Form 5500 · Employee benefit plan · ROCKFORD, IL
GOODWILL INDUSTRIES OF NORTHERN ILLINOIS AND WISCONSIN STATELINE AREA
The filing calls this plan GOODWILL INDUSTRIES OF NORTHERN ILLINOIS AND WISCONSIN STATELINE AREA WELFARE BENEFITS WRAP PLAN.
GOODWILL INDUSTRIES OF NORTHERN ILLINOIS AND WISCONSIN STATELINE AREA of ROCKFORD, IL insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is ASSUREDPARTNERS OF ILLINOIS, LLC. Coverage is written through BLUECROSS BLUESHIELD OF ILLINOIS and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 36-2167846 · plan 505 · plan year 2025, filed Jul 21, 2026
Get an email when this employer files a new Form 5500, and again about four months before its plan renews.
2,668 other employer plans in Illinois have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
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
Also declared: death benefits, 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 health, dental, vision, life and disability; the largest, with BLUECROSS BLUESHIELD OF ILLINOIS, covers 224 people.
Reported premium across the insured contracts is $1,421,335, with $63,581 in disclosed broker commissions — about 4.5% 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.
ASSUREDPARTNERS OF ILLINOIS, LLC is the broker of record on 1 of the 3 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including BLUECROSS BLUESHIELD OF ILLINOIS, DEARBORN LIFE INSURANCE COMPANY and UNUM LIFE INSURANCE COMPANY OF AMERICA. 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, Dental | 224 | Jan 1, 2026 | $1,333,362 | $54,218 |
| DEARBORN LIFE INSURANCE COMPANY | Vision, Life | 274 | Jan 1, 2026 | $48,571 | $6,430 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Disability | 239 | Jan 1, 2026 | $39,402 | $2,933 |
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.
Reported to OSHA
Reported to OSHA for 2025: 649 employees, 18 recordable cases, 170 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
Subscribers see how this compares with similar plans in Illinois. A subscription also adds this plan's filing history and the renewal calendar for its state. See plans and prices
Without an account you can open 10 employer, broker and carrier pages a day, including through an AI assistant, and 50 a day with a free account. Paid plans are what keep these records free to read.
Renewal calendar
2,668 other employer plans in Illinois are January 1 renewals (policy year ends December).
Their policy years end in December, like this plan’s, so most renew January 1. The calendar lists every insured group by renewal date and state, with broker of record, carrier and disclosed commission. You can preview the five largest in each month for free.
Claude & ChatGPT
Look up records from Claude or ChatGPT
Add Form5500Lookup to Claude or ChatGPT and ask about any employer, broker or carrier in plain English. Lookups are free. Renewal lists, full books of business and exports are included with a subscription.
Building a list or a tool from these records? Match a list you already have from $29 per 1,000 records, or license the whole dataset as a weekly file for $499 a month. See both
More employer plans in Illinois — largest plans, brokers, carriers and renewal months.