Form 5500 · Employee benefit plan · SALEM, OR
AMERITIES HOLDINGS, LLC
The filing calls this plan AMERITIES HOLDINGS, LLC PLAN.
AMERITIES HOLDINGS, LLC of SALEM, OR is a 108-participant manufacturing employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is EDGEWOOD PARTNERS INSURANCE. Coverage is written through BLUECROSS BLUESHIELD OF OKLAHOMA and 2 other carriers. The plan's most recent policy period ended in November.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 20-2193267 · plan 502 · plan year 2025, filed Jun 24, 2026
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
The filing carries code 4S: this plan is filing again after previously being exempt.
Benefits declared on this filing
Also declared: death benefits.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 6 insured contracts covering health, dental, vision, life and disability; the largest, with BLUECROSS BLUESHIELD OF OKLAHOMA, covers 213 people.
Reported premium across the insured contracts is $1,457,117, with $84,024 in disclosed broker commissions — about 5.8% of premium.
The health contract's policy period ended in November, while at least one ancillary line's policy period ended in December. The plan is on a split renewal cycle.
EDGEWOOD PARTNERS INSURANCE is the broker of record on 1 of the 6 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including BLUECROSS BLUESHIELD OF OKLAHOMA, DELTA DENTAL and STANDARD INSURANCE COMPANY. BLUECROSS BLUESHIELD OF OKLAHOMA writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF OKLAHOMA | Health | 213 | Dec 1, 2025 | $1,257,074 | $62,854 |
| STANDARD INSURANCE COMPANY | Life | 94 | Dec 1, 2025 | $45,641 | $9,196 |
| STANDARD INSURANCE COMPANY | Disability | 94 | Dec 1, 2025 | $27,137 | $5,428 |
| STANDARD INSURANCE COMPANY | Disability | 94 | Dec 1, 2025 | $25,120 | $5,024 |
| STANDARD INSURANCE COMPANY | Vision | 96 | Dec 1, 2025 | $11,715 | $1,522 |
| DELTA DENTAL | Dental | 91 | Jan 1, 2026 | $90,430 | $0 |
Premium and claims on this contract
DELTA DENTAL, contract 16171. For the contract year on this filing, the carrier reported $90,430 in premium earned and $70,530 in claims incurred. Dividing one by the other gives 78%.
- DELTA DENTAL, contract 16171 reported $15,499 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
How this plan compares
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