| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FORTIPHI LLC3 | P.O. BOX 1547 MOUNT VERNON, WA 98273 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $17K | — | $17K | 3.00% |
| FORTIPHI LLC3 | P.O. BOX 1547 MOUNT VERNON, WA 98273 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $6K | — | $6K | 2.36% |
| FORTIPHI LLC3 | P.O. BOX 1547 MOUNT VERNON, WA 98273 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $3K | — | $3K | 2.28% |
| FORTIPHI LLC3 | P.O. BOX 1547 MOUNT VERNON, WA 98273 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $17 | $5K | 3.56% |
| FORTIPHI LLC3 | P.O. BOX 1547 MOUNT VERNON, WA 98273 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $912 | — | $912 | 2.94% |
| FORTIPHI LLC3 | P.O. BOX 1547 MOUNT VERNON, WA 98273 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 7.26% |
| GREYHAVENS CONSULTING LLC3 | 1313 E MAPLE STREET BELLINGHAM, WA 98225 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $739 | — | $739 | 3.60% |
| PAMELA COPLE SMITH3 | 411 HIGHLAND DRIVE SEATTLE, WA 98109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $241 | $15 | $256 | 1.25% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $143 | $68 | $211 | 1.03% |
| JOEL N NEWMAN AGENCY LLC3 | 12390 LAKE CITY WAY NE SEATTLE, WA 98125 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $158 | $48 | $206 | 1.00% |
| BRIAN T MURPHY LLC3 | 5002 47TH AVE SW SEATTLE, WA 98136 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $107 | — | $107 | 0.52% |
| ROBERT MORRISON3 | 937 THIMBLEBERRY DRIVE CASTLE ROCK, WA 98611 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $91 | $7 | $98 | 0.48% |
| TAI D SHIN3 | 2950 POPPY LANE SW TUMWATER, WA 98512 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $70 | $82 | 0.40% |
| MARK CHARLES MORGAN3 | 2590 WILLAMETTE DRIVE NE LACEY, WA 98516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $47 | $33 | $80 | 0.39% |
| PREMIER WORKSITE SOLUTIONS INC3 | 806 NW 79TH STREET VANCOUVER, WA 98665 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | $15 | $45 | 0.22% |
| ROXANA BUSCHMAN3 | 400 NORTHEAST 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $43 | $1 | $44 | 0.21% |
| JODI MOYLAN3 | 3658 BRIDGEPORT WAY W APT B302 UNIVERSITY PLACE, WA 98466 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | $1 | $36 | 0.18% |
| GABRIEL ANGEL CANALS3 | 1329 NE 236TH AVE WOOD VILLAGE, OR 97060 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $7 | $27 | 0.13% |
| BUSINESS SOLUTIONS SPECIALIST LLC3 Filed as: BUSINESS SOLUTIONS SPECIALIST, LLC | 13104 116TH CT NE KIRKLAND, WA 98034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $17 | $25 | 0.12% |
| CHRISTOPHER ROBERT BERRY3 | 20110 75TH AVE WEST LYNNWOOD, WA 98036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $10 | $18 | 0.09% |
| CHRISTINE LYNN MORGESTER3 | 2137 N Q STREET WASHOUGAL, WA 98671 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.08% |
| JULIE WOLDEN3 | 2231 LARCH STREET LONGVIEW, WA 98632 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $1 | $8 | 0.04% |
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 | 428 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 428 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 145 | $1.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 428 | $139K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 428 | $160K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 33 | $21K |
| Long-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 33 | $21K |
| Prescription drug(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 145 | $1.0M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 428 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 428 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.