Form 5500 · Employee benefit plan · DAVENPORT, IA
MOBOTREX
The filing calls this plan MOBOTREX EMPLOYEE BENEFITS PLAN.
MOBOTREX of DAVENPORT, IA insures dental, vision, life, disability and stop-loss coverage for its employees, per Schedule A of its Form 5500. Its broker of record is ZACH CORPORATION DBA GROUP BEN. Coverage is written through WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA and 1 other carrier. The plan's most recent policy period ended in March.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 36-2656899 · plan 502 · plan year 2026, filed Sep 17, 2026
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60 other employer plans in Iowa have policy years ending in March. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
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.
Benefits declared on this filing
2 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.
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 9 insured contracts covering dental, vision, life, disability and stop-loss; the largest, with WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA, covers 180 people.
The filing declares dental, vision, life, disability and health. Health appears 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 2 contracts here that do not say what they cover.
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 $2,351,648 in premium and $53,703 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 across the insured contracts is $2,632,768, with $79,179 in disclosed broker commissions — about 3% of premium.
The most recent policy period ended in March, and the plan year ends March 31. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | Stop-loss | 180 | Apr 1, 2026 | $2,351,648 | $53,703 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 140 | Apr 1, 2026 | $67,598 | $6,760 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | — | 41 | Apr 1, 2026 | $15,404 | $3,851 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Dental | 177 | Apr 1, 2026 | $92,142 | $3,287 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 217 | Apr 1, 2026 | $31,598 | $3,160 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 78 | Jan 1, 2026 | $30,818 | $3,082 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 217 | Apr 1, 2026 | $22,716 | $2,272 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | — | 44 | Apr 1, 2026 | $6,531 | $1,633 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Vision | 169 | Apr 1, 2026 | $14,313 | $1,431 |
Premium and claims on this contract
WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA, contract A98. For the contract year on this filing, the carrier reported $2,351,648 in premium earned and $1,716,485 in claims incurred. Dividing one by the other gives 73%.
- WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA, contract A98 reported $635,164 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: 179 employees, 9 recordable cases, 197 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
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