Form 5500 · Employee benefit plan · ROSEBURG, OR
CON-VEY, LLC WELFARE BENEFIT PLAN
CON-VEY, LLC WELFARE BENEFIT PLAN of ROSEBURG, OR is a 110-participant manufacturing employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is PCF INSURANCE SERVICES OF THE WEST. Coverage is written through REGENCE BLUECROSS BLUESHIELD OF OREGON and 1 other carrier. The plan's most recent policy period ended in June.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 83-1677561 · plan 501 · plan year 2025, filed Oct 6, 2025
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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.
Benefits declared on this filing
Also declared: other welfare.
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 2 insured contracts covering health, dental, vision, life and disability; the largest, with REGENCE BLUECROSS BLUESHIELD OF OREGON, covers 109 people.
Reported premium across the insured contracts is $2,085,154, with $44,242 in disclosed broker commissions — about 2.1% of premium.
The most recent policy period ended in June, and the plan year ends June 30. Group contracts typically renew on that annual cycle.
PCF INSURANCE SERVICES OF THE WEST is the broker of record on all 2 contracts.
Two carriers split the book: REGENCE BLUECROSS BLUESHIELD OF OREGON and PRINCIPAL LIFE INSURANCE COMPANY.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| REGENCE BLUECROSS BLUESHIELD OF OREGON | Health | 109 | Jul 1, 2025 | $1,964,644 | $29,950 |
| PRINCIPAL LIFE INSURANCE COMPANY | Health, Dental, Vision, Life, Disability | 117 | Jul 1, 2025 | $120,510 | $14,292 |
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.
Reported to OSHA
Reported to OSHA for 2025: 116 employees, 5 recordable cases, 3 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
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