# PINE HAVEN CHRISTIAN HOME, INC. EMPLOYEE BENEFITS PLAN

Health and welfare plan sponsored by **PINE HAVEN CHRISTIAN HOME, INC.**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | PINE HAVEN CHRISTIAN HOME, INC. |
| EIN | 390816900 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | SHEBOYGAN, WI |
| Industry | hospital & health care |
| Funding | fully insured |
| Total premiums | $1.0M |
| Participants | 110 |
| Persons covered | 122 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| PREVEA360 HEALTH PLAN | Health |
| DELTA DENTAL OF WISCONSIN | Dental |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Life, Other |
| WYSSTA INSURANCE COMPANY INC | Vision |

## Brokers

| Broker | Placed with |
|---|---|
| M3 INSURANCE SOLUTIONS INC | PREVEA360 HEALTH PLAN |
| M3 INSURANCE SOLUTIONS INC | DELTA DENTAL OF WISCONSIN |
| M3 INSURANCE SOLUTIONS INC | RELIANCE STANDARD LIFE INSURANCE COMPANY |
| WATCHTOWER TECHNOLOGIES INC | RELIANCE STANDARD LIFE INSURANCE COMPANY |
| ALERA GROUP, INC. | RELIANCE STANDARD LIFE INSURANCE COMPANY |
| M3 INSURANCE SOLUTIONS 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/390816900-501
- Cite as: PlanOptica, https://planoptica.com/welfare/390816900-501
- More: https://planoptica.com/llms.txt · API waitlist: https://planoptica.com/developers