Evergreen Goodwill of Northwest Washington
Overview
Evergreen Goodwill of Northwest Washington sponsors a self-funded health plan that covered 1,938 participants in plan year 2024. The plan year starts in November. Alongside medical, its benefits filing reports life insurance, dental, vision, long-term disability, and more.
- Plan type
- ERISA welfare benefit plan, self-funded (benefits paid from employer assets or a trust)
- Participants
- 1,938
- Plan year
- Begins November 1 · next renewal November 2027
- Health plans filed
- Seattle Goodwill Industries Health and Welfare Benefit Plan, plan 501 (1,938 participants)
- Broker compensation
- $43K across insured contracts
Insurance carriers
Insured coverage reported on Schedule A. Self-funded medical claims aren't reported there.
| Carrier | Coverage | Covered | Premium | Broker comp |
|---|---|---|---|---|
| Ameritas Life Insurance Corporation | Dental | 2,228 | $506K | $25K |
| Metropolitan Life Insurance Company | Life, Long-term disability | 1,609 | $114K | $18K |
| Wellspring Family Services EAP | Employee Assistance Program | 1,932 | $17K | — |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 1,938 participants × $2,371 national average per member. Usually higher once dependents are counted.
Typical savings opportunity found in independent reviews of plans this size.
Form 5500 filing details
- Filing
- Form 5500 with Schedule A, plan year 2024
- Plan sponsor
- Evergreen Goodwill of Northwest Washington
- Sponsor EIN
- 91-0568708
- Plan number
- 501
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 91-0568708 in the Department of Labor's EFAST2 Form 5500 search.
Retirement plan
- Plan
- Evergreen Goodwill of Northwest Washington 403(b) Plan
- Type
- Defined contribution plan
- Participants
- 2,099
About this data
Source: Evergreen Goodwill of Northwest Washington's Form 5500 filing for plan year 2024 and its Schedule A insurance reports, published by the U.S. Department of Labor. "Self-funded" means the filing reports benefits paid from employer assets or a trust, with no medical insurance contract or with a stop-loss contract. Pharmacy figures are StreamRX estimates based on national averages. StreamRX is not affiliated with Evergreen Goodwill of Northwest Washington.