Form 5500 · Employee benefit plan · HOLLAND, OH

UNION CONSTRUCTION WORKERS HEALTH PLAN

UNION CONSTRUCTION WORKERS HEALTH PLAN of HOLLAND, OH insures dental, vision and life coverage for its employees, per Schedule A of its Form 5500. Its broker of record is DELAWARE VALLEY HEALTH CARE COALITI. Coverage is written through DELTA DENTAL OF OHIO and 2 other carriers. The plan's most recent policy period ended in May.

Benefits broker of record

DELAWARE VALLEY HEALTH CARE COALITI

Insurance carrier

DELTA DENTAL OF OHIO

Policy year ends

Mayas filed for plan year 2025

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 34-4442536 · plan 501 · plan year 2025, filed Mar 12, 2026

Get an email when this employer files a new Form 5500, and again about four months before its plan renews.

How this plan is funded

Self-funded as reported

The filing reports benefits paid from the plan's own money, and no medical insurance contract on Schedule A.

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.

All participants at the start of the year

2,245

Active at start of year

1,839

Active at end of year

1,877

Disclosed commissions

Typical renewal

June 1

Benefits declared on this filing

Healthdeclared, not on Schedule A

Dentalinsured — DELTA DENTAL OF OHIO5,147 of 2,245 participants

Visioninsured — VISION SERVICE PLAN2,254 of 2,245 participants

Lifeinsured — THE UNION LABOR LIFE INSURANCE COMPANY1,855 of 2,245 participants (83%)

Disabilitydeclared, not 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.

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 3 insured contracts covering dental, vision and life; the largest, with DELTA DENTAL OF OHIO, covers 5,147 people.

The filing declares dental, vision, life, health and disability. Health 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.

Reported premium is $2,239,497; the filing discloses no broker commission on these contracts.

The most recent policy period ended in May, and the plan year ends May 31. Group contracts typically renew on that annual cycle.

DELAWARE VALLEY HEALTH CARE COALITI is the broker of record on 1 of the 3 contracts; the rest name a different broker or none.

Schedule A insurance contracts

Carrier	Benefits	Covered	Renews	Premium	Commission
DELTA DENTAL OF OHIO	Dental	5,147	Jun 1, 2025	$1,995,970	$0
VISION SERVICE PLAN	Vision	2,254	Jun 1, 2025	$186,238	$0
THE UNION LABOR LIFE INSURANCE COMPANY	Life	1,855	Sep 1, 2024	$57,289	$0

Premium and claims on these contracts

DELTA DENTAL OF OHIO, contract 001674. For the contract year on this filing, the carrier reported $1,995,970 in premium earned and $1,891,780 in claims incurred. Dividing one by the other gives 95%.

VISION SERVICE PLAN, contract 12135799. For the contract year on this filing, the carrier reported $186,238 in premium earned and $144,775 in claims incurred. Dividing one by the other gives 78%.

DELTA DENTAL OF OHIO, contract 001674 reported $98,932 in retention.
VISION SERVICE PLAN, contract 12135799 reported $28,169 in retention.

Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.

Only experience-rated contracts report these figures, so most filings leave them blank.

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.

See the filing at the Department of Labor

Administrator and service providers

Plan administrator on the filing

UNION CONSTRUCTION WORKERS HEALTH PLAN

EIN 34-4442536

NOA

Accounting and audit · Contract administrator · EIN 34-1337680

$1,600,948

paid directly by the plan

COMMUNITY INSURANCE COMPANY

Claims processing · Contract administrator · Recordkeeping and information management · EIN 31-1440175

$1,025,590

paid directly by the plan

ANTHEM

Claims processing · Contract administrator · Recordkeeping and information management · EIN 06-1475928

$998,838

paid directly by the plan

EMPIRX HEALTH LLC

Claims processing · EIN 47-1226691

$346,387

paid directly by the plan

ALLOTTA L FARLEY CO., L.P.A.

Named on Schedule C · EIN 34-1316963

$85,933

paid directly by the plan

SEGAL COMPANY

Named on Schedule C · EIN 31-1975125

$66,667

paid directly by the plan

JOHNSON INVESTMENT COUNSEL

Named on Schedule C · EIN 31-1801770

$36,760

paid directly by the plan

BUCK GLOBAL, LLC

Named on Schedule C · EIN 13-3954297

$31,560

paid directly by the plan

CLARKS, SCHAEFER, HACKETT & CO.

Accounting and audit · EIN 31-0800053

$29,500

paid directly by the plan

MARINER INSTITUTIONAL LLC

Named on Schedule C · EIN 26-2766689

$21,633

paid directly by the plan

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

Plan assets at year end

$80,131,797

Paid out in benefits

$33,675,107

Paid to insurance carriersSchedule H, line 2e(2)

$1,287,050

Independent accountantEIN 34-1337680

NOA

Accountant's opinion (Schedule H, line 3a)

Unmodified

Audit fee

$38,435

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.

How this plan compares

Subscribers see how this compares with similar plans in Ohio. A subscription also adds this plan's filing history and the renewal calendar for its state. See plans and prices

Without an account you can open 10 employer, broker and carrier pages a day, including through an AI assistant, and 50 a day with a free account. Paid plans are what keep these records free to read.

More employer plans in Ohio — largest plans, brokers, carriers and renewal months.