Form 5500 · Employee benefit plan · PEORIA, IL
FIDELITY ON CALL, LTD.
The filing calls this plan FIDELITY ON CALL HEALTH AND WELLNESS PLAN.
FIDELITY ON CALL, LTD. of PEORIA, IL insures health, dental, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is GROUP BENEFITS LTD. Coverage is written through BLUECROSS BLUESHIELD OF ILLINOIS and 3 other carriers. The plan's most recent policy period ended in September.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 37-1329215 · plan 501 · plan year 2024, filed Apr 15, 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.
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
Schedule A lists 4 insured contracts covering health, dental, life and disability; the largest, with BLUECROSS BLUESHIELD OF ILLINOIS, covers 94 people.
Reported premium across the insured contracts is $752,836, with $32,714 in disclosed broker commissions — about 4.3% of premium.
The most recent policy period ended in September, and the plan year ends September 30. Group contracts typically renew on that annual cycle.
GROUP BENEFITS LTD is the broker of record on all 4 contracts.
4 carriers appear on the filing, including BLUECROSS BLUESHIELD OF ILLINOIS, STANDARD INSURANCE COMPANY, DELTA DENTAL OF ILLINOIS and KANSAS CITY LIFE INSURANCE COMPANY. BLUECROSS BLUESHIELD OF ILLINOIS writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF ILLINOIS | Health | 94 | Oct 1, 2024 | $669,952 | $27,538 |
| STANDARD INSURANCE COMPANY | Disability | 40 | Oct 1, 2024 | $50,243 | $2,627 |
| DELTA DENTAL OF ILLINOIS | Dental | 59 | Oct 1, 2024 | $30,697 | $2,333 |
| KANSAS CITY LIFE INSURANCE COMPANY | Life | 62 | Oct 1, 2024 | $1,944 | $216 |
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.
Reported to OSHA
Reported to OSHA for 2025: 57 employees, 4 recordable cases, 24 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
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