401k Plan data: HEAD START OF LANE COUNTY plan

HEAD START OF LANE COUNTY 401k Plan overview

Plan Name	HEAD START OF LANE COUNTY
Plan identification number	503

HEAD START OF LANE COUNTY Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Prepaid legal Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

HEAD START OF LANE COUNTY has sponsored the creation of one or more 401k plans.

Company Name: HEAD START OF LANE COUNTY

Employer identification number (EIN): 930728229

NAIC Classification: 611000

Additional information about HEAD START OF LANE COUNTY

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division

Incorporation Date: 1978-10-02

Company Identification Number: 13158316

Legal Registered Office Address: 221 B STREET

SPRINGFIELD
United States of America (USA)
97477

More information about HEAD START OF LANE COUNTY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEAD START OF LANE COUNTY

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2022-10-01 CLAIRE VERSAW 2024-04-09
503 2021-10-01 BLANCA FLORES 2023-07-07
503 2020-10-01 TIM ROCHHOLZ 2022-04-25
503 2019-10-01 ALISSA KING 2021-02-03
503 2018-10-01 ALISSA KING 2020-05-14
503 2017-10-01 ALISSA KING 2019-03-28
503 2016-10-01
503 2015-10-01 TIM ROCHHOLZ
503 2014-10-01 MARY SCARPINATO
503 2013-10-01 MARY SCARPINATO
503 2012-10-01 MARY SCARPINATO
503 2011-10-01 MARY SCARPINATO
503 2010-10-01 MARY SCARPINATO
503 2009-10-01 ANNIE SOTO IRVING KIM 2010-12-29
503 2009-10-01 ANNIE SOTO IRVING KIM 2010-12-28

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
503	2022-10-01	CLAIRE VERSAW	2024-04-09
503	2021-10-01	BLANCA FLORES	2023-07-07
503	2020-10-01	TIM ROCHHOLZ	2022-04-25
503	2019-10-01	ALISSA KING	2021-02-03
503	2018-10-01	ALISSA KING	2020-05-14
503	2017-10-01	ALISSA KING	2019-03-28
503	2016-10-01
503	2015-10-01	TIM ROCHHOLZ
503	2014-10-01	MARY SCARPINATO
503	2013-10-01	MARY SCARPINATO
503	2012-10-01	MARY SCARPINATO
503	2011-10-01	MARY SCARPINATO
503	2010-10-01	MARY SCARPINATO
503	2009-10-01	ANNIE SOTO		IRVING KIM	2010-12-29
503	2009-10-01	ANNIE SOTO		IRVING KIM	2010-12-28

