Form 5500 · Employee benefit plan · WILMINGTON, MA

BOT NORTH ATLANTIC STATES CARPENTERS HEALTH BENEFITS FUND

The filing calls this plan N. ATLANTIC STATES CARP. HEALTH BENEFITS FUND.

BOT NORTH ATLANTIC STATES CARPENTERS HEALTH BENEFITS FUND of WILMINGTON, MA is a 23,396-participant construction employer — a large group whose insured benefits are disclosed on Schedule A of its Form 5500. Coverage is written through BLUE MEDICARE ADVANTAGE and 1 other carrier. The plan's most recent policy period ended in December.

Benefits broker of record

Not disclosed

Insurance carrier

BLUE MEDICARE ADVANTAGE

Policy year ends

Decemberas filed for plan year 2024

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 04-6374357 · plan 501 · plan year 2024, filed Oct 10, 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.

All participants at the start of the year

23,396

Active at start of year

19,509

Active at end of year

18,857

Disclosed commissions

Typical renewal

January 1

Benefits declared on this filing

Healthinsured — BLUE MEDICARE ADVANTAGE2,222 of 23,396 participants (9.5%)

Dentaldeclared, not on Schedule A

Visiondeclared, not on Schedule A

Lifeinsured — METROPOLITAN LIFE INSURANCE COMPANY19,551 of 23,396 participants (84%) on the largest contract

Disabilitydeclared, not on Schedule A

Health: BLUE MEDICARE ADVANTAGE covers 2,222 of 23,396 participants (9.5%) on Schedule A.

Also declared: supplemental unemployment, 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 3 insured contracts covering health and life.

The filing declares health, life, dental, vision and disability. Dental, vision and disability appear with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.

Reported premium is $7,007,262; the filing discloses no broker commission on these contracts.

The health contract's policy period ended in December, while at least one ancillary line's policy period ended in March. 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
BLUE MEDICARE ADVANTAGE	Health	2,222	Jan 1, 2025	$6,123,406	$0
METROPOLITAN LIFE INSURANCE COMPANY	Life	19,551	Apr 1, 2024	$605,423	$0
METROPOLITAN LIFE INSURANCE COMPANY	Life	8,307	Apr 1, 2024	$278,433	$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

BOT NORTH ATLANTIC STATES CARPENTERS HEALTH BENEFITS FUND

EIN 04-6374357

INDEPENDENCE ADMINISTRATORS

Claims processing · Contract administrator · Recordkeeping and information management · EIN 23-2184623

$4,934,022

paid directly by the plan

EXPRESS SCRIPTS INC

Claims processing · Contract administrator · EIN 43-1420563

$3,508,549

paid directly by the plan

NAS CARPENTERS PENSION FUND (CCA)

Plan administrator · EIN 51-6040899

$1,677,000

paid directly by the plan

DELTA DENTAL OF MA

Claims processing · EIN 04-6143185

$673,622

paid directly by the plan

THE SEGAL COMPANY (EASTERN STATES)

Named on Schedule C · EIN 13-1835864

$557,294

paid directly by the plan

KGA INC

Named on Schedule C · EIN 04-3526805

$354,945

paid directly by the plan

LEVEL CARE HEALTH CONSORTIUM

Claims processing · EIN 83-2819398

$254,706

paid directly by the plan

CHARTWELL INVESTMENT PARTNERS LLC

Named on Schedule C · EIN 36-4776242

$193,385

paid directly by the plan

MELLON INVESTMENTS CORPORATION

Named on Schedule C · EIN 25-6078093

$178,643

paid directly by the plan

SCHULTHEIS & PANETTIERI LLP

Accounting and audit · EIN 13-1577780

$143,000

paid directly by the plan

KRAKOW SOURIS & LANDRY LLC

Named on Schedule C · EIN 04-3363718

$141,000

paid directly by the plan

WEDGE CAPITAL MANAGEMENT LLP

Named on Schedule C · EIN 56-1557450

$130,408

paid directly by the plan

OREILLY GROSSO GROSS & JONES PC

Named on Schedule C · EIN 04-3318596

$118,200

paid directly by the plan

BENEFIT RESOURCE LLC

Recordkeeping and information management · EIN 45-3261121

$100,313

paid directly by the plan

DODGE & COX INVESTMENT MANAGERS

Named on Schedule C · EIN 94-1441976

$97,837

paid directly by the plan

LOOMIS SAYLES & COMPANY

Named on Schedule C · EIN 04-3200030

$91,544

paid directly by the plan

STATE STREET BANK & TRUST CO

Custodian · EIN 04-1867445

$67,071

paid directly by the plan

WELLINGTON TRUST COMPANY NA

Named on Schedule C · EIN 04-2755549

$58,838

paid directly by the plan

BLACKROCK INSTL TRUST COMPANY NA

Investment advisory · EIN 94-3112180

$54,062

paid directly by the plan

BRIDGEWAY BENEFIT TECHNOLOGIES

Named on Schedule C · EIN 52-1796473

$50,400

paid directly by the plan

MEKETA INVESTMENT GROUP

Named on Schedule C · EIN 04-2659023

$50,332

paid directly by the plan

PERFECT PRINTING SOLUTIONS INC

Named on Schedule C · EIN 47-4140223

$44,782

paid directly by the plan

FIRST AMERICAN ADMINISTRATORS

Claims processing · EIN 31-1656473

$37,972

paid directly by the plan

NATIONAL SOFTWARE INC

Named on Schedule C · EIN 46-0638016

$11,696

paid directly by the plan

WITHUMSMITH+BROWN, P.C.

Accounting and audit · EIN 22-2027092

$9,293

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

$938,960,372

Paid out in benefits

$310,513,011

Paid to insurance carriersSchedule H, line 2e(2)

$6,522,755

Independent accountantEIN 13-1577780

SCHULTHEIS & PANETTIERI, LLP

Accountant's opinion (Schedule H, line 3a)

Unmodified

Audit fee

$143,000

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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