Form 5500 · Employee benefit plan · MIDLOTHIAN, TX
BASELINE CONTRACTING, LLC FKA PAYNE CONCRETE
The filing calls this plan BASELINE CONTRACTING, LLC BENEFIT WELFARE PLAN.
BASELINE CONTRACTING, LLC FKA PAYNE CONCRETE of MIDLOTHIAN, TX files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is BRINSON BENEFITS, INC.. Coverage is written through BLUECROSS BLUESHIELD OF TEXAS and 1 other carrier. The plan's most recent policy period ended in May.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 88-4360573 · plan 501 · plan year 2024, filed Nov 5, 2024
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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
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 and vision.
Reported premium across the insured contracts is $115,793, with $8,093 in disclosed broker commissions — about 7% of premium.
The most recent policy period ended in May, and the plan year ends May 31. Group contracts typically renew on that annual cycle.
BRINSON BENEFITS, INC. is the broker of record on all 2 contracts.
Two carriers split the book: BLUECROSS BLUESHIELD OF TEXAS and HUMANA INSURANCE COMPANY.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF TEXAS | Health | 20 | Jun 1, 2024 | $99,358 | $6,450 |
| HUMANA INSURANCE COMPANY | Dental, Vision | 23 | Jun 1, 2024 | $16,435 | $1,643 |
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.
Reported to OSHA
Reported to OSHA for 2025: 109 employees, 2 recordable cases, 0 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
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