Form 5500 · Employee benefit plan · PROPHETSTOWN, IL
ROCK RIVER LUMBER & GRAIN
ROCK RIVER LUMBER & GRAIN of PROPHETSTOWN, IL insures dental, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is USI INSURANCE SERVICE LLC. Coverage is written through THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 36-1694760 · plan 504 · plan year 2025, filed Jul 13, 2026
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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
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 dental, life and disability; the largest, with THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA, covers 111 people.
Reported premium across the insured contracts is $82,580, with $11,762 in disclosed broker commissions — about 14% 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 |
|---|---|---|---|---|---|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Dental, Life, Disability | 111 | Jan 1, 2026 | $82,580 | $11,762 |
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.
Reported to OSHA
Reported to OSHA for 2025: 138 employees, 3 recordable cases, 75 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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