Form 5500 · Employee benefit plan · TOMAH, WI
TOMAH MEMORIAL HOSPITAL
TOMAH MEMORIAL HOSPITAL of TOMAH, WI files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is ASSUREDPARTNERS GREAT PLAINS, LLC. Coverage is written through DELTA DENTAL OF WISCONSIN and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 39-0799566 · plan 506 · as of Jul 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Commission |
|---|---|---|---|---|
| DELTA DENTAL OF WISCONSIN | Dental | 263 | December | $13,484 |
| WYSSTA INSURANCE COMPANY INC | Vision | 176 | December | $1,512 |
| COMPCARE HEALTH SERVICES INSURANCE CORPORATION | Health | 607 | December | $0 |
Questions
Who is TOMAH MEMORIAL HOSPITAL's benefits broker?
Per its most recent Form 5500 Schedule A, TOMAH MEMORIAL HOSPITAL's broker of record is ASSUREDPARTNERS GREAT PLAINS, LLC.
What insurance carrier does TOMAH MEMORIAL HOSPITAL use?
TOMAH MEMORIAL HOSPITAL's benefit plan is written through DELTA DENTAL OF WISCONSIN, among 3 disclosed carriers.
When does TOMAH MEMORIAL HOSPITAL's group plan renew?
The most recent Schedule A policy period for TOMAH MEMORIAL HOSPITAL ended in December. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from TOMAH MEMORIAL HOSPITAL's public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.