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Form 5500 · Employee benefit plan · DUBLIN, CA

CEMENT MASONS HEALTH & WELFARE TRUST FOR N CAL

The filing calls this plan CEMENT MASONS HEALTH AND WELFARE TRUST FUND FOR NORTHERN CALIFORNIA.

CEMENT MASONS HEALTH & WELFARE TRUST FOR N CAL of DUBLIN, CA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is THE SEGAL COMPANY(EASTERN STATES),. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 4 other carriers. The plan's most recent policy period ended in December.

Benefits broker of record
Policy year ends
Decemberas filed for plan year 2025

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 94-1291152 · plan 501 · plan year 2025, filed Jun 15, 2026

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
3,090
Active at start of year
2,656
Active at end of year
2,653
Disclosed commissions
$9,204
Typical renewal
January 1

Benefits declared on this filing

Healthinsured — KAISER FOUNDATION HEALTH PLAN, INC.3,140 of 3,090 participants on the largest contract
Dentalinsured — UNITEDHEALTHCARE INSURANCE COMPANY81 of 3,090 participants (2.6%) on the largest contract
Visiondeclared, not on Schedule A
Lifenot declared on this filing
Disabilitydeclared, not on Schedule A

Dental: the largest of the 2 insured dental contracts, with UNITEDHEALTHCARE INSURANCE COMPANY, covers 81 of 3,090 participants (2.6%) on Schedule A.

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 5 insured contracts covering health, dental and stop-loss; the largest, with KAISER FOUNDATION HEALTH PLAN, INC., covers 3,140 people.

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

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 $17,024,046, with $9,204 in disclosed broker commissions — about 0.1% 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
THE UNION LABOR LIFE INSURANCE COMPANYStop-loss1,992Jan 1, 2025$386,848$9,204
KAISER FOUNDATION HEALTH PLAN, INC.Health3,140Jan 1, 2025$15,166,799$0
ANTHEM MEDICARE PREFERRED (PPO)Health336Sep 1, 2025$1,361,782$0
UNITEDHEALTHCARE INSURANCE COMPANYDental81Sep 1, 2025$69,563$0
DELTA DENTAL OF CALIFORNIADental243Sep 1, 2025$39,054$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
CEMENT MASONS HEALTH & WELFARE TRUST FOR N CAL
EIN 94-1291152
ANTHEM BLUE CROSS OF CALIFORNIA
Claims processing · EIN 95-4331852
$487,055
paid directly by the plan
THE SEGAL COMPANY
Named on Schedule C · EIN 94-1503999
$231,426
paid directly by the plan
EIDE BAILLY LLP
Accounting and audit · EIN 45-0250958
$218,816
paid directly by the plan
DELTA DENTAL
Claims processing · EIN 94-1461312
$174,585
paid directly by the plan
UNITED BEHAVIORAL HEALTH DBA OPTUM
Claims processing · EIN 94-2649097
$100,972
paid directly by the plan
WITHUMSMITH+BROWN, PC
Accounting and audit · EIN 22-2027092
$92,867
paid directly by the plan
BULLIVANT HOUSER BAILEY PC
Named on Schedule C · EIN 93-1129534
$60,583
paid directly by the plan
MCMORGAN & COMPANY LLC
Named on Schedule C · EIN 52-2334338
$59,719
paid directly by the plan
MORGAN STANLEY
Named on Schedule C · EIN 36-3145972
$54,013
paid directly by the plan
VISION SERVICE PLAN
Claims processing · EIN 94-1632821
$35,404
paid directly by the plan
FREMONT BANK
Named on Schedule C · EIN 94-1569025
$25,030
paid directly by the plan
GARCIA HAMILTON & ASSOCIATES
Named on Schedule C · EIN 76-0589652
$21,651
paid directly by the plan
US BANK NATIONAL ASSOCIATION
Custodian · EIN 31-0841368
$6,326
paid directly by the plan
SEGALL BRYANT & HAMILL, LLC
Named on Schedule C · EIN 35-2679129
$5,687
paid directly by the plan
OPTUM RX INC.
Claims processing · EIN 33-0441200
$0
paid directly by the plan
SEGAL SELECT INSURANCE SERVICES INC
Named on Schedule C · EIN 46-0619194
$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
$107,184,756
Paid out in benefits
$39,748,444
Paid to insurance carriersSchedule H, line 2e(2)
$16,541,622
Independent accountantEIN 22-2027092
WITHUMSMITH+BROWN, PC
Accountant's opinion (Schedule H, line 3a)
Unmodified
Audit fee
$92,867

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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Renewal calendar

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