# LAKE RIDGE BANK EMPLOYEE BENEFITS PLAN

Health and welfare plan sponsored by **LAKE RIDGE BANK**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | LAKE RIDGE BANK |
| EIN | 390634040 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | MONONA, WI |
| Industry | financial services |
| Funding | mixed |
| Total premiums | $4.8M |
| Participants | 370 |
| Persons covered | 664 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| QUARTZ HEALTH BENEFIT PLANS CORPORATION | Health, Rx, HMO |
| STANDARD INSURANCE COMPANY | Life, Other, LTD, Indemnity |
| WYSSTA INSURANCE COMPANY INC | Vision |

## Brokers

| Broker | Placed with |
|---|---|
| HAUSMANN-JOHNSON INSURANCE INC | QUARTZ HEALTH BENEFIT PLANS CORPORATION |
| HAUSMANN GROUP INC | STANDARD INSURANCE COMPANY |
| HAUSMANN GROUP INC | WYSSTA INSURANCE COMPANY INC |

## About this data

- Source: public Form 5500 filings from the U.S. Department of Labor (EBSA), rebuilt on each DOL release.
- Full page (charts, history, peer benchmarks, fees, contacts): https://planoptica.com/welfare/390634040-501
- Cite as: PlanOptica, https://planoptica.com/welfare/390634040-501
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