Form 5500 · Employee benefit plan · ABBOTSFORD, WI
ABBYBANK
The filing calls this plan ABBYBANK WELFARE BENEFIT PLAN.
Public Form 5500 records show how ABBYBANK of ABBOTSFORD, WI, a finance and insurance employer, structures its employee benefits. Its broker of record is MCCLONE AGENCY INC. Coverage is written through ASPIRUS HEALTH PLAN and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 39-1087461 · plan 501 · plan year 2025, filed May 6, 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
Also declared: death benefits.
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.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
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 6 insured contracts covering health, dental, vision, life and disability; the largest, with ASPIRUS HEALTH PLAN, covers 153 people.
Reported premium across the insured contracts is $1,538,956, with $29,649 in disclosed broker commissions — about 1.9% 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.
MCCLONE AGENCY INC is the broker of record on 4 of the 6 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including ASPIRUS HEALTH PLAN, DELTA DENTAL OF WISCONSIN, UNITED OF OMAHA LIFE INSURANCE COMPANY and WYSSTA INSURANCE COMPANY INC. ASPIRUS HEALTH PLAN writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| ASPIRUS HEALTH PLAN | Health | 153 | Jan 1, 2026 | $1,408,556 | $18,207 |
| DELTA DENTAL OF WISCONSIN | Dental | 76 | Jan 1, 2026 | $78,899 | $5,246 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 106 | Jan 1, 2026 | $16,962 | $2,446 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 38 | Jan 1, 2026 | $10,870 | $1,631 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 106 | Jan 1, 2026 | $14,352 | $1,435 |
| WYSSTA INSURANCE COMPANY INC | Vision | 76 | Jan 1, 2026 | $9,317 | $684 |
Premium and claims on these contracts
ASPIRUS HEALTH PLAN, contract ASP10093. For the contract year on this filing, the carrier reported $1,408,556 in premium earned and $1,541,697 in claims incurred. Dividing one by the other gives 109%.
DELTA DENTAL OF WISCONSIN, contract 07318 00000. For the contract year on this filing, the carrier reported $78,899 in premium earned and $63,943 in claims incurred. Dividing one by the other gives 81%.
- ASPIRUS HEALTH PLAN, contract ASP10093 reported $7,665 in retention.
- DELTA DENTAL OF WISCONSIN, contract 07318 00000 reported $22,266 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.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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