Form 5500 · Employee benefit plan · JAMESTOWN, ND
AGRARIA INSURANCE COMPANY
The filing calls this plan EMPLOYEE GROUP HEALTH PLAN.
AGRARIA INSURANCE COMPANY of JAMESTOWN, ND files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Coverage is written through BLUE CROSS BLUE SHIELD OF NORTH DAKOTA. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 45-0214096 · plan 502 · plan year 2025, filed Jul 30, 2026
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
The filing says this plan is subject to the Form M-1 requirement for multiple-employer welfare arrangements.
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.
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
The filing discloses a single insured line, health, through BLUE CROSS BLUE SHIELD OF NORTH DAKOTA, covering 151 people.
Reported premium is $1,309,026; the filing discloses no broker commission on these contracts.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
No broker of record is named on the Schedule A. The contracts may be written directly with the carrier, or the broker fields were left blank on the filing.
At 68 participants this is a small group; Form 5500 is required once a welfare plan reaches 100 participants, or when it is funded through insurance contracts.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | Health | 151 | Jan 1, 2026 | $1,309,026 | $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.
Other plans filed by this employer
How this plan compares
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