Form 5500 · Employee benefit plan · STAYTON, OR
SANTIAM MEMORIAL HOSPITAL
The filing calls this plan SANTIAM MEMORIAL HOSPITAL EMPLOYEE BENEFIT PLAN.
SANTIAM MEMORIAL HOSPITAL of STAYTON, OR spreads its employee benefits across 6 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is ACRISURE TEXAS RISK ADVISORS & INSU. Coverage is written through SUN LIFE ASSURANCE COMPANY OF CANADA and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 93-0415219 · plan 508 · plan year 2025, filed Jul 31, 2026
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744 other employer plans in Oregon have policy years ending in December. 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.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
Benefits declared on this filing
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 11 insured contracts covering health, dental, vision, life, disability and stop-loss; the largest, with SUN LIFE ASSURANCE COMPANY OF CANADA, covers 516 people.
The filing lists a stop-loss contract. On its own that does not settle whether the plan pays its own claims.
Reported premium across the insured contracts is $3,011,630, with $298,115 in disclosed broker commissions — about 9.9% of premium.
The health contract's policy period ended in December, while at least one ancillary line's policy period ended in May. The plan is on a split renewal cycle.
ACRISURE TEXAS RISK ADVISORS & INSU is the broker of record on 1 of the 11 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SUN LIFE ASSURANCE COMPANY OF CANADA | Health, Stop-loss | 516 | Jan 1, 2026 | $1,470,422 | $141,720 |
| CONSOCIATE GROUP | Health | 475 | Jun 1, 2025 | $628,617 | $95,520 |
| NORTHWESTERN MUTUAL | Disability | 0 | Jan 1, 2026 | $126,530 | $17,150 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Dental | 542 | Jan 1, 2026 | $282,459 | $12,711 |
| NORTHWESTERN MUTUAL | Life | 578 | Jan 1, 2026 | $71,468 | $10,179 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 333 | Jan 1, 2026 | $29,415 | $7,942 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 683 | Jan 1, 2026 | $31,708 | $4,756 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Vision | 509 | Jan 1, 2026 | $44,550 | $4,455 |
| PRINCIPAL LIFE INSURANCE COMPANY | Disability | 221 | Jun 1, 2025 | $32,539 | $3,682 |
| OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | Dental | 494 | Jun 1, 2025 | $293,922 | $0 |
| CONSOCIATE GROUP | Vision | 475 | Jun 1, 2025 | — | $0 |
Premium and claims on these contracts
NORTHWESTERN MUTUAL, contract 661668. For the contract year on this filing, the carrier reported $125,730 in premium earned and $-104,962 in claims incurred. Dividing one by the other gives -83%.
NORTHWESTERN MUTUAL, contract 661668. For the contract year on this filing, the carrier reported $70,809 in premium earned and $-24,032 in claims incurred. Dividing one by the other gives -34%.
- NORTHWESTERN MUTUAL, contract 661668 reported $230,692 in retention.
- NORTHWESTERN MUTUAL, contract 661668 reported $94,841 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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