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Form 5500 · Employee benefit plan · LAWRENCEVILLE, IL

LAWRENCE COUNTY MEMORIAL HOSPITAL

Public Form 5500 records show how LAWRENCE COUNTY MEMORIAL HOSPITAL of LAWRENCEVILLE, IL, a health care and social assistance employer, structures its employee benefits. Its broker of record is ASSUREDPARTNERS. Coverage is written through UNITED OF OMAHA LIFE INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in December.

Benefits broker of record
Plan renews
December

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 80-0618988 · plan 501 · as of Aug 2026

Participants
170
Carriers on file
2
Disclosed commissions
$27,965
Renewal month
December

Plan brief

Schedule A lists 2 insured contracts covering dental, vision, life and disability; the largest, with UNITED OF OMAHA LIFE INSURANCE COMPANY, covers 179 people.

Reported premium across the insured contracts is $274,995, with $27,965 in disclosed broker commissions — about 10% 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 is the broker of record on all 2 contracts.

Two carriers split the book: UNITED OF OMAHA LIFE INSURANCE COMPANY and EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO..

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
UNITED OF OMAHA LIFE INSURANCE COMPANYDental, Life, Disability179December$254,003$25,875
EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO.Vision291December$20,992$2,090

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