2023 Form 5500 filing — Southern Mill, Inc. Health And Dental Benefits 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 20241015082810NAL0056625538003) for Southern Mill, Inc. Health And Dental Benefits Plan, reported by Southern Mills, Inc. Tencate Protective Fabrics under EIN 58-0439110 and plan number 501. It reports 556 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241015082810NAL0056625538003
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Southern Mills, Inc. Tencate Protective Fabrics
- EIN
- 58-0439110
- Plan number
- 501
- Location
- Union City, GA
- Participants
- 556
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $579,920
- Total liabilities (EOY)
- $579,920
- Net assets (EOY)
- $0
- Employer contributions
- $3,710,414
- Participant contributions
- $2,025,803
- Total income / additions
- $5,736,217
- Benefits paid
- $5,423,175
- Administrative expenses
- $313,042
- Total expenses
- $5,736,217
- Net increase / (decrease)
- $0
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| United Healthcare Services Inc. | CLAIMS PROCESSOR | $328,320 | $0 |
| United Healthcare Services Inc. | CLAIMS PROCESSOR | $6,282 | not reported in the loaded dataset |