Form 5500 · Employee benefit plan · EUGENE, OR
HIV ALLIANCE
The filing calls this plan HIV ALLIANCE EMPLOYEE BENEFITS PLAN.
HIV ALLIANCE of EUGENE, OR spreads its employee benefits across 5 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is ALLIANT INSURANCE SERVICES, INC.. Coverage is written through PACIFICSOURCE HEALTH PLANS and 4 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 93-0963546 · plan 501 · plan year 2025, filed May 29, 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.
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 5 insured contracts covering health, dental, vision, life and disability; the largest, with PACIFICSOURCE HEALTH PLANS, covers 100 people.
Reported premium across the insured contracts is $1,599,789, with $42,241 in disclosed broker commissions — about 2.6% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
ALLIANT INSURANCE SERVICES, INC. is the broker of record on 4 of the 5 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including PACIFICSOURCE HEALTH PLANS, OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON, UNUM INSURANCE COMPANY and UNUM LIFE INSURANCE COMPANY OF AMERICA. PACIFICSOURCE HEALTH PLANS writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| PACIFICSOURCE HEALTH PLANS | Health, Vision | 100 | Jan 1, 2026 | $1,437,212 | $20,672 |
| UNUM INSURANCE COMPANY | — | 78 | Jan 1, 2026 | $39,884 | $13,959 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 138 | Jan 1, 2026 | $38,690 | $4,620 |
| OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | Dental | 89 | Jan 1, 2026 | $71,169 | $2,139 |
| VISION SERVICE PLAN | Vision | 60 | Jan 1, 2026 | $12,834 | $851 |
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.
Reported to OSHA
Reported to OSHA for 2025: 140 employees, 3 recordable cases, 0 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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