Form 5500 · Employee benefit plan · PORTLAND, OR
MULTNOMAH ATHLETIC CLUB
The filing calls this plan MULTNOMAH ATHLETIC CLUB EMPLOYEE BENEFIT PLAN.
MULTNOMAH ATHLETIC CLUB of PORTLAND, OR files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is THE PARTNERS GROUP. Coverage is written through PROVIDENCE HEALTH PLAN and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 93-0232310 · plan 501 · plan year 2025, filed Jul 21, 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: 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 8 insured contracts covering health, dental, vision, life and disability; the largest, with PROVIDENCE HEALTH PLAN, covers 274 people.
Reported premium across the insured contracts is $2,454,929, with $98,562 in disclosed broker commissions — about 4% 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.
THE PARTNERS GROUP is the broker of record on 7 of the 8 contracts; the rest name a different broker or none.
6 carriers appear on the filing, including PROVIDENCE HEALTH PLAN, OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON, STANDARD INSURANCE COMPANY and VISION SERVICE PLAN. PROVIDENCE HEALTH PLAN writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| PROVIDENCE HEALTH PLAN | Health | 274 | Jan 1, 2026 | $2,142,210 | $64,266 |
| RELIASTAR LIFE INSURANCE COMPANY | — | 129 | Jan 1, 2026 | $21,384 | $12,750 |
| STANDARD INSURANCE COMPANY | Life | 308 | Jan 1, 2026 | $51,933 | $7,809 |
| STANDARD INSURANCE COMPANY | Disability | 308 | Jan 1, 2026 | $38,715 | $5,807 |
| OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | Dental | 290 | Jan 1, 2026 | $148,500 | $5,413 |
| VISION SERVICE PLAN | Vision | 204 | Jan 1, 2026 | $24,199 | $1,452 |
| STANDARD INSURANCE COMPANY | Disability | 82 | Jan 1, 2026 | $7,098 | $1,065 |
| UPRISE HEALTH | — | 640 | Jan 1, 2026 | $20,890 | $0 |
Premium and claims on these contracts
STANDARD INSURANCE COMPANY, contract 751344. For the contract year on this filing, the carrier reported $48,250 in premium earned and $1,275 in claims incurred. Dividing one by the other gives 3%.
STANDARD INSURANCE COMPANY, contract 751344. For the contract year on this filing, the carrier reported $35,903 in premium earned and $8,844 in claims incurred. Dividing one by the other gives 25%.
STANDARD INSURANCE COMPANY, contract 751344. For the contract year on this filing, the carrier reported $6,586 in premium earned and $79 in claims incurred. Dividing one by the other gives 1%.
- STANDARD INSURANCE COMPANY, contract 751344 reported $46,982 in retention.
- STANDARD INSURANCE COMPANY, contract 751344 reported $27,059 in retention.
- STANDARD INSURANCE COMPANY, contract 751344 reported $6,507 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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