Form 5500 · Employee benefit plan · BRISTOL, IN
ROBERT WEED PLYWOOD CORPORATION
The filing calls this plan ROBERT WEED PLYWOOD CORPORATION WELFARE PLAN.
ROBERT WEED PLYWOOD CORPORATION of BRISTOL, IN is a 174-participant manufacturing employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is MARSH & MCLENNAN AGENCY LLC. Coverage is written through UNITED OF OMAHA LIFE INSURANCE COMPANY and 4 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 35-1129111 · plan 501 · plan year 2024, filed May 27, 2025
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
Also declared: death benefits, 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 5 insured contracts covering health, dental, vision, life and disability; the largest, with UNITED OF OMAHA LIFE INSURANCE COMPANY, covers 103 people.
Reported premium across the insured contracts is $219,027, with $24,310 in disclosed broker commissions — about 11% 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.
MARSH & MCLENNAN AGENCY LLC is the broker of record on 4 of the 5 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including UNITED OF OMAHA LIFE INSURANCE COMPANY, DELTA DENTAL OF INDIANA, STANDARD INSURANCE COMPANY and VISION SERVICE PLAN. UNITED OF OMAHA LIFE INSURANCE COMPANY writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life, Disability | 103 | Jan 1, 2025 | $91,013 | $10,119 |
| DELTA DENTAL OF INDIANA | Dental | 193 | Jan 1, 2025 | $74,511 | $6,594 |
| STANDARD INSURANCE COMPANY | Health | 63 | Jan 1, 2025 | $35,458 | $6,244 |
| VISION SERVICE PLAN | Vision | 77 | Jan 1, 2025 | $14,920 | $1,353 |
| NEW AVENUES | — | 106 | Jan 1, 2025 | $3,125 | $0 |
Premium and claims on this contract
DELTA DENTAL OF INDIANA, contract 10107. For the contract year on this filing, the carrier reported $74,511 in premium earned and $59,757 in claims incurred. Dividing one by the other gives 80%.
- DELTA DENTAL OF INDIANA, contract 10107 reported $15,177 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.
How this plan compares
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