Form 5500 · Employee benefit plan · MILES CITY, MT
OFTEDAL CONSTRUCTION INC
The filing calls this plan OFTEDAL CONSTRUCTION HEALTH BENEFITS PLAN.
OFTEDAL CONSTRUCTION INC of MILES CITY, MT files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is NOVO BENEFITS, LLC. Coverage is written through PACE UNDERWRITERS and 1 other carrier. The plan's most recent policy period ended in January.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 81-0307943 · plan 501 · plan year 2024, filed Jul 31, 2026
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How this plan is funded
Self-funded as reported
The filing reports a stop-loss contract and no medical premium, which is what a plan that pays its own claims reports.
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: 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.
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 3 insured contracts are stop-loss coverage, split across PACE UNDERWRITERS and UNITEDHEALTHCARE INSURANCE COMPANY.
The filing declares health, dental and life. Health, dental and life 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 only insured piece of the health benefit is stop-loss coverage, and the filing reports the plan paying its own claims. The 2 stop-loss contracts report $450,074 in premium and $0 in commission. The rest of the premium and commission above is on the plan's other insured lines, and none of it is medical premium.
Reported premium across the insured contracts is $472,280, with $2,224 in disclosed broker commissions — about 0.5% of premium.
The most recent policy period ended in January, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNITEDHEALTHCARE INSURANCE COMPANY | — | 189 | Jan 2, 2025 | $22,206 | $2,224 |
| PACE UNDERWRITERS | Stop-loss | 136 | Jan 2, 2025 | $278,587 | $0 |
| PACE UNDERWRITERS | Stop-loss | 53 | Jan 2, 2025 | $171,487 | $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.
Other plans filed by this employer
How this plan compares
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