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Form 5500 · Employee benefit plan · PASADENA, CA

BOARD OF TRUSTEES, CALIFORNIA IRONWORKERS FIELD WELFARE PLAN

The filing calls this plan CALIFORNIA IRONWORKERS FIELD WELFARE PLAN.

Public Form 5500 records show how BOARD OF TRUSTEES, CALIFORNIA IRONWORKERS FIELD WELFARE PLAN of PASADENA, CA, a construction employer, structures its employee benefits. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 10 other carriers. The plan's most recent policy period ended in May.

Benefits broker of record
Not disclosed
Insurance carrier
KAISER FOUNDATION HEALTH PLAN, INC.
Policy year ends
Mayas filed for plan year 2025

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 95-6042868 · plan 501 · plan year 2025, filed Mar 11, 2026

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How this plan is funded

Fully insured as reported

The plan's own financial statement reports paying insurance carriers about what the insurance contracts report in premium.

All participants at the start of the year
11,872
Active at start of year
9,903
Active at end of year
8,550
Disclosed commissions
$0
Typical renewal
June 1

Benefits declared on this filing

Healthinsured — KAISER FOUNDATION HEALTH PLAN, INC.3,754 of 11,872 participants (32%) on the largest contract
Dentalinsured — HEALTH NET96 of 11,872 participants (0.8%) on the largest contract
Visioninsured — HEALTH NET96 of 11,872 participants (0.8%) on the largest contract
Lifedeclared, no contract here says it covers this
Disabilitynot declared on this filing

Dental: the largest of the 5 insured dental contracts, with HEALTH NET, covers 96 of 11,872 participants (0.8%) on Schedule A.

Vision: the largest of the 2 insured vision contracts, with HEALTH NET, covers 96 of 11,872 participants (0.8%) on Schedule A.

One contract on this filing does not say which benefits it covers, so a line above may be insured by it.

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.

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 13 insured contracts covering health, dental and vision; the largest, with KAISER FOUNDATION HEALTH PLAN, INC., covers 3,754 people.

The filing declares health, dental, vision and life. Life appears with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on the contract here that does not say what it covers.

Reported premium is $51,501,237; the filing discloses no broker commission on these contracts.

The most recent policy period ended in May, and the plan year ends May 31. Group contracts typically renew on that annual cycle.

No broker of record is named on the Schedule A. The contracts may be written directly with the carrier, or the broker fields were left blank on the filing.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
KAISER FOUNDATION HEALTH PLAN, INC.Health3,754Sep 1, 2024$25,798,597$0
KAISER FOUNDATION HEALTH PLAN, INC.Health3,248Sep 1, 2024$17,097,884$0
UNITEDHEALTHCARE INSURANCE COMPANYHealth1,964Jun 1, 2025$6,428,564$0
HEALTH NETHealth, Dental, Vision96Jun 1, 2025$916,787$0
HEALTH PLAN OF NEVADAHealth, Vision39Jun 1, 2025$447,568$0
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY—23,487Jun 1, 2025$207,803$0
UNITEDHEALTHCARE OF CALIFORNIAHealth102Jun 1, 2025$200,263$0
UNITEDHEALTHCARE OF ARIZONAHealth58Jun 1, 2025$157,794$0
UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.Health40Jun 1, 2025$132,755$0
DELTA DENTAL OF CALIFORNIAHealth, Dental307Jun 1, 2025$68,411$0
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC.Health, Dental148Jun 1, 2025$26,602$0
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC.Health, Dental71Jun 1, 2025$17,593$0
SUN LIFE ASSURANCE COMPANY OF CANADADental2Jun 1, 2025$616$0

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.

See the filing at the Department of Labor

Administrator and service providers

Plan administrator on the filing
BOARD OF TRUSTEES, CALIFORNIA IRONWORKERS FIELD WELFARE PLAN
EIN 95-6042868
EVERSIDE HEALTH, LLC
Named on Schedule C · EIN 83-0674262
$14,792,458
paid directly by the plan
IRONWORKERS EMPLOYEES' BENEFIT CORP
Contract administrator · EIN 95-3084599
$3,729,338
paid directly by the plan
ANTHEM BLUE CROSS LIFE & HEALTH
Claims processing · Contract administrator · Recordkeeping and information management · EIN 95-4331852
$2,585,661
paid directly by the plan
DELTA DENTAL OF CALIFORNIA
Claims processing · EIN 94-1461312
$535,834
paid directly by the plan
OPTUM RX INC.
Claims processing · EIN 33-0441200
$290,204
paid directly by the plan
KRAW LAW GROUP, APC
Named on Schedule C · EIN 32-0465891
$228,710
paid directly by the plan
MILLIMAN, INC.
Named on Schedule C · EIN 91-0675641
$200,000
paid directly by the plan
WITHUMSMITH+BROWN, PC
Accounting and audit · EIN 22-2027092
$177,671
paid directly by the plan
LOGICALIS, INC.
Named on Schedule C · EIN 13-4000122
$92,052
paid directly by the plan
TOP TIER RESOURCES, INC.
Named on Schedule C · EIN 82-2957919
$77,801
paid directly by the plan
IRON MOUNTAIN INC.
Named on Schedule C · EIN 04-3038590
$57,603
paid directly by the plan
WELLS FARGO BANK, N.A.
Named on Schedule C · EIN 94-1347393
$56,223
paid directly by the plan
LEVEL 3 FINANCING, INC.
Named on Schedule C · EIN 47-0735805
$46,201
paid directly by the plan
ROTH STAFFING COMPANIES LP
Named on Schedule C · EIN 33-0633164
$39,349
paid directly by the plan
RVK, INC.
Named on Schedule C · EIN 93-0910652
$6,070
paid directly by the plan
HOUSE OF PRINTING INC.
Named on Schedule C · EIN 95-2234833
$5,054
paid directly by the plan
MARSH MCLENNAN COMPANIES, INC
Named on Schedule C · EIN 36-2668272
$0
paid directly by the plan

The plan administrator is from line 3a of the main form. The service providers are named on Schedule C of this filing. We publish company names only.

Money the plan held and paid out

Plan assets at year end
$257,459,437
Paid out in benefits
$228,025,710
Paid to insurance carriersSchedule H, line 2e(2)
$60,830,015
Independent accountantEIN 22-2027092
WITHUMSMITH+BROWN, PC
Accountant's opinion (Schedule H, line 3a)
Unmodified
Audit fee
$179,350

Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H

These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.

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