Form 5500 · Employee benefit plan · MEDFORD, OR
NISHA JACKSON, INC.
The filing calls this plan NISHA JACKSON, INC. DBA ONEPEAK MEDICAL GROUP HEALTH PLAN.
Public Form 5500 records show how NISHA JACKSON, INC. of MEDFORD, OR, a health care and social assistance employer, structures its employee benefits. Its broker of record is THE BALDWIN GROUP SOUTHEAST, LLC. Coverage is written through AETNA LIFE INSURANCE COMPANY and 3 other carriers. The plan's most recent policy period ended in January.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 20-0686677 · plan 501 · plan year 2026, filed Aug 14, 2026
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
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 4 insured contracts covering dental, vision, life and disability; the largest, with AETNA LIFE INSURANCE COMPANY, covers 212 people.
The filing declares dental, vision, life, disability and health. Health appears with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
Reported premium across the insured contracts is $226,019, with $21,674 in disclosed broker commissions — about 9.6% of premium.
The most recent policy period ended in January, and the plan year ends January 31. Group contracts typically renew on that annual cycle.
THE BALDWIN GROUP SOUTHEAST, LLC is the broker of record on 2 of the 4 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life, Disability | 212 | Feb 1, 2026 | $64,357 | $9,336 |
| AETNA LIFE INSURANCE COMPANY | Dental | 212 | Jan 1, 2026 | $100,876 | $8,355 |
| VISION SERVICE PLAN | Vision | 170 | Jan 1, 2026 | $27,429 | $2,816 |
| WILLAMETTE DENTAL INSURANCE, INC. | Dental | 59 | Jan 1, 2026 | $33,357 | $1,167 |
Premium and claims on this contract
WILLAMETTE DENTAL INSURANCE, INC., contract OR518. For the contract year on this filing, the carrier reported $33,357 in premium earned and $19,499 in claims incurred. Dividing one by the other gives 58%.
- WILLAMETTE DENTAL INSURANCE, INC., contract OR518 reported $5,337 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
How this plan compares
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