Form 5500 · Employee benefit plan · PORTLAND, OR
SAPPHIRE HEALTH SERVICES
SAPPHIRE HEALTH SERVICES of PORTLAND, OR spreads its employee benefits across 5 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is AGM BENEFITS. Coverage is written through KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST and 4 other carriers. The plan's most recent policy period ended in January.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 45-2982259 · plan 501 · plan year 2026, filed Aug 28, 2026
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15 other employer plans in Oregon have policy years ending in January. 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: 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 5 insured contracts covering health, dental, vision and life; the largest, with KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST, covers 344 people.
Reported premium across the insured contracts is $4,205,510, with $234,522 in disclosed broker commissions — about 5.6% of premium.
The health contract's policy period ended in January, while at least one ancillary line's policy period ended in December. The plan is on a split renewal cycle.
AGM BENEFITS is the broker of record on 1 of the 5 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST, UNITED OF OMAHA LIFE INSURANCE COMPANY, KAISER FOUNDATION HEALTH PLAN OF WASHINGTON and PACIFICSOURCE HEALTH PLANS. KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SYMETRA LIFE INSURANCE COMPANY | — | 44 | Jan 1, 2026 | $179,763 | $103,397 |
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | Health | 344 | Feb 1, 2026 | $3,251,012 | $96,530 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Dental, Vision, Life | 1,045 | May 1, 2025 | $309,304 | $22,916 |
| KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | Health | 28 | Feb 1, 2026 | $240,022 | $6,970 |
| PACIFICSOURCE HEALTH PLANS | Health | 20 | Feb 1, 2026 | $225,409 | $4,709 |
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.
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Renewal calendar
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