Plan Statistics for HEAD START OF LANE COUNTY

401k plan membership statisitcs for HEAD START OF LANE COUNTY

Measure Date Value
2022: HEAD START OF LANE COUNTY 2022 401k membership
Total participants, beginning-of-year 2022-10-01 277
Total number of active participants reported on line 7a of the Form 5500 2022-10-01 276
Number of retired or separated participants receiving benefits 2022-10-01 0
Number of other retired or separated participants entitled to future benefits 2022-10-01 0
Total of all active and inactive participants 2022-10-01 276
Number of employers contributing to the scheme 2022-10-01 0
2021: HEAD START OF LANE COUNTY 2021 401k membership
Total participants, beginning-of-year 2021-10-01 200
Total number of active participants reported on line 7a of the Form 5500 2021-10-01 277
Number of retired or separated participants receiving benefits 2021-10-01 0
Number of other retired or separated participants entitled to future benefits 2021-10-01 0
Total of all active and inactive participants 2021-10-01 277
Number of employers contributing to the scheme 2021-10-01 0
2020: HEAD START OF LANE COUNTY 2020 401k membership
Total participants, beginning-of-year 2020-10-01 217
Total number of active participants reported on line 7a of the Form 5500 2020-10-01 200
Number of retired or separated participants receiving benefits 2020-10-01 0
Number of other retired or separated participants entitled to future benefits 2020-10-01 0
Total of all active and inactive participants 2020-10-01 200
Number of employers contributing to the scheme 2020-10-01 0
2019: HEAD START OF LANE COUNTY 2019 401k membership
Total participants, beginning-of-year 2019-10-01 237
Total number of active participants reported on line 7a of the Form 5500 2019-10-01 241
Number of retired or separated participants receiving benefits 2019-10-01 0
Number of other retired or separated participants entitled to future benefits 2019-10-01 0
Total of all active and inactive participants 2019-10-01 241
Number of employers contributing to the scheme 2019-10-01 0
2018: HEAD START OF LANE COUNTY 2018 401k membership
Total participants, beginning-of-year 2018-10-01 238
Total number of active participants reported on line 7a of the Form 5500 2018-10-01 246
Number of retired or separated participants receiving benefits 2018-10-01 1
Number of other retired or separated participants entitled to future benefits 2018-10-01 0
Total of all active and inactive participants 2018-10-01 247
Number of employers contributing to the scheme 2018-10-01 0
2017: HEAD START OF LANE COUNTY 2017 401k membership
Total participants, beginning-of-year 2017-10-01 226
Total number of active participants reported on line 7a of the Form 5500 2017-10-01 238
Number of retired or separated participants receiving benefits 2017-10-01 0
Number of other retired or separated participants entitled to future benefits 2017-10-01 0
Total of all active and inactive participants 2017-10-01 238
Number of employers contributing to the scheme 2017-10-01 0
2016: HEAD START OF LANE COUNTY 2016 401k membership
Total participants, beginning-of-year 2016-10-01 234
Total number of active participants reported on line 7a of the Form 5500 2016-10-01 226
Number of retired or separated participants receiving benefits 2016-10-01 0
Number of other retired or separated participants entitled to future benefits 2016-10-01 0
Total of all active and inactive participants 2016-10-01 226
2015: HEAD START OF LANE COUNTY 2015 401k membership
Total participants, beginning-of-year 2015-10-01 229
Total number of active participants reported on line 7a of the Form 5500 2015-10-01 234
Number of retired or separated participants receiving benefits 2015-10-01 0
Number of other retired or separated participants entitled to future benefits 2015-10-01 0
Total of all active and inactive participants 2015-10-01 234
2014: HEAD START OF LANE COUNTY 2014 401k membership
Total participants, beginning-of-year 2014-10-01 226
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 229
Number of retired or separated participants receiving benefits 2014-10-01 0
Number of other retired or separated participants entitled to future benefits 2014-10-01 0
Total of all active and inactive participants 2014-10-01 229
2013: HEAD START OF LANE COUNTY 2013 401k membership
Total participants, beginning-of-year 2013-10-01 227
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 226
Number of retired or separated participants receiving benefits 2013-10-01 0
Number of other retired or separated participants entitled to future benefits 2013-10-01 0
Total of all active and inactive participants 2013-10-01 226
2012: HEAD START OF LANE COUNTY 2012 401k membership
Total participants, beginning-of-year 2012-10-01 239
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 227
Number of retired or separated participants receiving benefits 2012-10-01 0
Number of other retired or separated participants entitled to future benefits 2012-10-01 0
Total of all active and inactive participants 2012-10-01 227
2011: HEAD START OF LANE COUNTY 2011 401k membership
Total participants, beginning-of-year 2011-10-01 223
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 239
Number of retired or separated participants receiving benefits 2011-10-01 0
Number of other retired or separated participants entitled to future benefits 2011-10-01 0
Total of all active and inactive participants 2011-10-01 239
2010: HEAD START OF LANE COUNTY 2010 401k membership
Total participants, beginning-of-year 2010-10-01 246
Total number of active participants reported on line 7a of the Form 5500 2010-10-01 223
Number of retired or separated participants receiving benefits 2010-10-01 0
Number of other retired or separated participants entitled to future benefits 2010-10-01 0
Total of all active and inactive participants 2010-10-01 223
2009: HEAD START OF LANE COUNTY 2009 401k membership
Total participants, beginning-of-year 2009-10-01 229
Total number of active participants reported on line 7a of the Form 5500 2009-10-01 246
Total of all active and inactive participants 2009-10-01 246
Total participants 2009-10-01 246

