | $17 | 0.07% |
| GARY FANCHER INSURANCE PLLC3 | 1918 COOPER DRIVE IRVING, TX 75061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 0.06% |
| BROOKS AGENCY INC3 | 14812 COUNTY RD 424 LINDALE, TX 75777 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.05% |
| ZACHAREE KEITH SIAHPUSH3 | 6727 MLK JR WAY S STE M SEATTLE, WA 98118 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $1 | $10 | 0.04% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.04% |
| MARK CHARLES MORGAN3 | 1880 SOUTH DAIRY ASHFORD HOUSTON, TX 77077 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.03% |
| JODI MOYLAN3 | 19103 MERIDIAN EAST PUYALLUP, WA 98375 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.03% |
| CHRISTOPHER ROBERT BERRY3 | 9222 168TH ST SE SNOHOMISH, WA 98296 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.01% |
| SCOTT FENTON3 Filed as: SCOTT RONALD FENTON | 10506 RUSTIC RD SOUTH SEATTLE, WA 98178 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| PCF INSURANCE SERVICES OF THE WEST3 | 815 CLEVELAND AVE STE 200 MOUNT VERNON, WA 98273 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $0 | $2K | 11.08% |
| PCF INSURANCE SERVICES OF THE WEST3 | 815 CLEVELAND AVE STE 200 MOUNT VERNON, WA 98273 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | $0 | $9K | 43.83% |
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 | 363 | 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) | 363 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 247 | $1.3M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 0 | $21K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 363 | $45K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 18 | $23K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 363 | $21K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 363 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 363 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.