Form 5500 · Employee benefit plan · DIXON, IL
RAYNOR MANUFACTURING COMPANY
The filing calls this plan RAYNOR MFG. CO. HEALTH CARE PLAN.
RAYNOR MANUFACTURING COMPANY of DIXON, IL files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is ASSUREDPARTNERS OF ILLINOIS, LLC. Coverage is written through BLUECROSS BLUESHIELD OF ILLINOIS. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 36-2069924 · plan 502 · plan year 2025, filed May 18, 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
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 BLUECROSS BLUESHIELD OF ILLINOIS, covers 385 people.
Reported premium across the insured contracts is $3,173,740, with $14,622 in disclosed broker commissions — about 0.5% 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.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF ILLINOIS | Health, Dental | 385 | Jan 1, 2026 | $3,173,740 | $14,622 |
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: 536 employees, 17 recordable cases, 245 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
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