Form 5500 · Employee benefit plan · WAUSAU, WI
ORTHOPAEDIC CENTERS OF WISCONSIN, S.C.
The filing calls this plan ORTHOPAEDIC CENTERS OF WISCONSIN, S.C. WELFARE BENEFIT PLAN.
ORTHOPAEDIC CENTERS OF WISCONSIN, S.C. of WAUSAU, WI is a 156-participant health care and social assistance employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is HUB INTERNATIONAL MIDWEST LTD. Coverage is written through SUN LIFE ASSURANCE COMPANY OF CANADA and 1 other carrier. The plan's most recent policy period ended in April.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 39-1975482 · plan 501 · plan year 2025, filed May 14, 2026
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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 2 insured contracts covering vision, life and disability; the largest, with SUN LIFE ASSURANCE COMPANY OF CANADA, covers 157 people.
The filing declares vision, life, disability, health and dental. Health and dental appear 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 $170,542, with $13,782 in disclosed broker commissions — about 8.1% of premium.
The most recent policy period ended in April, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
HUB INTERNATIONAL MIDWEST LTD is the broker of record on 1 of the 2 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SUN LIFE ASSURANCE COMPANY OF CANADA | Life, Disability | 157 | May 1, 2025 | $156,056 | $12,601 |
| WYSSTA INSURANCE COMPANY INC | Vision | 90 | May 1, 2025 | $14,486 | $1,181 |
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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