Form 5500 · Employee benefit plan · MOMENCE, IL
SILVA INTERNATIONAL, INC.
The filing calls this plan SILVA INTERNATIONAL, INC. WRAP BENEFIT PLAN.
Public Form 5500 records show how SILVA INTERNATIONAL, INC. of MOMENCE, IL, a manufacturing employer, structures its employee benefits. Its broker of record is MULTIPLE AGENTS - SEE ATTACHMENTS*. Coverage is written through UNITEDHEALTHCARE INSURANCE COMPANY and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 36-3039735 · plan 505 · plan year 2024, filed Jul 24, 2025
Get an email when this employer files a new Form 5500, and again about four months before its plan renews.
2,668 other employer plans in Illinois have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
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
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 4 insured contracts covering health, dental, vision and life; the largest, with UNITEDHEALTHCARE INSURANCE COMPANY, covers 238 people.
Reported premium across the insured contracts is $2,104,306, with $35,773 in disclosed broker commissions — about 1.7% 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.
MULTIPLE AGENTS - SEE ATTACHMENTS* is the broker of record on 1 of the 4 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including UNITEDHEALTHCARE INSURANCE COMPANY, DELTA DENTAL OF ILLINOIS, AFLAC and VISION SERVICE PLAN. UNITEDHEALTHCARE INSURANCE COMPANY writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| AFLAC | — | 126 | Jan 1, 2025 | $87,893 | $27,176 |
| DELTA DENTAL OF ILLINOIS | Dental | 218 | Jan 1, 2025 | $92,305 | $6,958 |
| VISION SERVICE PLAN | Vision | 166 | Jan 1, 2025 | $18,256 | $1,044 |
| UNITEDHEALTHCARE INSURANCE COMPANY | Health, Life | 238 | Jan 1, 2025 | $1,905,852 | $595 |
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: 264 employees, 3 recordable cases, 10 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
How this plan compares
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Renewal calendar
2,668 other employer plans in Illinois are January 1 renewals (policy year ends December).
Their policy years end in December, like this plan’s, so most renew January 1. The calendar lists every insured group by renewal date and state, with broker of record, carrier and disclosed commission. You can preview the five largest in each month for free.
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