Measure	Date	Value
2022: HEAD START OF LANE COUNTY 2022 401k membership
Total participants, beginning-of-year	2022-10-01	277
Total number of active participants reported on line 7a of the Form 5500	2022-10-01	276
Number of retired or separated participants receiving benefits	2022-10-01	0
Number of other retired or separated participants entitled to future benefits	2022-10-01	0
Total of all active and inactive participants	2022-10-01	276
Number of employers contributing to the scheme	2022-10-01	0
2021: HEAD START OF LANE COUNTY 2021 401k membership
Total participants, beginning-of-year	2021-10-01	200
Total number of active participants reported on line 7a of the Form 5500	2021-10-01	277
Number of retired or separated participants receiving benefits	2021-10-01	0
Number of other retired or separated participants entitled to future benefits	2021-10-01	0
Total of all active and inactive participants	2021-10-01	277
Number of employers contributing to the scheme	2021-10-01	0
2020: HEAD START OF LANE COUNTY 2020 401k membership
Total participants, beginning-of-year	2020-10-01	217
Total number of active participants reported on line 7a of the Form 5500	2020-10-01	200
Number of retired or separated participants receiving benefits	2020-10-01	0
Number of other retired or separated participants entitled to future benefits	2020-10-01	0
Total of all active and inactive participants	2020-10-01	200
Number of employers contributing to the scheme	2020-10-01	0
2019: HEAD START OF LANE COUNTY 2019 401k membership
Total participants, beginning-of-year	2019-10-01	237
Total number of active participants reported on line 7a of the Form 5500	2019-10-01	241
Number of retired or separated participants receiving benefits	2019-10-01	0
Number of other retired or separated participants entitled to future benefits	2019-10-01	0
Total of all active and inactive participants	2019-10-01	241
Number of employers contributing to the scheme	2019-10-01	0
2018: HEAD START OF LANE COUNTY 2018 401k membership
Total participants, beginning-of-year	2018-10-01	238
Total number of active participants reported on line 7a of the Form 5500	2018-10-01	246
Number of retired or separated participants receiving benefits	2018-10-01	1
Number of other retired or separated participants entitled to future benefits	2018-10-01	0
Total of all active and inactive participants	2018-10-01	247
Number of employers contributing to the scheme	2018-10-01	0
2017: HEAD START OF LANE COUNTY 2017 401k membership
Total participants, beginning-of-year	2017-10-01	226
Total number of active participants reported on line 7a of the Form 5500	2017-10-01	238
Number of retired or separated participants receiving benefits	2017-10-01	0
Number of other retired or separated participants entitled to future benefits	2017-10-01	0
Total of all active and inactive participants	2017-10-01	238
Number of employers contributing to the scheme	2017-10-01	0
2016: HEAD START OF LANE COUNTY 2016 401k membership
Total participants, beginning-of-year	2016-10-01	234
Total number of active participants reported on line 7a of the Form 5500	2016-10-01	226
Number of retired or separated participants receiving benefits	2016-10-01	0
Number of other retired or separated participants entitled to future benefits	2016-10-01	0
Total of all active and inactive participants	2016-10-01	226
2015: HEAD START OF LANE COUNTY 2015 401k membership
Total participants, beginning-of-year	2015-10-01	229
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	234
Number of retired or separated participants receiving benefits	2015-10-01	0
Number of other retired or separated participants entitled to future benefits	2015-10-01	0
Total of all active and inactive participants	2015-10-01	234
2014: HEAD START OF LANE COUNTY 2014 401k membership
Total participants, beginning-of-year	2014-10-01	226
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	229
Number of retired or separated participants receiving benefits	2014-10-01	0
Number of other retired or separated participants entitled to future benefits	2014-10-01	0
Total of all active and inactive participants	2014-10-01	229
2013: HEAD START OF LANE COUNTY 2013 401k membership
Total participants, beginning-of-year	2013-10-01	227
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	226
Number of retired or separated participants receiving benefits	2013-10-01	0
Number of other retired or separated participants entitled to future benefits	2013-10-01	0
Total of all active and inactive participants	2013-10-01	226
2012: HEAD START OF LANE COUNTY 2012 401k membership
Total participants, beginning-of-year	2012-10-01	239
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	227
Number of retired or separated participants receiving benefits	2012-10-01	0
Number of other retired or separated participants entitled to future benefits	2012-10-01	0
Total of all active and inactive participants	2012-10-01	227
2011: HEAD START OF LANE COUNTY 2011 401k membership
Total participants, beginning-of-year	2011-10-01	223
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	239
Number of retired or separated participants receiving benefits	2011-10-01	0
Number of other retired or separated participants entitled to future benefits	2011-10-01	0
Total of all active and inactive participants	2011-10-01	239
2010: HEAD START OF LANE COUNTY 2010 401k membership
Total participants, beginning-of-year	2010-10-01	246
Total number of active participants reported on line 7a of the Form 5500	2010-10-01	223
Number of retired or separated participants receiving benefits	2010-10-01	0
Number of other retired or separated participants entitled to future benefits	2010-10-01	0
Total of all active and inactive participants	2010-10-01	223
2009: HEAD START OF LANE COUNTY 2009 401k membership
Total participants, beginning-of-year	2009-10-01	229
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	246
Total of all active and inactive participants	2009-10-01	246
Total participants	2009-10-01	246

