2023 Form 5500 filing — 40 Square Health Plan Trust
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 20240731152510NAL0021788577001) for 40 Square Health Plan Trust, reported by 40 Square Cooperative Solutions under EIN 35-2605951 and plan number 501. It reports 343 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20240731152510NAL0021788577001
- Filing year
- 2023
- Form type
- 3
- Plan sponsor
- 40 Square Cooperative Solutions
- EIN
- 35-2605951
- Plan number
- 501
- Location
- Bloomington, MN
- Participants
- 343
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $1,225,910
- Total liabilities (EOY)
- $981,253
- Net assets (EOY)
- $244,657
- Employer contributions
- $4,697,952
- Total income / additions
- $4,697,952
- Benefits paid
- $2,864,783
- Administrative expenses
- $2,153,644
- Total expenses
- $5,018,427
- Net increase / (decrease)
- -$320,475
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Pf Re, Inc | NONE | $553,121 | not reported in the loaded dataset |
| Concord Management Resources | NONE | $439,282 | not reported in the loaded dataset |
| 40 Square Cooperative Solutions | NONE | $335,744 | not reported in the loaded dataset |
| Aetna | NOEN | $226,894 | not reported in the loaded dataset |
| Reliance Standard | NONE | $59,635 | not reported in the loaded dataset |
| Windsor Strategy Partners, Inc | NONE | $42,000 | not reported in the loaded dataset |
| Ifc | NONE | $40,752 | not reported in the loaded dataset |
| Hcp National Insurance Services | NONE | $38,488 | not reported in the loaded dataset |
| Withumsmith+Brown | NONE | $27,456 | not reported in the loaded dataset |
| Strategic Underwriting Solutions | NONE | $18,655 | not reported in the loaded dataset |
| Great Plains Financial | NONE | $18,450 | not reported in the loaded dataset |
| Genova Burns | NONE | $17,633 | not reported in the loaded dataset |
| Farmers Union Insurance Agency | NONE | $9,990 | not reported in the loaded dataset |
| Amy Nesemeier | NONE | $8,595 | not reported in the loaded dataset |
| Cal Jeremiason Agency Inc | NONE | $7,740 | not reported in the loaded dataset |
| Risty Benefits | NONE | $6,498 | not reported in the loaded dataset |