Form 5500 · Employee benefit plan · CONCORD, CA
UFCW COMPREHENSIVE BENEFITS TRUST
UFCW COMPREHENSIVE BENEFITS TRUST of CONCORD, CA is a 1,731-participant retail employer — a large group whose insured benefits are disclosed on Schedule A of its Form 5500. Its broker of record is INTERREMEDY INSURANCES SERVICES LLC. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 82-2616834 · plan 502 · plan year 2024, filed Oct 15, 2025
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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.
Benefits declared on this filing
Dental: LIBERTY DENTAL PLAN OF CALIFORNIA, INC. covers 13 of 1,731 participants (0.8%) on Schedule A.
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, life and stop-loss; the largest, with KAISER FOUNDATION HEALTH PLAN, INC., covers 903 people.
The filing declares health, dental, life, 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 $8,295,109, with $83,179 in disclosed broker commissions — about 1% of premium.
The most recent policy period ended in December, 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 |
|---|---|---|---|---|---|
| THE NORTH RIVER INSURANCE COMPANY | Stop-loss | 1,314 | Jan 1, 2025 | $1,663,571 | $83,179 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 903 | Jan 1, 2025 | $6,478,375 | $0 |
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Life | 4,430 | Jan 1, 2025 | $112,847 | $0 |
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Life | 2,590 | Jan 1, 2025 | $38,938 | $0 |
| LIBERTY DENTAL PLAN OF CALIFORNIA, INC. | Dental | 13 | Jan 1, 2025 | $1,378 | $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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