# BOONE ELECTRIC CONSTRUCTION WELFARE BENEFIT PLAN

Health and welfare plan sponsored by **INTERLOCK PERFORMANCE GROUP**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | INTERLOCK PERFORMANCE GROUP |
| EIN | 201962392 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | PUYALLUP, WA |
| Industry | construction |
| Funding | fully insured |
| Total premiums | $2.9M |
| Participants | 168 |
| Persons covered | 226 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| KAISER PERMANENTE | Health, Rx, Vision, PPO |
| MUTUAL OF OMAHA INSURANCE COMPANY | Dental, Life, Other |
| WILLAMETTE DENTAL INSURANCE, INC. | Dental, HMO |
| FIRST CHOICE HEALTH | Other |

## Brokers

| Broker | Placed with |
|---|---|
| BERG BENEFITS, INC. | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. |
| INSURANCE, INC. | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. |
| BERG BENEFITS, INC. | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON |
| BERG BENEFITS, INC. | UNITED OF OMAHA LIFE INSURANCE COMPANY |
| BERG BENEFITS, INC. | WILLAMETTE DENTAL OF WASHINGTON, INC. |

## About this data

- Source: public Form 5500 filings from the U.S. Department of Labor (EBSA), rebuilt on each DOL release.
- Full page (charts, history, peer benchmarks, fees, contacts): https://planoptica.com/welfare/201962392-501
- Cite as: PlanOptica, https://planoptica.com/welfare/201962392-501
- More: https://planoptica.com/llms.txt · API waitlist: https://planoptica.com/developers