Form 5500 · Employee benefit plan · BELOIT, WI
FIRST NATIONAL BANK AND TRUST COMPANY
Public Form 5500 records show how FIRST NATIONAL BANK AND TRUST COMPANY of BELOIT, WI, a finance and insurance employer, structures its employee benefits. Coverage is written through BLUE CROSS & BLUE SHIELD OF WISCONSIN (BCBSW) (G0422) and 1 other carrier. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 39-0159135 · plan 504 · as of Aug 2026
Plan brief
All 2 insured contracts are stop-loss coverage, split across BLUE CROSS & BLUE SHIELD OF WISCONSIN (BCBSW) (G0422) and COMPCARE HEALTH SERVICES INSURANCE CORPORATION (G0423).
The only insured piece of the health benefit is stop-loss coverage — the plan itself is self-funded, so premium and commission here reflect the stop-loss contract, not medical premium.
Reported premium is $1,643,616; the filing discloses no broker commission on these contracts.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
No broker of record is named on the Schedule A — the contracts may be direct-written or the broker fields were left blank on the filing.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS & BLUE SHIELD OF WISCONSIN (BCBSW) (G0422) | Stop-loss | 327 | December | $821,808 | $0 |
| COMPCARE HEALTH SERVICES INSURANCE CORPORATION (G0423) | Stop-loss | 327 | December | $821,808 | $0 |
More employer plans in Wisconsin — largest plans, brokers, carriers and renewal months.