Form 5500 · Employee benefit plan · MILWAUKIE, OR
TEEN CHALLENGE INTERNATIONAL PACIFIC NW CENTER
The filing calls this plan TEEN CHALLENGE INTERNATIONAL PACIFIC NW CENTER ALL OTHER EMPLOYEES- HEALTH AND WELFARE PLAN.
Public Form 5500 records show how TEEN CHALLENGE INTERNATIONAL PACIFIC NW CENTER of MILWAUKIE, OR, a retail employer, structures its employee benefits. Its broker of record is B H INSURANCE LLC. Coverage is written through REGENCE BLUECROSS BLUESHIELD OF OREGON and 1 other carrier. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 93-0844063 · plan 502 · plan year 2025, filed Feb 24, 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: death benefits, 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.
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 2 insured contracts covering health, dental, vision and life; the largest, with REGENCE BLUECROSS BLUESHIELD OF OREGON, covers 184 people.
Reported premium across the insured contracts is $701,981, with $22,582 in disclosed broker commissions — about 3.2% of premium.
The health contract's policy period ended in December, while at least one ancillary line's policy period ended in July. The plan is on a split renewal cycle.
B H INSURANCE LLC is the broker of record on 1 of the 2 contracts; the rest name a different broker or none.
Two carriers split the book: REGENCE BLUECROSS BLUESHIELD OF OREGON and PRINCIPAL LIFE INSURANCE COMPANY.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| REGENCE BLUECROSS BLUESHIELD OF OREGON | Health | 184 | Jan 1, 2025 | $542,841 | $12,375 |
| PRINCIPAL LIFE INSURANCE COMPANY | Dental, Vision, Life | 249 | Aug 1, 2025 | $159,140 | $10,207 |
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
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