Form 5500 · Employee benefit plan · BOLINGBROOK, IL
DYWIDAG
The filing calls this plan DYWIDAG LIFE PLAN.
Public Form 5500 records show how DYWIDAG of BOLINGBROOK, IL, a mining and energy extraction employer, structures its employee benefits. Its broker of record is ASSUREDPARTNERS OF ILLINOIS, LLC. Coverage is written through PRUDENTIAL INSURANCE COMPANY OF AMERICA. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 13-2635618 · plan 505 · plan year 2024, filed Jul 30, 2025
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How this plan is funded
Self-funded as reported
The filing names a third-party administrator on Schedule A and reports no medical premium.
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
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, life, through PRUDENTIAL INSURANCE COMPANY OF AMERICA, covering 160 people.
Reported premium across the insured contracts is $62,920, with $19,292 in disclosed broker commissions — about 31% 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.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Life | 160 | Jan 1, 2025 | $62,920 | $19,292 |
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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