Form 5500 Responses for HEAD START OF LANE COUNTY

2022: HEAD START OF LANE COUNTY 2022 form 5500 responses
2022-10-01	Type of plan entity	Single employer plan
2022-10-01	Plan funding arrangement – Insurance	Yes
2022-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-10-01	Plan benefit arrangement – Insurance	Yes
2022-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: HEAD START OF LANE COUNTY 2021 form 5500 responses
2021-10-01	Type of plan entity	Single employer plan
2021-10-01	Plan funding arrangement – Insurance	Yes
2021-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-10-01	Plan benefit arrangement – Insurance	Yes
2021-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: HEAD START OF LANE COUNTY 2020 form 5500 responses
2020-10-01	Type of plan entity	Single employer plan
2020-10-01	Plan funding arrangement – Insurance	Yes
2020-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-10-01	Plan benefit arrangement – Insurance	Yes
2020-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: HEAD START OF LANE COUNTY 2019 form 5500 responses
2019-10-01	Type of plan entity	Single employer plan
2019-10-01	Plan funding arrangement – Insurance	Yes
2019-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-10-01	Plan benefit arrangement – Insurance	Yes
2019-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: HEAD START OF LANE COUNTY 2018 form 5500 responses
2018-10-01	Type of plan entity	Single employer plan
2018-10-01	Plan funding arrangement – Insurance	Yes
2018-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-10-01	Plan benefit arrangement – Insurance	Yes
2018-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: HEAD START OF LANE COUNTY 2017 form 5500 responses
2017-10-01	Type of plan entity	Single employer plan
2017-10-01	Plan funding arrangement – Insurance	Yes
2017-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-10-01	Plan benefit arrangement – Insurance	Yes
2017-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: HEAD START OF LANE COUNTY 2016 form 5500 responses
2016-10-01	Type of plan entity	Single employer plan
2016-10-01	Submission has been amended	No
2016-10-01	This submission is the final filing	No
2016-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-10-01	Plan is a collectively bargained plan	No
2016-10-01	Plan funding arrangement – Insurance	Yes
2016-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-10-01	Plan benefit arrangement – Insurance	Yes
2016-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: HEAD START OF LANE COUNTY 2015 form 5500 responses
2015-10-01	Type of plan entity	Single employer plan
2015-10-01	Submission has been amended	No
2015-10-01	This submission is the final filing	No
2015-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-10-01	Plan is a collectively bargained plan	No
2015-10-01	Plan funding arrangement – Insurance	Yes
2015-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-10-01	Plan benefit arrangement – Insurance	Yes
2015-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: HEAD START OF LANE COUNTY 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Submission has been amended	No
2014-10-01	This submission is the final filing	No
2014-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-10-01	Plan is a collectively bargained plan	No
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: HEAD START OF LANE COUNTY 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Submission has been amended	No
2013-10-01	This submission is the final filing	No
2013-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-10-01	Plan is a collectively bargained plan	No
2013-10-01	Plan funding arrangement – Insurance	Yes
2013-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-10-01	Plan benefit arrangement – Insurance	Yes
2013-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: HEAD START OF LANE COUNTY 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	Submission has been amended	No
2012-10-01	This submission is the final filing	No
2012-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-10-01	Plan is a collectively bargained plan	No
2012-10-01	Plan funding arrangement – Insurance	Yes
2012-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-10-01	Plan benefit arrangement – Insurance	Yes
2012-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: HEAD START OF LANE COUNTY 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	Submission has been amended	No
2011-10-01	This submission is the final filing	No
2011-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-10-01	Plan is a collectively bargained plan	No
2011-10-01	Plan funding arrangement – Insurance	Yes
2011-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-10-01	Plan benefit arrangement – Insurance	Yes
2011-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: HEAD START OF LANE COUNTY 2010 form 5500 responses
2010-10-01	Type of plan entity	Single employer plan
2010-10-01	Submission has been amended	No
2010-10-01	This submission is the final filing	No
2010-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-10-01	Plan is a collectively bargained plan	No
2010-10-01	Plan funding arrangement – Insurance	Yes
2010-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-10-01	Plan benefit arrangement – Insurance	Yes
2010-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: HEAD START OF LANE COUNTY 2009 form 5500 responses
2009-10-01	Type of plan entity	Single employer plan
2009-10-01	Submission has been amended	Yes
2009-10-01	This submission is the final filing	No
2009-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-10-01	Plan is a collectively bargained plan	No
2009-10-01	Plan funding arrangement – Insurance	Yes
2009-10-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	GLUG0BYGS
Policy instance	4
CASCADE HEALTH SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	00
Policy instance	3
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 75069 )
Policy contract number	OR56
Policy instance	2
