401k Plan data: EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN plan

EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN 401k Plan overview

Plan Name	EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN
Plan identification number	001

EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

EASTER SEALS OREGON has sponsored the creation of one or more 401k plans.

Company Name: EASTER SEALS OREGON

Employer identification number (EIN): 930386885

NAIC Classification: 813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about EASTER SEALS OREGON

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division

Incorporation Date: 2047-05-02

Company Identification Number: 4554317

Legal Registered Office Address: 7300 SW HUNZIKER RD STE 103

PORTLAND
United States of America (USA)
97223

More information about EASTER SEALS OREGON

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01
001 2016-01-01 DAVID CHEVEALLIER 2017-07-05
001 2015-01-01 ROSALIE BUTTERMORE 2016-06-07
001 2014-01-01 ROSALIE BUTTERMORE 2015-06-11
001 2013-01-01 J. DAVID CHEVEALLIER
001 2012-01-01 J. DAVID CHEVEALLIER
001 2011-01-01 DONNA M. WALLER
001 2010-01-01 DONNA M. WALLER 2011-07-26

Plan Statistics for EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN

401k plan membership statisitcs for EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN

Measure Date Value
2013: EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 36
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 35
Total of all active and inactive participants 2013-01-01 71
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 71
Number of participants with account balances 2013-01-01 55
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 15
2012: EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 72
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 38
Total of all active and inactive participants 2012-01-01 110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 110
Number of participants with account balances 2012-01-01 84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 14
2011: EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 138
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 94
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 48
Total of all active and inactive participants 2011-01-01 142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 142
Number of participants with account balances 2011-01-01 115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 17

Measure	Date	Value
2013: EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	36
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	35
Total of all active and inactive participants	2013-01-01	71
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	71
Number of participants with account balances	2013-01-01	55
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	15
2012: EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	72
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	38
Total of all active and inactive participants	2012-01-01	110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	110
Number of participants with account balances	2012-01-01	84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	14
2011: EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	138
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	94
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	48
Total of all active and inactive participants	2011-01-01	142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	142
Number of participants with account balances	2011-01-01	115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	17

Financial Data on EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN

Measure	Date	Value
2013 : EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$438,048
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$297,975
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$289,176
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$49,782
Value of total assets at end of year	2013-12-31	$2,099,450
Value of total assets at beginning of year	2013-12-31	$1,959,377
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$8,799
Total interest from all sources	2013-12-31	$19,069
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$150,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$49,782
Participant contributions at end of year	2013-12-31	$57,309
Participant contributions at beginning of year	2013-12-31	$59,352
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$140,073
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$2,099,450
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,959,377
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in pooled separate accounts at end of year	2013-12-31	$1,361,985
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$1,407,833
Interest on participant loans	2013-12-31	$1,827
Interest earned on other investments	2013-12-31	$17,242
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$680,156
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$492,192
Net investment gain/loss from pooled separate accounts	2013-12-31	$369,197
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$289,176
Contract administrator fees	2013-12-31	$8,799
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	CARON & BLETZER,
Accountancy firm EIN	2013-12-31	043499945
2012 : EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$327,130
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$185,835
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$177,842
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$122,051
Value of total assets at end of year	2012-12-31	$1,959,377
Value of total assets at beginning of year	2012-12-31	$1,818,082
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$7,993
Total interest from all sources	2012-12-31	$16,462
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Administrative expenses professional fees incurred	2012-12-31	$7,993
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$150,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$112,546
Participant contributions at end of year	2012-12-31	$59,352
Participant contributions at beginning of year	2012-12-31	$49,889
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$141,295
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,959,377
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,818,082
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$1,407,833
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$1,312,687
Interest on participant loans	2012-12-31	$1,702
Interest earned on other investments	2012-12-31	$14,760
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$492,192
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$455,506
Net investment gain/loss from pooled separate accounts	2012-12-31	$188,617
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$9,505
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$177,842
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2012-12-31	043499945
2011 : EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$208,633
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$57,254
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$50,426
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$227,457
Value of total assets at end of year	2011-12-31	$1,818,082
Value of total assets at beginning of year	2011-12-31	$1,666,703
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$6,828
Total interest from all sources	2011-12-31	$14,990
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$150,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$117,776
Participant contributions at end of year	2011-12-31	$49,889
Participant contributions at beginning of year	2011-12-31	$13,330
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$1,915
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$151,379
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,818,082
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,666,703
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in pooled separate accounts at end of year	2011-12-31	$1,312,687
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$1,225,509
Interest on participant loans	2011-12-31	$1,188
Interest earned on other investments	2011-12-31	$13,802
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$455,506
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$427,864
Net investment gain/loss from pooled separate accounts	2011-12-31	$-33,814
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$107,766
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$50,426
Contract administrator fees	2011-12-31	$6,828
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	JAMES E. RICHMAN, CPA, PC
Accountancy firm EIN	2011-12-31	931309646

Form 5500 Responses for EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN

2013: EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: EASTER SEALS OREGON QUALIFIED EMPLOYEES' SAVINGS AND RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

498598

Policy instance

Insurance contract or identification number	498598
Number of Individuals Covered	71
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $5,000
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,000
Insurance broker organization code?	3
Insurance broker name	LINSCO PRIVATE LEDGER CORP

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

498598

Policy instance

Insurance contract or identification number	498598
Number of Individuals Covered	110
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $4,627
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,627
Insurance broker organization code?	3
Insurance broker name	LINSCO PRIVATE LEDGER CORP

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

498598

Policy instance

Insurance contract or identification number	498598
Number of Individuals Covered	142
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $542
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	EASTER SEALS OREGON
Employer identification number (EIN):	930386885
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations

Jurisdiction of Incorporation:	Oregon Secretary of State Corporations Division
Incorporation Date:	2047-05-02
Company Identification Number:	4554317
Legal Registered Office Address:	7300 SW HUNZIKER RD STE 103 PORTLAND United States of America (USA) 97223

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2023-01-01
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01
001	2016-01-01	DAVID CHEVEALLIER	2017-07-05
001	2015-01-01	ROSALIE BUTTERMORE	2016-06-07
001	2014-01-01	ROSALIE BUTTERMORE	2015-06-11
001	2013-01-01	J. DAVID CHEVEALLIER
001	2012-01-01	J. DAVID CHEVEALLIER
001	2011-01-01	DONNA M. WALLER
001	2010-01-01	DONNA M. WALLER	2011-07-26