Form 5500 · Employee benefit plan · COON RAPIDS, MN
THE JOHN ROBERTS COMPANY
The filing calls this plan THE JOHN ROBERTS COMPANY WELFARE BENEFITS PLAN.
THE JOHN ROBERTS COMPANY of COON RAPIDS, MN is a 200-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 MEDICA INSURANCE COMPANY and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 41-0763427 · plan 501 · plan year 2024, filed Jul 28, 2025
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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
Also declared: 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 3 insured contracts covering health, vision, life and disability; the largest, with MEDICA INSURANCE COMPANY, covers 237 people.
The filing declares health, vision, life, disability and dental. Dental appears with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
Reported premium across the insured contracts is $1,593,269, with $9,322 in disclosed broker commissions — about 0.6% 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 1 of the 3 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life, Disability | 182 | Jan 1, 2025 | $146,484 | $8,852 |
| FIDELITY SECURITY LIFE INSURANCE COMPANY | Vision | 113 | Jan 1, 2025 | $4,622 | $470 |
| MEDICA INSURANCE COMPANY | Health | 237 | Jan 1, 2025 | $1,442,163 | $0 |
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
Named on Schedule C of this filing. We publish company names only.
Other plans filed by this employer
How this plan compares
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