# IMPERIAL BROWN, INC. WELFARE BENEFIT PLAN

Health and welfare plan sponsored by **IMPERIAL BROWN, INC.**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | IMPERIAL BROWN, INC. |
| EIN | 930692209 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | PORTLAND, OR |
| Industry | Manufacturing |
| Funding | mixed |
| Total premiums | $402K |
| Participants | 307 |
| Persons covered | 306 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| UNUM LIFE INSURANCE COMPANY OF AMERICA | STD, Indemnity, LTD, Life, Other |
| STARMOUNT LIFE INSURANCE COMPANY | Dental |

## Brokers

| Broker | Placed with |
|---|---|
| SUSAN ELIZABETH RUSSELL | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| DAVID J MCCLELLAN | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| JENNIFER MCCLELLAN | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| RUSSELL, MARLEY | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| PARKS BENEFITS & ENROLLMENT LLC | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| BENEFITS COUNT INC | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| PAYNE, CRISTY L | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| ZACHARY EUGENE VICKERS | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| ARTHUR WAYNE JORDAN JR | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| BARRETT L PATTERSON | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| JACK ALLEN NORRIS | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| ERIKA D DALTON | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| LISA A BALLANCE | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| TUCTO & ASSOCIATES CORP | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| PHOENIX CAPTIVE SOLUTIONS LLC | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| DAVID J MCCLELLAN | STARMOUNT LIFE INSURANCE COMPANY |
| PAYNE, CRISTY L | STARMOUNT LIFE INSURANCE COMPANY |
| RUSSELL, SUSAN | STARMOUNT LIFE INSURANCE COMPANY |
| PAYNE, CRISTY L | UNUM LIFE INSURANCE COMPANY OF AMERICA |
| RUSSELL, SUSAN | UNUM LIFE INSURANCE COMPANY OF AMERICA |
| DAVID J MCCLELLAN | UNUM LIFE 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/930692209-501
- Cite as: PlanOptica, https://planoptica.com/welfare/930692209-501
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