Form 5500 · Employee benefit plan · PORTLAND, OR
LACROSSE FOOTWEAR, INC.
The filing calls this plan LACROSSE FOOTWEAR, INC. HEALTH AND WELFARE PLAN.
Public Form 5500 records show how LACROSSE FOOTWEAR, INC. of PORTLAND, OR, a manufacturing employer, structures its employee benefits. Its broker of record is MERCER HEALTH AND BENEFITS, LLC. Coverage is written through REGENCE BLUECROSS BLUESHIELD OF OREGON and 7 other carriers. The plan's most recent policy period ended in May.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 39-1446816 · plan 501 · plan year 2025, filed Dec 17, 2025
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27 other employer plans in Oregon have policy years ending in May. 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: prepaid legal, 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 10 insured contracts covering health, dental, vision, life and disability; the largest, with REGENCE BLUECROSS BLUESHIELD OF OREGON, covers 354 people.
Reported premium across the insured contracts is $3,366,179, with $139,023 in disclosed broker commissions — about 4.1% of premium.
The most recent policy period ended in May, and the plan year ends May 31. Group contracts typically renew on that annual cycle.
MERCER HEALTH AND BENEFITS, LLC is the broker of record on 4 of the 10 contracts; the rest name a different broker or none.
8 carriers appear on the filing, including REGENCE BLUECROSS BLUESHIELD OF OREGON, KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST, STANDARD INSURANCE COMPANY and RELIASTAR LIFE INSURANCE COMPANY. REGENCE BLUECROSS BLUESHIELD OF OREGON writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| REGENCE BLUECROSS BLUESHIELD OF OREGON | Health | 354 | Jun 1, 2025 | $2,354,915 | $82,601 |
| RELIASTAR LIFE INSURANCE COMPANY | — | 112 | Jun 1, 2025 | $29,988 | $18,621 |
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | Health | 107 | Jun 1, 2025 | $569,243 | $16,771 |
| STANDARD INSURANCE COMPANY | Life | 281 | Jun 1, 2025 | $95,233 | $6,053 |
| STANDARD INSURANCE COMPANY | Dental | 222 | Jun 1, 2025 | $217,138 | $5,666 |
| STANDARD INSURANCE COMPANY | Disability | 281 | Jun 1, 2025 | $50,179 | $5,505 |
| FEDERAL INSURANCE COMPANY | — | 276 | Jun 1, 2025 | $7,055 | $2,117 |
| FIDELITY SECURITY LIFE INSURANCE COMPANY | Vision | 461 | Jun 1, 2025 | $29,406 | $1,458 |
| LEGALPLANS, USA | — | 18 | Jun 1, 2025 | $2,310 | $231 |
| CANOPY | — | 475 | Jun 1, 2025 | $10,712 | $0 |
Premium and claims on these contracts
STANDARD INSURANCE COMPANY, contract 142411-A. For the contract year on this filing, the carrier reported $95,233 in premium earned and $97,061 in claims incurred. Dividing one by the other gives 102%.
STANDARD INSURANCE COMPANY, contract 142411. For the contract year on this filing, the carrier reported $217,138 in premium earned and $171,265 in claims incurred. Dividing one by the other gives 79%.
STANDARD INSURANCE COMPANY, contract 142411-C. For the contract year on this filing, the carrier reported $50,179 in premium earned and $-80,422 in claims incurred. Dividing one by the other gives -160%.
- STANDARD INSURANCE COMPANY, contract 142411-A reported $25,403 in retention.
- STANDARD INSURANCE COMPANY, contract 142411 reported $45,873 in retention.
- STANDARD INSURANCE COMPANY, contract 142411-C reported $130,603 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.
Other plans filed by this employer
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Renewal calendar
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