Form 5500 · Employee benefit plan · LA CROSSE, WI
KWIK TRIP, INC.
The filing calls this plan KWIK TRIP, INC. EMPLOYEE WELFARE BENEFIT PLAN.
Public Form 5500 records show how KWIK TRIP, INC. of LA CROSSE, WI, a retail employer, structures its employee benefits. Its broker of record is TIC INC.. Coverage is written through STANDARD INSURANCE COMPANY and 4 other carriers. The plan's most recent policy period ended in September.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 39-1036365 · plan 501 · plan year 2025, filed Apr 29, 2026
Get an email when this employer files a new Form 5500, and again about four months before its plan renews.
75 other employer plans in Wisconsin have policy years ending in September. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
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
Health: the largest of the 2 insured health contracts, with PAN-AMERICAN LIFE INSURANCE COMPANY, covers 1,066 of 34,632 participants (3.1%) on Schedule A.
Dental: DELTA DENTAL OF WISCONSIN covers 2,753 of 34,632 participants (7.9%) on Schedule A.
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.
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 13 insured contracts covering health, dental, vision, life and disability; the largest, with STANDARD INSURANCE COMPANY, covers 18,191 people.
Reported premium across the insured contracts is $16,690,935, with $533,141 in disclosed broker commissions — about 3.2% of premium.
The most recent policy period ended in September, and the plan year ends September 30. Group contracts typically renew on that annual cycle.
TIC INC. is the broker of record on 11 of the 13 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including STANDARD INSURANCE COMPANY, AMERICAN HERITAGE LIFE INSURANCE COMPANY, WYSSTA INSURANCE COMPANY INC and PAN-AMERICAN LIFE INSURANCE COMPANY. STANDARD INSURANCE COMPANY writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| STANDARD INSURANCE COMPANY | Disability | 18,191 | Oct 1, 2025 | $4,426,238 | $282,296 |
| STANDARD INSURANCE COMPANY | Life | 15,285 | Oct 1, 2025 | $2,333,951 | $204,555 |
| PAN-AMERICAN LIFE INSURANCE COMPANY | Health | 1,066 | Oct 1, 2025 | $1,143,531 | $11,560 |
| DELTA DENTAL OF WISCONSIN | Dental | 2,753 | Oct 1, 2025 | $888,615 | $11,538 |
| STANDARD INSURANCE COMPANY | Disability | 7,651 | Oct 1, 2025 | $2,189,318 | $9,365 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | 4,498 | Oct 1, 2025 | $988,262 | $4,873 |
| STANDARD INSURANCE COMPANY | Disability | 2,035 | Oct 1, 2025 | $425,883 | $3,655 |
| WYSSTA INSURANCE COMPANY INC | Vision | 2,310 | Oct 1, 2025 | $210,528 | $2,108 |
| STANDARD INSURANCE COMPANY | Life | 3,010 | Oct 1, 2025 | $139,472 | $1,406 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | 5,172 | Oct 1, 2025 | $932,956 | $901 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | 6,686 | Oct 1, 2025 | $1,649,789 | $867 |
| PAN-AMERICAN LIFE INSURANCE COMPANY | Health | 1 | Oct 1, 2025 | $1,687 | $17 |
| WYSSTA INSURANCE COMPANY INC | Vision | 9,247 | Oct 1, 2025 | $1,360,705 | $0 |
Premium and claims on these contracts
STANDARD INSURANCE COMPANY, contract 758187. For the contract year on this filing, the carrier reported $4,426,238 in premium earned and $3,186,191 in claims incurred. Dividing one by the other gives 72%.
STANDARD INSURANCE COMPANY, contract 758187. For the contract year on this filing, the carrier reported $2,333,951 in premium earned and $1,737,158 in claims incurred. Dividing one by the other gives 74%.
STANDARD INSURANCE COMPANY, contract 758187. For the contract year on this filing, the carrier reported $2,189,318 in premium earned and $1,113,381 in claims incurred. Dividing one by the other gives 51%.
STANDARD INSURANCE COMPANY, contract 167202. For the contract year on this filing, the carrier reported $425,883 in premium earned and $378,088 in claims incurred. Dividing one by the other gives 89%.
STANDARD INSURANCE COMPANY, contract 167202. For the contract year on this filing, the carrier reported $139,472 in premium earned and $200,827 in claims incurred. Dividing one by the other gives 144%.
- STANDARD INSURANCE COMPANY, contract 758187 reported $1,288,530 in retention.
- STANDARD INSURANCE COMPANY, contract 758187 reported $806,755 in retention.
- STANDARD INSURANCE COMPANY, contract 758187 reported $1,075,937 in retention.
- STANDARD INSURANCE COMPANY, contract 167202 reported $145,085 in retention.
- STANDARD INSURANCE COMPANY, contract 167202 reported $45,315 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.
Reported to OSHA
Reported to OSHA for 2025: 3,253 employees, 118 recordable cases, 453 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
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