2023 Form 5500 filing — Southern Star Retiree Medical Coverage 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 20241010164704NAL0034794416001) for Southern Star Retiree Medical Coverage Plan, reported by Southern Star Central Gas Pipeline, Inc. under EIN 73-0183220 and plan number 505. It reports 298 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241010164704NAL0034794416001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Southern Star Central Gas Pipeline, Inc.
- EIN
- 73-0183220
- Plan number
- 505
- Location
- Owensboro, KY
- Participants
- 298
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $36,552,845
- Total liabilities (EOY)
- $139,177
- Net assets (EOY)
- $36,413,668
- Employer contributions
- $1,500,000
- Participant contributions
- $609,794
- Total income / additions
- $4,652,597
- Benefits paid
- $1,887,387
- Administrative expenses
- $251,911
- Total expenses
- $2,139,298
- Net increase / (decrease)
- $2,513,299
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| United Healthcare Services, Inc. | CLAIMS PROCESSOR | $240,888 | $0 |
| Verisoure Services, Inc. | NONE | $33,112 | not reported in the loaded dataset |
| U.S. Bank | TRUSTEE | $21,522 | not reported in the loaded dataset |
| Dean Dorton | NONE | $21,500 | not reported in the loaded dataset |
| Alliant Insurance Services | BROKER | $7,018 | not reported in the loaded dataset |