Form 5500 · Employee benefit plan · PRAIRIE DU CHIEN, WI
PRAIRIE DU CHIEN MEMORIAL HOSPITAL ASSOCIATION INC
The filing calls this plan CROSSING RIVERS HEALTH WELFARE BENEFITS PLAN.
PRAIRIE DU CHIEN MEMORIAL HOSPITAL ASSOCIATION INC of PRAIRIE DU CHIEN, WI insures health, vision, life, disability and stop-loss coverage for its employees, per Schedule A of its Form 5500. Its broker of record is STEALTH PARTNER GROUP, LLC. Coverage is written through SUN LIFE ASSURANCE COMPANY OF CANADA and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 39-0926284 · plan 515 · plan year 2025, filed Jul 21, 2026
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1,633 other employer plans in Wisconsin have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
Benefits declared on this filing
One contract on this filing does not say which benefits it covers, so a line above may be insured by it.
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 5 insured contracts covering health, vision, life, disability and stop-loss; the largest, with SUN LIFE ASSURANCE COMPANY OF CANADA, covers 274 people.
The filing declares health, vision, life, disability and dental. Dental appears with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on the contract here that does not say what it covers.
The filing lists a stop-loss contract. On its own that does not settle whether the plan pays its own claims.
Reported premium across the insured contracts is $2,974,767, with $205,521 in disclosed broker commissions — about 6.9% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SYMETRA LIFE INSURANCE COMPANY | Health | 274 | Jan 1, 2026 | $1,116,576 | $79,319 |
| SYMETRA LIFE INSURANCE COMPANY | Life, Disability | 274 | Jan 1, 2026 | $521,682 | $61,294 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Health, Stop-loss | 274 | Jul 1, 2025 | $1,212,804 | $60,549 |
| NGL | Vision | 236 | Jan 1, 2026 | $54,491 | $4,359 |
| HCC LIFE INSURANCE COMPANY | — | 274 | Jan 1, 2026 | $69,214 | $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.
Other plans filed by this employer
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Renewal calendar
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