Form 5500 · Employee benefit plan · MANTENO, IL
GOTION ILLINOIS NEW ENERGY, INC
The filing calls this plan GOTION ILLINOIS NEW ENERGY, INC WELFARE BENEFIT PLAN.
GOTION ILLINOIS NEW ENERGY, INC of MANTENO, IL files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is MARSH USA. Coverage is written through BLUECROSS BLUESHIELD OF ILLINOIS and 1 other carrier. The plan's most recent policy period ended in February.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 93-4455730 · plan 501 · plan year 2026, filed Aug 17, 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
Also declared: other welfare, death benefits.
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.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
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 7 insured contracts covering health, dental, vision, life and disability; the largest, with BLUECROSS BLUESHIELD OF ILLINOIS, covers 426 people.
Reported premium across the insured contracts is $3,080,945, with $134,904 in disclosed broker commissions — about 4.4% of premium.
The most recent policy period ended in February, and the plan year ends February 28. Group contracts typically renew on that annual cycle.
MARSH USA is the broker of record on 1 of the 7 contracts; the rest name a different broker or none.
Two carriers split the book: BLUECROSS BLUESHIELD OF ILLINOIS and STANDARD INSURANCE COMPANY.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF ILLINOIS | Health | 426 | Mar 1, 2026 | $2,704,961 | $111,653 |
| STANDARD INSURANCE COMPANY | Disability | 319 | Mar 1, 2026 | $47,018 | $6,013 |
| STANDARD INSURANCE COMPANY | Life | 319 | Mar 1, 2026 | $66,067 | $5,930 |
| STANDARD INSURANCE COMPANY | Disability | 319 | Mar 1, 2026 | $62,566 | $5,539 |
| STANDARD INSURANCE COMPANY | Dental | 246 | Mar 1, 2026 | $164,743 | $2,963 |
| STANDARD INSURANCE COMPANY | Health | 64 | Mar 1, 2026 | $9,690 | $2,459 |
| STANDARD INSURANCE COMPANY | Vision | 234 | Mar 1, 2026 | $25,900 | $347 |
Premium and claims on these contracts
STANDARD INSURANCE COMPANY, contract 173859. For the contract year on this filing, the carrier reported $47,018 in premium earned and $20,695 in claims incurred. Dividing one by the other gives 44%.
STANDARD INSURANCE COMPANY, contract 173859. For the contract year on this filing, the carrier reported $66,067 in premium earned and $14,835 in claims incurred. Dividing one by the other gives 22%.
STANDARD INSURANCE COMPANY, contract 173859. For the contract year on this filing, the carrier reported $62,566 in premium earned and $41,677 in claims incurred. Dividing one by the other gives 67%.
STANDARD INSURANCE COMPANY, contract 173859. For the contract year on this filing, the carrier reported $164,743 in premium earned and $83,885 in claims incurred. Dividing one by the other gives 51%.
STANDARD INSURANCE COMPANY, contract 173859. For the contract year on this filing, the carrier reported $25,900 in premium earned and $12,557 in claims incurred. Dividing one by the other gives 48%.
- STANDARD INSURANCE COMPANY, contract 173859 reported $29,852 in retention.
- STANDARD INSURANCE COMPANY, contract 173859 reported $51,235 in retention.
- STANDARD INSURANCE COMPANY, contract 173859 reported $38,964 in retention.
- STANDARD INSURANCE COMPANY, contract 173859 reported $80,859 in retention.
- STANDARD INSURANCE COMPANY, contract 173859 reported $13,345 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
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: 211 employees, 7 recordable cases, 2 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
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