St. Croix Chippewa Indians of Wisconsin
Overview
St. Croix Chippewa Indians of Wisconsin sponsors a self-funded health plan that covered 994 participants in plan year 2025, about the same as the prior year. The plan year starts in May. Alongside medical, its benefits filing reports life insurance, dental, vision, short-term disability, and more.
- Plan type
- ERISA welfare benefit plan, self-funded (benefits paid from employer assets or a trust)
- Participants
- 994 · prior year 1,006
- Plan year
- Begins May 1 · next renewal May 2027
- Health plans filed
- St. Croix Chippewa Indians of Wisconsin Health & Welfare Plan, plan 501 (994 participants)
- Broker compensation
- $14K across insured contracts
Insurance carriers
Insured coverage reported on Schedule A. Self-funded medical claims aren't reported there.
| Carrier | Coverage | Covered | Premium | Broker comp |
|---|---|---|---|---|
| Humana Insurance Company | Dental, Vision | 919 | $387K | $10K |
| Principal Life Insurance Company | Life, Long-term disability | 954 | $196K | $4K |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 994 participants × $2,371 national average per member. Usually higher once dependents are counted.
Typical savings opportunity found in independent reviews of plans this size.
Form 5500 filing details
- Filing
- Form 5500 with Schedule A, plan year 2025
- Plan sponsor
- St. Croix Chippewa Indians of Wisconsin
- Sponsor EIN
- 39-1210835
- Plan number
- 501
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 39-1210835 in the Department of Labor's EFAST2 Form 5500 search.
Retirement plan
- Plan
- St. Croix Chippewa Indians of Wisconsin Enterprise 401(k) Plan
- Type
- 401(k) plan
- Participants
- 157
About this data
Source: St. Croix Chippewa Indians of Wisconsin's Form 5500 filing for plan year 2025 and its Schedule A insurance reports, published by the U.S. Department of Labor. "Self-funded" means the filing reports benefits paid from employer assets or a trust, with no medical insurance contract or with a stop-loss contract. Pharmacy figures are StreamRX estimates based on national averages. StreamRX is not affiliated with St. Croix Chippewa Indians of Wisconsin.