2023 Form 5500 filing — Country Cupboard Inn Cafeteria Plan
Plain-English filing summary
According to public Form 5500 filings published through the U.S. Department of Labor (DOL) Employee Benefits Security Administration (EBSA) via the EFAST2 system, this is the 2023 Form 5500 filing (EFAST2 acknowledgement 20240604122827NAL0010354915001) for Country Cupboard Inn Cafeteria Plan, reported by Country Cupboard Inn under EIN 23-2361693 and plan number 501. It reports 28 participants. Attached schedules in the loaded dataset include Schedule I (small plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20240604122827NAL0010354915001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Country Cupboard Inn
- EIN
- 23-2361693
- Plan number
- 501
- Location
- Lewisburg, PA
- Participants
- 28
- Schedules available
- Schedule I, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $53,001
- Total liabilities (EOY)
- $18,872
- Net assets (EOY)
- $34,129
- Employer contributions
- $316,924
- Participant contributions
- $109
- Total income / additions
- $317,930
- Benefits paid
- $171,876
- Administrative expenses
- $13,821
- Total expenses
- $291,489
- Net increase / (decrease)
- $26,441
- Schedule source
- Schedule I
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Geisinger Health Plan | ADMIN | $13,821 | not reported in the loaded dataset |
| Brown & Brown (Pa) | BROKER | $10,740 | not reported in the loaded dataset |
| Brown & Brown Of Pa | BROKER | $10,740 | not reported in the loaded dataset |
| The Benecon Group, LLC | BROKER | $6,891 | not reported in the loaded dataset |
| Connectcare 3 | OTHER | $1,880 | not reported in the loaded dataset |
| Innovu | BROKER | $1,444 | not reported in the loaded dataset |