Form 5500 · Employee benefit plan · GREEN BAY, WI
FOSBER AMERICA, INC.
Public Form 5500 records show how FOSBER AMERICA, INC. of GREEN BAY, WI, a wholesale trade employer, structures its employee benefits. Its broker of record is MCCLONE AGENCY INC. Coverage is written through UNITEDHEALTHCARE INSURANCE COMPANY and 2 other carriers. The plan's most recent policy period ended in May.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 39-1714500 · plan 501 · as of Aug 2026
Plan brief
Schedule A lists 3 insured contracts covering vision, life and disability; the largest, with UNITEDHEALTHCARE INSURANCE COMPANY, covers 203 people.
Reported premium across the insured contracts is $148,972, with $17,692 in disclosed broker commissions — about 12% of premium.
The most recent policy period ended in May, and the plan year ends May 31. Group contracts typically renew on that annual cycle.
MCCLONE AGENCY INC is the broker of record on 2 of the 3 contracts; the rest name a different broker or none.
3 carriers appear on the filing — UNITEDHEALTHCARE INSURANCE COMPANY, NORTHWESTERN MUTUAL and NATIONAL VISION ADMINISTRATORS, L.L.C. — with UNITEDHEALTHCARE INSURANCE COMPANY writing the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNITEDHEALTHCARE INSURANCE COMPANY | Life | 203 | May | $72,075 | $10,811 |
| NORTHWESTERN MUTUAL | Disability | 178 | May | $63,739 | $5,565 |
| NATIONAL VISION ADMINISTRATORS, L.L.C. | Vision | 346 | May | $13,158 | $1,316 |
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