Form 5500 · Employee benefit plan · COBURG, OR
JAJ ENTERPRISES, LLC
Public Form 5500 records show how JAJ ENTERPRISES, LLC of COBURG, OR, a other services employer, structures its employee benefits. Its broker of record is ALLIANT INSURANCE SERVICES, INC.. Coverage is written through REGENCE BLUECROSS BLUESHIELD OF OREGON and 1 other carrier. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 93-1210953 · plan 501 · plan year 2025, filed Jun 25, 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, 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.
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 and life; the largest, with REGENCE BLUECROSS BLUESHIELD OF OREGON, covers 178 people.
Reported premium across the insured contracts is $761,224, with $28,314 in disclosed broker commissions — about 3.7% 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 all 2 contracts.
Two carriers split the book: REGENCE BLUECROSS BLUESHIELD OF OREGON and THE LINCOLN NATIONAL LIFE INSURANCE COMPANY.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| REGENCE BLUECROSS BLUESHIELD OF OREGON | Health | 178 | Jan 1, 2026 | $684,424 | $20,634 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Dental, Vision, Life | 101 | Jan 1, 2026 | $76,800 | $7,680 |
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: 78 employees, 1 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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