BenefitsLedger
Employer health plan record · Plan year 2024 · Form 5500

Evergreen Goodwill of Northwest Washington

Updated Filing received by DOL

Evergreen Goodwill of Northwest Washington, a retail — general merchandise, sporting goods employer in Seattle, Washington, reported 1,938 participants in its health and welfare plan for plan year 2024. Its Form 5500 shows 3 insurance contracts with no premium reported and $42,835 in broker commissions and fees. The plan is self-funded (the employer pays claims itself). The Department of Labor received the filing on April 30, 2026, before the deadline.

Participants
1,938
−6.8% vs 2023
Premiums filed
none
self-funded or not filed
Broker commissions + fees
$42,835
−8.4% vs 2023
Commission rate
n/a
needs insured medical premium

Who was paid on Evergreen Goodwill of Northwest Washington's plan

Schedule A, Part I lists each broker or agent paid on each insurance contract and the amount. Totals below add every contract Evergreen Goodwill of Northwest Washington filed for 2024.

Broker or agentCommissionsFeesTotalContracts
USI Insurance Services · Virginia Beach, VA$31,339$11,496$42,8352

Source: DOL Form 5500 Schedule A, Part I (broker commissions and fees), plan year 2024, as published in EBSA's 2024 "Latest" dataset. Part I names whoever the carrier paid, which can be a firm or an individual agent; both are public record. Amounts exclude pay from carriers not tied to a listed contract.

Insurance contracts and carriers

Every insurance contract reported on Schedule A: carrier, what it covers, people covered at year end, earned premium, and broker compensation.

Carrier · coverageCoveredPremiumBroker payRate
Metropolitan Life Insurance Companylife, long-term disability1,609—$17,578—
Wellspring Family Services Eapcoverage not coded1,932———
Ameritas Life Insurance Corporationdental2,228—$25,257—

Source: DOL Form 5500 Schedule A, plan year 2024. Self-funded medical coverage has no premium; amounts shown for it are stop-loss or administrative contracts.

How Evergreen Goodwill of Northwest Washington compares

Medians across employers for plan year 2024, the most recent complete year. Commission rates use fully insured medical contracts only; dollar medians use every employer that disclosed broker pay.

Broker commissions + fees, dollars
Evergreen Goodwill of Northwest Washington
$42,835
Commission rate, % of medical premium

Not computable: no insured medical premium on the filing.

Source: BenefitsLedger benchmarks from 58,547 employer health plans with 100 or more participants, plan year 2024. Methodology.

Year over year

$46,773$42,835Broker pay20232024
Evergreen Goodwill of Northwest Washington: premiums and broker commissions + fees, 2023 vs 2024
20232024Change
Participants2,0801,938−6.8%
Premiums filed$0$0—
Broker commissions + fees$46,773$42,835−8.4%
Commission rate———

Source: DOL Form 5500 filings for plan years 2023 and 2024.

Filings and timeliness

Plans this employer filed under its EIN with a health benefit code. Large plans are due seven months after the plan year ends, or two and a half months later with an extension; amended filings carry the amendment date, so no timing is asserted for them.

PlanPlan year endReceived by DOLTimingParticipants
Seattle Goodwill Industries Health and Welfare Benefit Plan#501 · insurance, general assetsOctober 31, 2025April 30, 2026before deadline1,938

Source: DOL Form 5500 Part I and signature dates; "late" means received after the extended deadline (the 15th day of the tenth month after plan year end). What a late Form 5500 costs.

How much did Evergreen Goodwill of Northwest Washington pay in health insurance broker commissions in 2024?

Evergreen Goodwill of Northwest Washington's 2024 Form 5500 reports $42,835 in broker commissions and fees across 3 insurance contracts ($31,339 in commissions, $11,496 in fees), with USI Insurance Services receiving the largest share.

Is Evergreen Goodwill of Northwest Washington's health plan self-funded or fully insured?

The 2024 filing indicates the plan is self-funded (the employer pays claims itself).

How does Evergreen Goodwill of Northwest Washington's broker compensation compare with similar employers?

A commission-to-premium ratio cannot be computed for Evergreen Goodwill of Northwest Washington because the filing does not report medical premium on Schedule A (usual for self-funded plans). In dollars, employers with 1,000-4,999 participants that disclosed broker pay reported a median of $168,579.

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Record built October 24, 2026 from U.S. Department of Labor, EBSA Form 5500 datasets (2025, 2024, 2023 plan years, 'Latest' files). Filings can run 7 to 10 months behind the plan year; always confirm against current plan documents. BenefitsLedger is not affiliated with the U.S. Department of Labor. Open the DOL filing search.