Form 5500 · Employee benefit plan · ARVADA, CO
JOINT BOARD OF TRUSTEES FOR THE ROCKY MTN EMPLOYERS HEALTH BENEFIT PLN
The filing calls this plan ROCKY MOUNTAIN UFCW UNIONS & EMPLOYERS HEALTH BENEFIT PLAN - RETIREES.
JOINT BOARD OF TRUSTEES FOR THE ROCKY MTN EMPLOYERS HEALTH BENEFIT PLN of ARVADA, CO files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is THE SEGAL CO MIDWEST INC. Coverage is written through HUMANA INSURANCE COMPANY and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 84-6044454 · plan 502 · plan year 2025, filed Feb 13, 2026
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1,094 other employer plans in Colorado 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.
Benefits declared on this filing
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
All 4 insured contracts are health coverage, split across HUMANA INSURANCE COMPANY, UNITEDHEALTHCARE INSURANCE COMPANY and HUMANA INSURANCE COMPANY OF NEW YORK.
Reported premium across the insured contracts is $2,231,327, with $114,651 in disclosed broker commissions — about 5.1% of premium.
The most recent policy period ended in December, and the plan year ends April 30. Group contracts typically renew on that annual cycle.
THE SEGAL CO MIDWEST INC is the broker of record on 3 of the 4 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including HUMANA INSURANCE COMPANY, UNITEDHEALTHCARE INSURANCE COMPANY and HUMANA INSURANCE COMPANY OF NEW YORK. HUMANA INSURANCE COMPANY writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| HUMANA INSURANCE COMPANY | Health | 1,092 | Jan 1, 2025 | $1,872,683 | $108,746 |
| HUMANA INSURANCE COMPANY | Health | 62 | Jan 1, 2025 | $106,167 | $5,888 |
| HUMANA INSURANCE COMPANY OF NEW YORK | Health | 1 | Jan 1, 2025 | — | $17 |
| UNITEDHEALTHCARE INSURANCE COMPANY | Health | 12 | Jan 1, 2025 | $252,477 | $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.
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.
Other plans filed by this employer
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Renewal calendar
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