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Form 5500 · Employee benefit plan · GREENSBURG, IN

KOVA FERTILIZER, INC.

The filing calls this plan KOVA FERTILIZER, INC. EMPLOYEE HEALTH BENEFIT PLAN.

KOVA FERTILIZER, INC. of GREENSBURG, IN is a 153-participant manufacturing employer whose group benefits are disclosed in its annual Form 5500 filing. Coverage is written through THE NORTH RIVER INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in December.

Benefits broker of record
Not disclosed
Policy year ends
Decemberas filed for plan year 2025

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 35-0827132 · plan 501 · plan year 2025, filed Apr 24, 2026

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How this plan is funded

Self-funded as reported

The filing reports a stop-loss contract and no medical premium, which is what a plan that pays its own claims reports.

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.

All participants at the start of the year
153
Active at start of year
153
Active at end of year
157
Disclosed commissions
$0
Typical renewal
January 1

Benefits declared on this filing

Healthdeclared, not on Schedule A
Dentalnot declared on this filing
Visionnot declared on this filing
Lifeinsured — MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO.188 of 153 participants
Disabilitynot declared on this filing

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 2 insured contracts covering life and stop-loss; the largest, with THE NORTH RIVER INSURANCE COMPANY, covers 157 people.

The filing declares life and health. Health appears with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.

The only insured piece of the health benefit is stop-loss coverage, and the filing reports the plan paying its own claims. The stop-loss contract reports $1,885,299 in premium and $0 in commission. The rest of the premium and commission above is on the plan's other insured lines, and none of it is medical premium.

Reported premium is $1,902,120; the filing discloses no broker commission on these contracts.

The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
THE NORTH RIVER INSURANCE COMPANYStop-loss157Jan 1, 2026$1,885,299$0
MEDICAL BENEFITS MUTUAL LIFE INSURANCE CO.Life188Jan 1, 2026$16,821$0

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.

See the filing at the Department of Labor

Administrator and service providers

Plan administrator on the filing
KOVA FERTILIZER, INC.
EIN 35-0827132
SAGAMORE HEALTH NETWORK, INC
CONTRACT · EIN 35-1641636
$6,191
paid directly by the plan
MEDICAL BENEFITS ADMINSTRATORS INC
Plan administrator · EIN 31-1249371
$78,718
paid directly by the plan
COMPASS RISK PARTNERS LLC
BROKER · EIN 57-3004623
$59,149
paid directly by the plan

The plan administrator is from line 3a of the main form. The service providers are named on Schedule C of this filing. We publish company names only.

Other plans filed by this employer

How this plan compares

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