Form 5500 · Employee benefit plan · GRESHAM, OR
OUT OF THE BOX SOLUTIONS LLC
The filing calls this plan OUT OF THE BOX SOLUTIONS LLC HEALTH & WELFARE BENEFIT PLAN.
OUT OF THE BOX SOLUTIONS LLC of GRESHAM, OR files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is PCF INSURANCE SERVICES OF THE WEST. Coverage is written through PROVIDENCE HEALTH PLAN and 4 other carriers. The plan's most recent policy period ended in July.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 83-3539696 · plan 501 · plan year 2025, filed May 6, 2026
Get an email when this employer files a new Form 5500, and again about four months before its plan renews.
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 5 insured contracts covering health, dental, life and disability; the largest, with PROVIDENCE HEALTH PLAN, covers 97 people.
Reported premium across the insured contracts is $968,884, with $44,617 in disclosed broker commissions — about 4.6% of premium.
The most recent policy period ended in July, and the plan year ends July 31. Group contracts typically renew on that annual cycle.
PCF INSURANCE SERVICES OF THE WEST is the broker of record on 2 of the 5 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including PROVIDENCE HEALTH PLAN, TRANSAMERICA LIFE INSURANCE COMPANY, WILLAMETTE DENTAL INSURANCE, INC. and WELLFLEET INSURANCE COMPANY. PROVIDENCE HEALTH PLAN writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| PROVIDENCE HEALTH PLAN | Health | 97 | Aug 1, 2025 | $773,289 | $23,199 |
| WELLFLEET INSURANCE COMPANY | — | 94 | Aug 1, 2025 | $38,482 | $8,851 |
| TRANSAMERICA LIFE INSURANCE COMPANY | Health, Life, Disability | 63 | Aug 1, 2025 | $79,017 | $7,227 |
| PRINCIPAL LIFE INSURANCE COMPANY | Health, Dental | 67 | Aug 1, 2025 | $33,728 | $3,217 |
| WILLAMETTE DENTAL INSURANCE, INC. | Dental | 49 | Aug 1, 2025 | $44,368 | $2,123 |
Premium and claims on this contract
WILLAMETTE DENTAL INSURANCE, INC., contract OR525. For the contract year on this filing, the carrier reported $44,368 in premium earned and $34,182 in claims incurred. Dividing one by the other gives 77%.
- WILLAMETTE DENTAL INSURANCE, INC., contract OR525 reported $7,669 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.
How this plan compares
Subscribers see how this compares with similar plans in Oregon. A subscription also adds this plan's filing history and the renewal calendar for its state. See plans and prices
Without an account you can open 10 employer, broker and carrier pages a day, including through an AI assistant, and 50 a day with a free account. Paid plans are what keep these records free to read.
More employer plans in Oregon — largest plans, brokers, carriers and renewal months.