| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FORTIPHI LLC3 | PO BOX 1547 MOUNT VERNON, WA 98273 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $12K | $0 | $12K | 2.73% |
| FORTIPHI LLC3 | PO BOX 1547 MOUNT VERNON, WA 98273 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC | $3K | $0 | $3K | 2.41% |
| FORTIPHI LLC3 Filed as: FORTIPHI | PO BOX 1547 MOUNT VERNON, WA 98273 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $4K | $0 | $4K | 3.17% |
| PCF INSURANCE SERVICES OF THE WEST3 | DBA FORTIPHI MOUNT VERNON, WA 98273 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 7.05% |
| RYAN G YOUNG3 | 801 N NURSERY RD IRVING, TX 75061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $412 | $43 | $455 | 1.41% |
| RONALD JONES3 | 320 NANCY CT MOSCOW, ID 83843 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $229 | $37 | $266 | 0.83% |
| FORTIPHI LLC3 | PO BOX 1547 MOUNT VERNON, WA 98273 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $243 | $0 | $243 | 0.75% |
| MEGAN ELIZABETH CASTO3 | 10340 CARNEY DRIVE SE OLYMPIA, WA 98501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $202 | $27 | $229 | 0.71% |
| GREYHAVENS CONSULTING LLC3 | 1313 E MAPLE STREET BELLINGHAM, WA 98225 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $211 | $0 | $211 | 0.65% |
| DANIEL SHARP3 | 1911 98TH ST SE EVERETT, WA 98208 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $92 | $24 | $116 | 0.36% |
| CARYL ESTES3 | 15907 ASH WAY LYNNWOOD, WA 98087 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $108 | $3 | $111 | 0.34% |
| RICH IN BENEFITS INC3 | 13109 NE 123RD ST KIRKLAND, WA 98034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $101 | $0 | $101 | 0.31% |
| DEANA SCHROEDER3 | 23115 120TH AVE SE KENT, WA 98031 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $79 | $0 | $79 | 0.25% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 Filed as: DOUGLAS EDWARD VIESELMEYER | 14405 115TH AVE CT E PUYALLUP, WA 98374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $60 | $13 | $73 | 0.23% |
| G SCOTT COOKE3 Filed as: SCOTT PETERSON | 21926 43RD DRIVE SE BOTHELL, WA 98021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $71 | $0 | $71 | 0.22% |
| PAMELA COPLE SMITH3 | 411 HIGHLAND DR SEATTLE, WA 98109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $49 | $0 | $49 | 0.15% |
| CHRISTOPHER MICHAEL JONES3 | 6325 E 18TH AVE SPOKANE VALLEY, WA 99212 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $35 | $45 | 0.14% |
| JOEL N NEWMAN AGENCY LLC3 | 924-B NW 52ND ST SEATTLE, WA 98107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | $0 | $40 | 0.12% |
| BRIAN T MURPHY LLC3 | 5002 47TH AVE SW SEATTLE, WA 98136 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | $0 | $30 | 0.09% |
| ROXANA BUSCHMAN3 | 400 NORTHEAST 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | $0 | $29 | 0.09% |
| GARY FANCHER INSURANCE PLLC3 | 1918 COOPER DRIVE IRVING, TX 75061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | $1 | $29 | 0.09% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 0.08% |
| MARK CHARLES MORGAN3 | 1880 SOUTH DAIRY ASHFORD HOUSTON, TX 77077 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $0 | $19 | 0.06% |
| BROOKS AGENCY INC3 | 14812 COUNTY RD 424 LINDALE, TX 75777 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.06% |
| JODI MOYLAN3 | 19103 MERIDIAN EAST PUYALLUP, WA 98375 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.05% |
| GABRIEL ANGEL CANALS3 | 1329 NE 236TH AVE WOOD VILLAGE, OR 97060 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.02% |
| CHRISTOPHER ROBERT BERRY3 | 27108 162ND ST SE MONROE, WA 98272 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.02% |
| ANTONIO JOSE ANGELES3 Filed as: ANTONIO MICHAEL JAIME | 24345 252ND AVE SE MAPLE VALLEY, WA 98038 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $1 | $5 | 0.02% |
| CHRISTINE LYNN MORGESTER3 | 14913 S SUNTERRA LOOP OREGON CITY, OR 97045 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.01% |
| TAI D SHIN3 | 1301 PINE LEAF DR LAS VEGAS, NV 89144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.01% |
| PCF INSURANCE SERVICES OF THE WEST3 | 815 CLEVELAND AVE STE 200 MOUNT VERNON, WA 98273 | SUN LIFE ASSURANCE COMPANY OF CANADA | $544 | $0 | $544 | 7.88% |
| FORTIPHI LLC3 | PO BOX 1547 MOUNT VERNON, WA 98273 | SUN LIFE ASSURANCE COMPANY OF CANADA | $301 | $0 | $301 | 4.36% |
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 | 290 | 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) | 290 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | 123 | $703K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 290 | $7K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 290 | $39K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 29 | $32K |
| Long-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 290 | $39K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | 123 | $703K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 290 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
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.