| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FORTIPHI LLC3 | PO BOX 1547 MOUNT VERNON, WA 98273 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $20K | $0 | $20K | 3.10% |
| FORTIPHI LLC3 Filed as: FORTIPHI | PO BOX 1547 MOUNT VERNON, WA 98273 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $6K | $0 | $6K | 3.28% |
| FORTIPHI LLC3 | PO BOX 1547 MOUNT VERNON, WA 98273 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC | $3K | $0 | $3K | 3.02% |
| PCF INSURANCE SERVICES OF THE WEST3 | DBA FORTIPHI KIRKLANDMOUNT VERNON, WA 98273 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 8.59% |
| RYAN G YOUNG3 | 801 N NURSERY RD IRVING, TX 75061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $332 | $0 | $332 | 1.13% |
| CARYL ESTES3 | 15907 ASH WAY LYNNWOOD, WA 98087 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $236 | $0 | $236 | 0.81% |
| MEGAN ELIZABETH CASTO3 | 10340 CARNEY DRIVE SE OLYUMPIA, WA 98501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $220 | $0 | $220 | 0.75% |
| RONALD JONES3 | 320 NANCY CT MOSCOW, ID 83843 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $129 | $0 | $129 | 0.44% |
| ALCYON MOSCHOGIANIS3 | 2904 139TH PL SE MILL CREEK, WA 98012 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $107 | $0 | $107 | 0.37% |
| RICH IN BENEFITS INC3 | 13109 NE 123RD ST KIRKLAND, WA 98034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $89 | $0 | $89 | 0.30% |
| DANIEL SHARP3 | 1911 98TH ST SE KENT, WA 98031 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | $0 | $88 | 0.30% |
| PAMELA COPLE SMITH3 | 411 HIGHLAND DR SEATTLE, WA 98109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $49 | $0 | $49 | 0.17% |
| JOEL N NEWMAN AGENCY LLC3 | 924-B NW 52ND ST RIDGEFIELD, WA 98107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | $0 | $42 | 0.14% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 Filed as: DOUGLAS EDWARD VIESELMEYER | 14405 115TH AVE CT PUYALLUP, WA 98374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | $0 | $36 | 0.12% |
| DEANA SCHROEDER3 | 23115 120TH AVE SE KENT, WA 98031 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $0 | $33 | 0.11% |
| BRIAN T MURPHY LLC3 | 5002 47TH AVE SW SEATTLE, WA 98136 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $0 | $33 | 0.11% |
| ROXANA BUSCHMAN3 | 400 NORTHEAST 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | $0 | $31 | 0.11% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 0.08% |
| GARY FANCHER INSURANCE PLLC3 | 1918 COOPER DRIVE IRVING, TX 75061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $0 | $21 | 0.07% |
| MARK CHARLES MORGAN3 | 1880 SOUTH DAIRY ASHFORD HOUSTON, TX 77077 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | $0 | $17 | 0.06% |
| LISA LOUISE ROBBERSON3 Filed as: LISA LOUSIE ROBBERSON | 13120 102ND LN NE #3 KIRKLAND, WA 98034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.05% |
| BROOKS AGENCY INC3 | 14812 COUNTY RD 424 LINDALE, TX 75777 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.05% |
| JODI MOYLAN3 | 19103 MERIDIAN EAST PUYALLUP, WA 98375 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 0.05% |
| CHRISTOPHER ROBERT BERRY3 | 27108 162ND ST SE MONROE, WA 98272 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.02% |
| STEPHANIE SHEPPA3 Filed as: STEPHANIE JO HANSEN | 20144 GINA MARIE LANE BURLINGTON, WA 98233 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.02% |
| TAI D SHIN3 | 9610 LIGHTHEART AVE LAS VEGAS, NV 89148 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.01% |
| PCF INSURANCE SERVICES OF THE WEST3 | 815 CLEVELAND AVE STE 200 MOUNT VERNON, WA 98273 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $0 | $2K | 14.79% |
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 | 279 | 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) | 279 | 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 | 143 | $918K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 279 | $44K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 25 | $29K |
| Long-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 279 | $44K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | 143 | $918K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 279 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 279 | — |
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.