Form 5500 · Employee benefit plan · WEST DES MOINES, IA
HY-LINE INTERNATIONAL
The filing calls this plan HY-LINE VOLUNTARY EMPLOYEE BENEFICIARY ASSOCIATION PLAN AND TRUST.
Public Form 5500 records show how HY-LINE INTERNATIONAL of WEST DES MOINES, IA, a agriculture employer, structures its employee benefits. Coverage is written through WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA. The plan's most recent policy period ended in February.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 42-1106927 · plan 506 · plan year 2024, filed Apr 11, 2025
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How this plan is funded
Both, as reported
The filing reports both insurance premium and benefits paid from the plan's own money, and the two amounts do not line up.
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
Schedule A lists 1 insured contract covering health and dental; the largest, with WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA, covers 80 people.
Reported premium is $196,665; the filing discloses no broker commission on these contracts.
The most recent policy period ended in February, and the plan year ends June 30. Group contracts typically renew on that annual cycle.
No broker of record is named on the Schedule A. The contracts may be written directly with the carrier, or the broker fields were left blank on the filing.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | Health, Dental | 80 | Feb 29, 2024 | $196,665 | $0 |
Premium and claims on this contract
WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA, contract 00061885. For the contract year on this filing, the carrier reported $196,665 in premium earned and $191,469 in claims incurred. Dividing one by the other gives 97%.
- WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA, contract 00061885 reported $5,196 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.
Reported to OSHA
Reported to OSHA for 2025: 186 employees, 7 recordable cases, 0 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule I
These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.
Other plans filed by this employer
How this plan compares
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