# FSI, INC. GROUP LIFE AND DISABILITY PLAN

Health and welfare plan sponsored by **FSI, INC.**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | FSI, INC. |
| EIN | 391751953 |
| Plan number | 503 |
| Plan year | 2025 |
| Location | PORTAGE, WI |
| Industry | Accommodation and Food Services |
| Funding | fully insured |
| Total premiums | $205K |
| Participants | 498 |
| Persons covered | 301 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, STD, LTD, Other |

## Brokers

| Broker | Placed with |
|---|---|
| ASSUREDPARTNERS | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| MATTHEW C HARSH | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| KATIE AUSTIN SELZ | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| GERALD A GREENEN | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| VALUE ADDED SOLUTIONS | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| DANIEL SELZ | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| MARY R ROEMER | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| WENDY L SENN | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| CORCORAN & HOYT LLC | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| ERICK TAVAREZ | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| JODY ANN WALL | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| YESENIA A HERNANDEZ | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| DEBORAH ELIZABETH MAXWELL | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| JOESPH PATRICK HOFFMAN | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| DANIELS SOLUTIONS LLC | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| MARK HOLZINGER | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| OWENS EMPLOYEE BENEFITS OF FLORIDA | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| BARBARA SAXTON | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| ELAISIUS BONNER | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |

## 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/391751953-503
- Cite as: PlanOptica, https://planoptica.com/welfare/391751953-503
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