Form 5500 · Employee benefit plan · SHREVE, OH
CERCO I, INC.
The filing calls this plan CERCO I, INC. EMPLOYEE BENEFITS PLAN.
CERCO I, INC. of SHREVE, OH files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is MICHAEL D WARGO. Coverage is written through SKYWARD SPECIALTY INSURANCE and 2 other carriers. The plan's most recent policy period ended in June.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 27-1798479 · plan 501 · plan year 2025, filed Oct 28, 2025
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How this plan is funded
Self-funded as reported
The filing reports a stop-loss contract and no medical premium, which is what a plan that pays its own claims reports.
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
One contract on this filing does not say which benefits it covers, so a line above may be insured by it.
Also declared: other welfare.
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 vision, life, disability and stop-loss; the largest, with SKYWARD SPECIALTY INSURANCE, covers 150 people.
The filing declares vision, life, disability, health and dental. Health and dental appear with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on the contract here that does not say what it covers.
The only insured piece of the health benefit is stop-loss coverage, and the filing reports the plan paying its own claims. The stop-loss contract reports $208,575 in premium and $0 in commission. The rest of the premium and commission above is on the plan's other insured lines, and none of it is medical premium.
Reported premium across the insured contracts is $317,565, with $12,977 in disclosed broker commissions — about 4.1% of premium.
The most recent policy period ended in June, and the plan year ends June 30. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Vision, Life, Disability | 138 | Jul 1, 2025 | $89,281 | $11,006 |
| TOKIO MARINE HCC | — | 102 | Jul 1, 2025 | $19,709 | $1,971 |
| SKYWARD SPECIALTY INSURANCE | Stop-loss | 150 | Jul 1, 2025 | $208,575 | $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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