Form 5500 · Employee benefit plan · GREEN BAY, WI
RPI HOLDINGS, INC.
The filing calls this plan RPI HOLDINGS, INC. EMPLOYEE BENEFIT PLAN.
RPI HOLDINGS, INC. of GREEN BAY, WI spreads its employee benefits across 4 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is MICHAEL JOHNSON. Coverage is written through UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 98-1624455 · plan 501 · plan year 2025, filed Jul 30, 2026
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How this plan is funded
Self-funded as reported
The filing reports a stop-loss contract and no medical premium, which is what a plan that pays its own claims reports.
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
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 10 insured contracts covering health, dental, vision, life, disability and stop-loss; the largest, with UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK, covers 208 people.
The medical plan carries stop-loss coverage: the filing reports the plan paying its own health claims, with insured protection against large ones.
Reported premium across the insured contracts is $531,852, with $67,710 in disclosed broker commissions — about 13% 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.
MICHAEL JOHNSON is the broker of record on 2 of the 10 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK | Health, Stop-loss | 208 | Jan 1, 2026 | $368,036 | $51,372 |
| DELTA DENTAL OF PENNSYLVANIA | Dental | 238 | Jan 1, 2026 | $56,310 | $5,631 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Life | 164 | Jan 1, 2026 | $21,815 | $3,272 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Disability | 126 | Jan 1, 2026 | $43,975 | $3,078 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Disability | 163 | Jan 1, 2026 | $26,841 | $2,416 |
| FIDELITY SECURITY LIFE INSURANCE COMPANY | Vision | 178 | Jan 1, 2026 | $11,156 | $1,144 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | — | 84 | Jan 1, 2026 | $2,249 | $337 |
| FIDELITY SECURITY LIFE INSURANCE COMPANY | Vision | 0 | Jan 1, 2026 | — | $244 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | — | 164 | Jan 1, 2026 | $1,405 | $211 |
| FIDELITY SECURITY LIFE INSURANCE COMPANY | Vision | 1 | Jan 1, 2026 | $65 | $5 |
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.
How this plan compares
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