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number	22042
Policy instance	1
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 75069 )
Policy contract number	OR56
Policy instance	2
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number	22042
Policy instance	1
CASCADE HEALTH SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	00
Policy instance	3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	GLUG0BYGS
Policy instance	4
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 75069 )
Policy contract number	OR56
Policy instance	2
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	10181096
Policy instance	5
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number	22042
Policy instance	4
CASCADE HEALTH SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	00
Policy instance	3
PACIFICSOURCE HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 54976 )
Policy contract number	G0033523
Policy instance	1
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 75069 )
Policy contract number	OR56
Policy instance	2
PACIFICSOURCE HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 54976 )
Policy contract number	G0033523
Policy instance	1
CASCADE HEALTH SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	00
Policy instance	3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	10188791001
Policy instance	4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	10181096
Policy instance	6
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number	22042
Policy instance	5
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	1018879
Policy instance	4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	10181096
Policy instance	6
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 75069 )
Policy contract number	OR56
Policy instance	2
CASCADE HEALTH SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	00
Policy instance	3
PACIFICSOURCE HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 54976 )
Policy contract number	G0033523
Policy instance	1
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number	22042
Policy instance	5
PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 )
Policy contract number	100377
Policy instance	1
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	10181096
Policy instance	5
CASCADE HEALTH SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	00
Policy instance	4
PACIFICSOURCE HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 54976 )
Policy contract number	G0033523
Policy instance	2
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 75069 )
Policy contract number	OR56
Policy instance	3
CASCADE HEALTH SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	00
Policy instance	5
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	10181096
Policy instance	4
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 75069 )
Policy contract number	OR56/Z626
Policy instance	3
PACIFICSOURCE HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 54976 )
Policy contract number	G0033523
Policy instance	2
PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 )
Policy contract number	100377
Policy instance	1
PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 )
Policy contract number	100377
Policy instance	1
PACIFICSOURCE HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 54976 )
Policy contract number	G0033523
Policy instance	2
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 75069 )
Policy contract number	Z626/OR56
Policy instance	3
CASCADE HEALTH SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	00
Policy instance	5
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	10181096
Policy instance	4
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number	649934
Policy instance	5
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 75069 )
Policy contract number	Z626/OR56
Policy instance	2
CASCADE HEALTH SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	00
Policy instance	4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	10181096
Policy instance	3
PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 )
Policy contract number	100377
Policy instance	1
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number	649934
Policy instance	6
CASCADE HEALTH SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	00
Policy instance	5
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number	LTD116854
Policy instance	4
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	12333
Policy instance	3
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 75069 )
Policy contract number	Z626/OR56
Policy instance	2
PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 )
Policy contract number	100377
Policy instance	1
PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 )
Policy contract number	100377
Policy instance	1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number	LTD116854
Policy instance	4
CASCADE HEALTH SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	00
Policy instance	5
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	12333
Policy instance	3
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 75069 )
Policy contract number	Z626
Policy instance	2
PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 )
Policy contract number	100377
Policy instance	1
CASCADE HEALTH SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	00
Policy instance	5
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number	LTD116854
Policy instance	4
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 75069 )
Policy contract number	Z626
Policy instance	2
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	12333
Policy instance	3

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Company Name:	HEAD START OF LANE COUNTY
Employer identification number (EIN):	930728229
NAIC Classification:	611000

Jurisdiction of Incorporation:	Oregon Secretary of State Corporations Division
Incorporation Date:	1978-10-02
Company Identification Number:	13158316
Legal Registered Office Address:	221 B STREET SPRINGFIELD United States of America (USA) 97477