Form 5500 · Employee benefit plan · LAKEWOOD, WA
PUGET PAVING & CONSTRUCTION, INC.
The filing calls this plan PUGET PAVING & CONSTRUCTION, INC. HEALTH & WELFARE PROGRAM.
PUGET PAVING & CONSTRUCTION, INC. of LAKEWOOD, WA is a 59-participant construction employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is BENECO, FUTUREPLAN BY ASCENSUS. Coverage is written through REGENCE BS and 1 other carrier. The plan's most recent policy period ended in April.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 91-1142171 · plan 501 · plan year 2023, filed Oct 3, 2024
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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.
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 2 insured contracts are health coverage, split across REGENCE BS and HIA GUARDIAN.
Reported premium is $256,606; the filing discloses no broker commission on these contracts.
The most recent policy period ended in April, and the plan year ends April 30. Group contracts typically renew on that annual cycle.
BENECO, FUTUREPLAN BY ASCENSUS is the broker of record on all 2 contracts.
Two carriers split the book: REGENCE BS and HIA GUARDIAN.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| REGENCE BS | Health | 55 | May 1, 2023 | $236,739 | $0 |
| HIA GUARDIAN | Health | 55 | May 1, 2023 | $19,867 | $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. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 75 employees, 3 recordable cases, 1 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule I
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
How this plan compares
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