No insurance carriers on this filing. Self-funded welfare plans typically pay TPAs and PBMs through Schedule C, not Schedule A.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REGENCE BLUECROSS BLUESHIELD OF OR EIN 93-0238155 CLAIMS PROCESSOR | Claims processing Service code 12 | 100 SW MARKET STREET PORTLAND, OR 97201 | $496K |
| MERCER HUMAN RESOURCE CONSULTING EIN 13-2834414 CONSULTANT | Consulting (general) Service code 16 | 111 SW COLUMBIA STREET PORTLAND, OR 97201 | $120K |
| BENESYS EIN 38-2383171 THIRD PARTY ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | 18300 CASCADE AVENUE S TUKWILA, WA 98188 | $116K |
| JOSEPH L. REINHART, PC EIN 93-1162180 LEGAL COUNSEL | Legal Service code 29 | 7355 SW HERMOSO WAY TIGARD, OR 97223 | $99K |
| MODA EIN 93-2438772 CLAIMS PROCESSOR | Claims processing Service code 12 | 601 SW 2ND AVENUE PORTLAND, OR 97204 | $91K |
| VISION SERVICE PLAN EIN 93-0639517 CLAIMS PROCESSOR | Claims processing Service code 12 | PO BOX 60000 SAN FRANCISCO, CA 94160 | $15K |
| QUEST INVESTMENT MANAGEMENT INC. EIN 93-0880854 INVESTMENT MANAGER | Investment management Service code 28 | ONE SW COLUNBIA ST. 1100 PORTLAND, OR 97201 | $10K |
| BJORKLUND & MONTPLAISIR EIN 93-1015766 AUDITOR | Accounting (including auditing) Service code 10 | 9020 SW WASHINGTON SQU RD TIGARD, OR 97223 | $10K |
| MILLIMAN USA EIN 93-0675641 ACTUARY | Actuarial Service code 11 | 111 SW 5TH AVENUE PORTLAND, OR 97204 | $5K |
| US BANK NA EIN 41-6271370 INVESTMENT CUSTODIAN | Custodial (securities) Service code 19 | 555 SW OAK STREET PORTLAND, OR 97208 | $4K |
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 | 828 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 60 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 888 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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."
Self-funded plan with no stop-loss carrier attached. Catastrophic-risk exposure; stop-loss specialist sales target.