form5500lookup

Form 5500 · Employee benefit plan · DUBLIN, CA

BOARD OF TRUSTEES OF AUTOMOTIVE INDUSTRIES WELFARE PLAN

The filing calls this plan AUTOMOTIVE INDUSTRIES WELFARE PLAN.

Public Form 5500 records show how BOARD OF TRUSTEES OF AUTOMOTIVE INDUSTRIES WELFARE PLAN of DUBLIN, CA, a other services employer, structures its employee benefits. Its broker of record is SEGAL COMPANY. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 9 other carriers. The plan's most recent policy period ended in December.

Benefits broker of record
Policy year ends
Decemberas filed for plan year 2024

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 94-6078226 · plan 501 · plan year 2024, filed Oct 15, 2025

Get an email when this employer files a new Form 5500, and again about four months before its plan renews.

5,257 other employer plans in California have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.

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.

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.

All participants at the start of the year
3,548
Active at start of year
3,548
Active at end of year
3,517
Disclosed commissions
$9,289
Typical renewal
January 1

Benefits declared on this filing

Healthinsured — KAISER FOUNDATION HEALTH PLAN, INC.3,689 of 3,548 participants on the largest contract
Dentalinsured — DELTA DENTAL OF CALIFORNIA381 of 3,548 participants (11%) on the largest contract
Visioninsured — VISION SERVICE PLAN2,516 of 3,548 participants (71%)
Lifeinsured — RELIASTAR LIFE INSURANCE COMPANY4,732 of 3,548 participants
Disabilitydeclared, no contract here says it covers this

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

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.

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 10 insured contracts covering health, dental, vision, life and stop-loss; the largest, with KAISER FOUNDATION HEALTH PLAN, INC., covers 3,689 people.

The filing declares health, dental, vision, life and disability. Disability 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.

The filing lists a stop-loss contract. On its own that does not settle whether the plan pays its own claims.

Reported premium across the insured contracts is $33,231,782, with $9,289 in disclosed broker commissions — about 0% of premium.

The health contract's policy period ended in December, while at least one ancillary line's policy period ended in August. The plan is on a split renewal cycle.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
BERKSHIRE HATHAWAY SPECIALTY INSURANCE COMPANYStop-loss724Sep 1, 2024$1,179,079$9,289
KAISER FOUNDATION HEALTH PLAN, INC.Health3,689Sep 1, 2024$30,375,047$0
VISION SERVICE PLANVision2,516Jan 1, 2025$458,681$0
RELIASTAR LIFE INSURANCE COMPANYLife4,732Jan 1, 2025$379,689$0
UNITEDHEALTHCARE OF CALIFORNIAHealth53Jan 1, 2025$315,548$0
DELTA DENTAL OF CALIFORNIADental381Jan 1, 2025$291,965$0
UNITEDHEALTHCARE INSURANCE COMPANYDental230Jan 1, 2025$113,134$0
SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATIONHealth, Dental206Sep 1, 2024$65,772$0
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC.Health, Dental168Jan 1, 2025$36,183$0
HMC HEALTHWORKS, INC.—2,175Jan 1, 2025$16,684$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 OF AUTOMOTIVE INDUSTRIES WELFARE PLAN
EIN 94-6078226
HEALTH SERVICES & BENEFITS ADMINST
Claims processing · Contract administrator · Recordkeeping and information management · EIN 94-3089465
$1,407,748
paid directly by the plan
WITHUMSMITH+BROWN, PC
Accounting and audit · EIN 22-2027092
$386,881
paid directly by the plan
ANTHEM BLUE CROSS
Claims processing · EIN 95-4331852
$197,668
paid directly by the plan
DELTA DENTAL OF CALIFORNIA
Claims processing · EIN 94-1461312
$171,106
paid directly by the plan
THE SEGAL COMPANY
Named on Schedule C · EIN 94-1503999
$142,930
paid directly by the plan
GRAYSTONE CONSULTING/MORGAN STANLEY
Named on Schedule C · EIN 20-8764829
$128,360
paid directly by the plan
SALTZMAN & JOHNSON LAW CORPORATION
Named on Schedule C · EIN 93-2376174
$75,032
paid directly by the plan
FREMONT BANK
Custodian · EIN 94-1569025
$36,000
paid directly by the plan
WEX HEALTH, INC.
Named on Schedule C · EIN 06-1593514
$34,489
paid directly by the plan
OPTUMRX, INC.
Claims processing · EIN 33-0441200
$27,843
paid directly by the plan
MACKAY SHIELDS LLC
Named on Schedule C · EIN 13-5582869
$0
paid directly by the plan
NFP
Named on Schedule C · EIN 13-3616686
$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
$51,720,947
Paid out in benefits
$56,324,072
Paid to insurance carriersSchedule H, line 2e(2)
$35,076,550
Independent accountantEIN 22-2027092
WITHUMSMITH+BROWN, PC
Accountant's opinion (Schedule H, line 3a)
Unmodified
Audit fee
$51,118

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

Subscribers see how this compares with similar plans in California. A subscription also adds this plan's filing history and the renewal calendar for its state. See plans and prices

Without an account you can open 10 employer, broker and carrier pages a day, including through an AI assistant, and 50 a day with a free account. Paid plans are what keep these records free to read.

Renewal calendar

5,257 other employer plans in California are January 1 renewals (policy year ends December).

Their policy years end in December, like this plan’s, so most renew January 1. The calendar lists every insured group by renewal date and state, with broker of record, carrier and disclosed commission. You can preview the five largest in each month for free.

Claude & ChatGPT

Look up records from Claude or ChatGPT

Add Form5500Lookup to Claude or ChatGPT and ask about any employer, broker or carrier in plain English. Lookups are free. Renewal lists, full books of business and exports are included with a subscription.

Building a list or a tool from these records? Match a list you already have from $29 per 1,000 records, or license the whole dataset as a weekly file for $499 a month. See both

More employer plans in California — largest plans, brokers, carriers and renewal months.