Form 5500 · Employee benefit plan · RAPID CITY, SD
MOYLE PETROLEUM COMPANY
The filing calls this plan MOYLE PETROLEUM COMPANY WELFARE BENEFIT PLAN.
MOYLE PETROLEUM COMPANY of RAPID CITY, SD insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is PATRIOT GROWTH INSURANCE SERVICES. Coverage is written through WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA and 4 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 46-0253801 · plan 501 · plan year 2025, filed Sep 22, 2026
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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
Disability: the largest of the 2 insured disability contracts, with UNUM LIFE INSURANCE COMPANY OF AMERICA, covers 16 of 221 participants (7.2%) on Schedule A.
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 8 insured contracts covering health, dental, vision, life and disability; the largest, with WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA, covers 115 people.
Reported premium across the insured contracts is $1,210,013, with $39,041 in disclosed broker commissions — about 3.2% 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.
PATRIOT GROWTH INSURANCE SERVICES is the broker of record on 2 of the 8 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA, DELTA DENTAL OF SOUTH DAKOTA, VISION SERVICE PLAN and UNUM LIFE INSURANCE COMPANY OF AMERICA. WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA | Health | 115 | Jan 1, 2026 | $1,022,738 | $26,486 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life | 53 | Jan 1, 2026 | $20,471 | $3,203 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life | 23 | Jan 1, 2026 | $13,133 | $2,827 |
| DELTA DENTAL OF SOUTH DAKOTA | Dental | 284 | Jan 1, 2026 | $104,935 | $1,831 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Disability | 16 | Jan 1, 2026 | $9,933 | $1,689 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Disability | 29 | Jan 1, 2026 | $9,637 | $1,513 |
| VISION SERVICE PLAN | Vision | 163 | Jan 1, 2026 | $26,579 | $1,239 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | — | 3 | Jan 1, 2026 | $2,587 | $253 |
Premium and claims on this contract
WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA, contract B31. For the contract year on this filing, the carrier reported $1,022,738 in premium earned and $514,425 in claims incurred. Dividing one by the other gives 50%.
- WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA, contract B31 reported $508,313 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.
Other plans filed by this employer
How this plan compares
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