Form 5500 · Employee benefit plan · SPRINGFIELD, OR
HEAD START OF LANE COUNTY
HEAD START OF LANE COUNTY of SPRINGFIELD, OR spreads its employee benefits across 6 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is USI INSURANCE SERVICES LLC. Coverage is written through KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST and 5 other carriers. The plan's most recent policy period ended in October.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 93-0728229 · plan 503 · plan year 2025, filed Jun 1, 2026
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23 other employer plans in Oregon have policy years ending in October. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
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: death benefits, 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 6 insured contracts covering health, dental, vision, life and disability; the largest, with KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST, covers 181 people.
Reported premium across the insured contracts is $1,951,224, with $48,327 in disclosed broker commissions — about 2.5% of premium.
The health contract's policy period ended in October, while at least one ancillary line's policy period ended in December. The plan is on a split renewal cycle.
USI INSURANCE SERVICES LLC is the broker of record on 4 of the 6 contracts; the rest name a different broker or none.
6 carriers appear on the filing, including KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST, WILLAMETTE DENTAL INSURANCE, INC., AMERICAN FIDELITY ASSURANCE COMPANY and UNITED OF OMAHA LIFE INSURANCE COMPANY. KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | Health, Dental | 181 | Nov 1, 2024 | $1,778,430 | $40,626 |
| WILLAMETTE DENTAL INSURANCE, INC. | Dental | 178 | Nov 1, 2024 | $93,792 | $5,060 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life, Disability | 243 | Nov 1, 2024 | $19,872 | $3,282 |
| AMERITAS LIFE INSURANCE CORP. | Vision | 187 | Nov 1, 2024 | $9,803 | $980 |
| CASCADE HEALTH | — | 267 | Jan 1, 2025 | $10,588 | $0 |
| AMERICAN FIDELITY ASSURANCE COMPANY | Disability | 48 | Jan 1, 2025 | $38,739 | $-1,621 |
Premium and claims on this contract
WILLAMETTE DENTAL INSURANCE, INC., contract OR56. For the contract year on this filing, the carrier reported $93,792 in premium earned and $93,406 in claims incurred. Dividing one by the other gives 100%.
- WILLAMETTE DENTAL INSURANCE, INC., contract OR56 reported $14,820 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.
Other plans filed by this employer
How this plan compares
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