2023 Form 5500 filing — America'S Floor Source, LLC Employee Health & Welfare Benefit 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 20241009123251NAL0037750930001) for America'S Floor Source, LLC Employee Health & Welfare Benefit Plan, reported by America'S Floor Source, LLC under EIN 31-1708199 and plan number 501. It reports 261 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241009123251NAL0037750930001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- America'S Floor Source, LLC
- EIN
- 31-1708199
- Plan number
- 501
- Location
- Columbus, OH
- Participants
- 261
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $1,249,909
- Total liabilities (EOY)
- $1,233,860
- Net assets (EOY)
- $16,049
- Employer contributions
- $2,663,269
- Participant contributions
- $1,431,782
- Total income / additions
- $4,102,901
- Benefits paid
- $3,755,751
- Administrative expenses
- $351,500
- Total expenses
- $4,107,251
- Net increase / (decrease)
- -$4,350
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Business Administrators & Cons Inc | CONTRACT ADMINISTRATOR | $235,359 | $0 |
| Labrador Brokerage Agency, LLC | INSURANCE AGENT | $80,004 | $0 |
| Cigna Health & Life Insurance Co | NETWORK PROVIDER | $29,815 | $0 |