# LIFEWORKS NW WELFARE BENEFIT PLAN

Health and welfare plan sponsored by **LIFEWORKS NORTHWEST**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | LIFEWORKS NORTHWEST |
| EIN | 930502822 |
| Plan number | 502 |
| Plan year | 2025 |
| Location | PORTLAND, OR |
| Industry | mental health care |
| Funding | mixed |
| Total premiums | $4.1M |
| Participants | 513 |
| Persons covered | 513 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| PROVIDENCE HEALTH PLAN | Health, Rx, PPO |
| KAISER PERMANENTE | Health, Rx, Dental, HMO |
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Life, LTD, Other |
| UPRISEHEALTH | Other |

## Brokers

| Broker | Placed with |
|---|---|
| USI INSURANCE SERVICES LLC | PROVIDENCE HEALTH PLAN |
| USI INSURANCE SERVICES LLC | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST |
| USI INSURANCE SERVICES LLC | PRUDENTIAL INSURANCE COMPANY OF AMERICA |
| IMG | PRUDENTIAL INSURANCE COMPANY OF AMERICA |

## About this data

- Source: public Form 5500 filings from the U.S. Department of Labor (EBSA), rebuilt on each DOL release.
- Full page (charts, history, peer benchmarks, fees, contacts): https://planoptica.com/welfare/930502822-502
- Cite as: PlanOptica, https://planoptica.com/welfare/930502822-502
- More: https://planoptica.com/llms.txt · API waitlist: https://planoptica.com/developers