Form 5500 · Employee benefit plan · ALAMEDA, CA
BOARD OF TRUSTEES, NORTHERN CALIFORNIA BAKERY &
The filing calls this plan NORTHERN CALIFORNIA BAKERY & CONFECTIONERY HEALTH AND WELFARE FUND.
Public Form 5500 records show how BOARD OF TRUSTEES, NORTHERN CALIFORNIA BAKERY & of ALAMEDA, CA, a manufacturing employer, structures its employee benefits. Coverage is written through THE NORTH RIVER INSURANCE COMPANY and 3 other carriers. The plan's most recent policy period ended in May.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 94-6203695 · plan 501 · plan year 2024, filed Feb 17, 2025
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How this plan is funded
Both, as reported
The medical insurance contracts on the filing cover fewer than half the people in the plan, so the rest is paid another way.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
Benefits declared on this filing
Also declared: 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 4 insured contracts covering health, vision, life and stop-loss; the largest, with THE NORTH RIVER INSURANCE COMPANY, covers 1,272 people.
The medical plan carries stop-loss coverage: the filing reports the plan paying its own health claims, with insured protection against large ones.
Reported premium is $3,660,462; the filing discloses no broker commission on these contracts.
The health contract's policy period ended in May, while at least one ancillary line's policy period ended in December. The plan is on a split renewal 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
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| THE NORTH RIVER INSURANCE COMPANY | Stop-loss | 1,272 | Jan 1, 2024 | $2,439,105 | $0 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 209 | Jun 1, 2023 | $1,081,361 | $0 |
| VISION SERVICE PLAN | Vision | 1,281 | May 1, 2024 | $139,996 | $0 |
| AMALGAMATED LIFE INSURANCE COMPANY | Life | — | Nov 1, 2023 | — | $0 |
Premium and claims on this contract
VISION SERVICE PLAN, contract 12159342. For the contract year on this filing, the carrier reported $139,996 in premium earned and $98,913 in claims incurred. Dividing one by the other gives 71%.
- VISION SERVICE PLAN, contract 12159342 reported $20,999 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
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. The service providers are named on Schedule C of this filing. We publish company names only.
Money the plan held and paid out
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.
How this plan compares
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