Form 5500 · Retirement plan · OSHKOSH, WI
EVERGREEN RETIREMENT COMMUNITY, INC.
The filing calls this plan EVERGREEN RETIREMENT COMMUNITY, INC. 403(B) PLAN.
EVERGREEN RETIREMENT COMMUNITY, INC. of OSHKOSH, WI's retirement plan holds 3 insurance-company contracts (annuities or guaranteed-interest accounts), disclosed on Schedule A of its Form 5500. These are investment and funding contracts, not group health or welfare coverage. No medical, dental or life benefit is reported on this filing.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 39-1081800 · plan 001 · plan year 2024, filed Oct 13, 2025
Plan brief
Schedule A lists 3 insurance contracts held by the plan — annuities, guaranteed-interest accounts or similar funding vehicles. The largest number are with THE LINCOLN NATIONAL LIFE INSURANCE COMPANY.
The contracts held $1,638,109 at the end of the plan year, as reported on Schedule A.
$1,534 in agent commissions is disclosed across the contracts; LINCOLN - APS is the agent of record.
A Schedule A is filed for a retirement plan when plan assets sit in an insurance company contract. It reports the contract's balances and any agent commission. It does not report a health, dental or life premium, and it does not give a group renewal date.
The contract year ended in December.
Schedule A insurance contracts
| Carrier | Contract type | Covered | Year ends | Contract value | Commission |
|---|---|---|---|---|---|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Annuity / GIC | 14 | December | $182,677 | $1,258 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Annuity / GIC | 12 | December | $51,575 | $276 |
| MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | Annuity / GIC | 140 | December | $1,403,857 | $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
The plan administrator is from line 3a of the main form. The service providers are named on Schedule C of this filing. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 307 employees, 9 recordable cases, 7 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
What the plan holds
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H
Who runs the plan
From Schedule H of this filing.
We can name the recordkeeper and the auditor for large plans, the ones that file a Schedule C or a Schedule H. Smaller plans do not have to report either, so for most 401(k) plans in the country that information is not public anywhere.
Other plans filed by this employer
More employer plans in Wisconsin — largest plans, brokers, carriers and renewal months.