| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FORTIPHI LLC3 | P.O. BOX 1547 MOUNT VERNON, WA 98273 | GROUP HEALTH OPTIONS, INC. | $10K | — | $10K | 3.03% |
| FORTIPHI LLC3 | P.O. BOX 1547 MOUNT VERNON, WA 98273 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $5K | — | $5K | 2.01% |
| FORTIPHI LLC3 | P.O. BOX 1547 MOUNT VERNON, WA 98273 | GROUP HEALTH OPTIONS, INC. | $3K | — | $3K | 2.37% |
| FORTIPHI LLC3 | P.O. BOX 1547 MOUNT VERNON, WA 98273 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 4.40% |
| EMPLOYEE BENEFITS PLANNING LLC3 | P.O. BOX 1547 MOUNT VERNON, WA 98273 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 7.08% |
| GREYHAVENS CONSULTING LLC3 | 1313 E MAPLE STREET BELLINGHAM, WA 98225 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 5.73% |
| PAMELA COPLE SMITH3 | 411 HIGHLAND DRIVE SEATTLE, WA 98109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $460 | $37 | $497 | 2.09% |
| JAN STEWART THOMAS3 | 20304 53RD AVENUE W SEATTLE, WA 98040 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $348 | — | $348 | 1.46% |
| JOEL N NEWMAN AGENCY LLC3 | 7808 SE 28TH STREET MERCER ISLAND, WA 98040 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $224 | $118 | $342 | 1.44% |
| JOEL N NEWMAN AGENCY LLC3 Filed as: JOEL NEIL NEWMAN | 7515 86TH AVE SE MERCER ISLAND, WA 98040 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $110 | $157 | $267 | 1.12% |
| BRIAN T MURPHY LLC3 | 5002 47TH AVE SW SEATTLE, WA 98136 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $194 | $28 | $222 | 0.93% |
| MARK CHARLES MORGAN3 | 2590 WILLAMETTE DRIVE NE LACEY, WA 98516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | $138 | $172 | 0.72% |
| CHRISTINE LYNN MORGESTER3 | 9405 NE 100TH WAY VANCOUVER, WA 98662 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $134 | $28 | $162 | 0.68% |
| BRIAN T MURPHY LLC3 Filed as: BRIAN T MURPHY | 5002 47TH AVE SW SEATTLE, WA 98136 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $84 | $56 | $140 | 0.59% |
| DONNA J SCHWAIBE3 | 4328 S. FARR ROAD SPOKANE VALLEY, WA 99206 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $84 | — | $84 | 0.35% |
| LAURABETH CHRISTENSEN3 | 4824 186TH PLACE SW LYNNWOOD, WA 98037 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | $47 | $73 | 0.31% |
| JODI MOYLAN3 | 3658 BRIDGEPORT WAY W APT B302 UNIVERSITY PLACE, WA 98466 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | $32 | $66 | 0.28% |
| PREMIER WORKSITE SOLUTIONS INC3 | 806 NW 79TH STREET VANCOUVER, WA 98665 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $11 | $21 | 0.09% |
| ROXANA BUSCHMAN3 | 400 NORTHEAST 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.07% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $5 | $15 | 0.06% |
| FORTIPHI LLC3 | P.O. BOX 1547 MOUNT VERNON, WA 98273 | GROUP HEALTH COOPERATIVE | $352 | — | $352 | 2.30% |
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 | 456 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 456 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | GROUP HEALTH OPTIONS, INC. | 121 | $734K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 358 | $99K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 358 | $123K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 41 | $24K |
| Long-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 41 | $24K |
| Prescription drug(4 contracts, 3 carriers) | GROUP HEALTH OPTIONS, INC. | 121 | $734K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 358 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 358 | — |
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.