2023 Form 5500 filing — Energycap, LLC Group Medical 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 20240606144215NAL0035867472001) for Energycap, LLC Group Medical Plan, reported by Energycap, LLC under EIN 27-1272222 and plan number 501. It reports 83 participants. Attached schedules in the loaded dataset include Schedule I (small plan financials), Schedule C (service provider compensation).
Form 5500 2 · 2023
Filing snapshot
Net assets (EOY)-$25.4KReported net assets-$25,357
Participants83
Provider compensation$21.4K4 Schedule C row(s)$21,430
Schedules filedSchedule I, Schedule CLoaded schedules
- EFAST2 acknowledgement
- 20240606144215NAL0035867472001
- Plan sponsor
- Energycap, LLC
- EIN
- 27-1272222
- Plan number
- 501
- Location
- Boalsburg, PA
- Received date
- not reported in the loaded dataset
Schedule I · 2023
Reported financial snapshot
Reported figures as filed, in whole dollars. Only fields the filing reports are shown.
Reported balance (end of year)$168.7K total assets
Net assets-$25.4KLiabilities$194.1K
Full reported line items
- Total assets (EOY)
- $168,712
- Total liabilities (EOY)
- $194,069
- Net assets (EOY)
- -$25,357
- Employer contributions
- $479,129
- Participant contributions
- $5,739
- Total income / additions
- $491,776
- Benefits paid
- $429,573
- Administrative expenses
- $1,794
- Total expenses
- $632,375
- Net increase / (decrease)
- -$140,599
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| First National Insurance Agency | BROKER | $10,465 | not reported in the loaded dataset |
| The Benecon Group LLC | BROKER | $7,586 | not reported in the loaded dataset |
| Capital Bluecross | ADMIN | $1,794 | not reported in the loaded dataset |
| Connectcare3 | PATIENT ADVOCATE | $1,585 | not reported in the loaded dataset |