Form 5500 · Employee benefit plan · EAST MOLINE, IL
GREEN BUICK GMC, INC
The filing calls this plan GREEN BUICK GMC, INC EMPLOYEE BENEFITS PLAN.
GREEN BUICK GMC, INC of EAST MOLINE, IL is a 77-participant retail employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is LB BENEFITS INC. Coverage is written through BLUECROSS BLUESHIELD OF ILLINOIS and 3 other carriers. The plan's most recent policy period ended in May.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 27-0829052 · plan 502 · plan year 2025, filed Dec 31, 2025
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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
6 contracts on this filing do not say which benefits they cover, so a line above may be insured by one of them.
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 8 insured contracts covering health and vision; the largest, with BLUECROSS BLUESHIELD OF ILLINOIS, covers 130 people.
The filing declares health, vision, life and disability. Life and disability 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 one of the 6 contracts here that do not say what they cover.
Reported premium across the insured contracts is $1,095,567, with $49,836 in disclosed broker commissions — about 4.5% of premium.
The health contract's policy period ended in May, while at least one ancillary line's policy period ended in June. The plan is on a split renewal cycle.
LB BENEFITS INC is the broker of record on 2 of the 8 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF ILLINOIS | Health | 130 | Jun 1, 2025 | $993,086 | $39,678 |
| DEARBORN LIFE INSURANCE COMPANY | — | 138 | Jun 1, 2025 | $67,185 | $3,577 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | 53 | Jul 1, 2024 | $14,987 | $2,848 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | 4 | Jul 1, 2024 | $1,152 | $1,152 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | 38 | Jul 1, 2024 | $7,856 | $1,138 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | 39 | Jul 1, 2024 | $6,099 | $984 |
| AMERITAS LIFE INSURANCE CORP. | Vision | 63 | Jul 1, 2024 | $4,198 | $420 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | 7 | Jul 1, 2024 | $1,004 | $39 |
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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