Form 5500 · Employee benefit plan · PASADENA, CA
BOARD OF TRUSTEES, OPERATING ENGINEERS HEALTH AND
The filing calls this plan OPERATING ENGINEERS HEALTH AND WELFARE FUND.
Public Form 5500 records show how BOARD OF TRUSTEES, OPERATING ENGINEERS HEALTH AND of PASADENA, CA, a construction employer, structures its employee benefits. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 9 other carriers. The plan's most recent policy period ended in January.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 95-6034886 · plan 501 · plan year 2025, filed Apr 15, 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.
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
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 10 insured contracts covering health, dental and stop-loss; the largest, with KAISER FOUNDATION HEALTH PLAN, INC., covers 10,451 people.
The filing declares health, dental, vision, life and disability. Vision, life and disability appear 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 is $110,642,039; the filing discloses no broker commission on these contracts.
The health contract's policy period ended in January, while at least one ancillary line's policy period ended in June. The plan is on a split renewal cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 10,451 | Feb 1, 2025 | $70,090,460 | $0 |
| BLUE CROSS OF CALIFORNIA | Health | 2,727 | Feb 1, 2025 | $22,262,080 | $0 |
| SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | Health | 1,898 | Jul 1, 2025 | $9,624,573 | $0 |
| HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | Health | 431 | Jul 1, 2025 | $3,280,043 | $0 |
| WELLPOINT STOP LOSS | Stop-loss | 9,492 | Jul 1, 2025 | $2,807,942 | $0 |
| UNITED CONCORDIA INSURANCE COMPANY | Dental | 4,040 | Jul 1, 2025 | $2,085,805 | $0 |
| DELTA DENTAL OF CALIFORNIA | Dental | 923 | Jul 1, 2025 | $169,779 | $0 |
| CARELON BEHAVIORAL HEALTH | — | 9,082 | Jul 1, 2025 | $166,976 | $0 |
| UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | Dental | 567 | Jul 1, 2025 | $148,252 | $0 |
| SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | Health, Dental | 37 | Jul 1, 2025 | $6,129 | $0 |
Premium and claims on this contract
UNITED CONCORDIA INSURANCE COMPANY, contract SEE FOOTNOTE. For the contract year on this filing, the carrier reported $2,085,805 in premium earned and $1,617,988 in claims incurred. Dividing one by the other gives 78%.
- UNITED CONCORDIA INSURANCE COMPANY, contract SEE FOOTNOTE reported $345,200 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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