Form 5500 · Employee benefit plan · RICHFIELD, WI
DIELECTRIC MANUFACTURING, INC.
The filing calls this plan DIELECTRIC MANUFACTURING, INC. HEALTH AND WELFARE BENEFIT PLAN.
Public Form 5500 records show how DIELECTRIC MANUFACTURING, INC. of RICHFIELD, WI, a manufacturing employer, structures its employee benefits. Its broker of record is BROWN & BROWN INS SVCS INC. Coverage is written through DELTA DENTAL OF WISCONSIN and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 39-1083000 · plan 502 · plan year 2024, filed Jul 21, 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 4 insured contracts covering dental, vision, life and disability; the largest, with DELTA DENTAL OF WISCONSIN, covers 92 people.
The filing declares dental, vision, life, disability and health. Health 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 $117,599, with $9,495 in disclosed broker commissions — about 8.1% 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.
BROWN & BROWN INS SVCS INC is the broker of record on 2 of the 4 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| DELTA DENTAL OF WISCONSIN | Dental | 92 | Jan 1, 2025 | $71,944 | $4,312 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Disability | 18 | Jan 1, 2025 | $23,973 | $3,305 |
| KANSAS CITY LIFE INSURANCE COMPANY | Life | 100 | Jan 1, 2025 | $12,136 | $1,127 |
| WYSSTA INSURANCE COMPANY INC | Vision | 83 | Jan 1, 2025 | $9,546 | $751 |
Premium and claims on this contract
DELTA DENTAL OF WISCONSIN, contract 06216 00000. For the contract year on this filing, the carrier reported $71,879 in premium earned and $44,875 in claims incurred. Dividing one by the other gives 62%.
- DELTA DENTAL OF WISCONSIN, contract 06216 00000 reported $16,893 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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