Form 5500 · Employee benefit plan · CONCORD, CA
UFCW & EMPLOYERS BENEFIT TRUST
UFCW & EMPLOYERS BENEFIT TRUST of CONCORD, CA is a 25,895-participant retail employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is CARL W. ROMSTADT. Coverage is written through KAISER FOUNDATION HEALTH PLAN and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 94-6078804 · plan 502 · as of Aug 2026
Plan brief
Schedule A lists 3 insured contracts covering health, dental and life; the largest, with KAISER FOUNDATION HEALTH PLAN, covers 16,171 people.
Reported premium across the insured contracts is $98,273,489, with $1,162 in disclosed broker commissions — about 0% 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.
CARL W. ROMSTADT is the broker of record on 1 of the 3 contracts; the rest name a different broker or none.
3 carriers appear on the filing — KAISER FOUNDATION HEALTH PLAN, PRUDENTIAL INSURANCE COMPANY OF AMERICA and LIBERTY DENTAL PLAN OF CALIFORNIA, INC — with KAISER FOUNDATION HEALTH PLAN writing the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| LIBERTY DENTAL PLAN OF CALIFORNIA, INC | Health, Dental | 423 | December | $58,137 | $1,162 |
| KAISER FOUNDATION HEALTH PLAN | Health | 16,171 | May | $96,200,088 | $0 |
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Life | 76,631 | December | $2,015,264 | $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.
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