2023 Form 5500 filing — Medben Employee Medical 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 20241015093949NAL0048696624001) for Medben Employee Medical Welfare Benefit Plan, reported by Medical Benefits Mutual Life Insurance Co. under EIN 31-4210910 and plan number 501. It reports 121 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).

EFAST2 acknowledgement
20241015093949NAL0048696624001
Filing year
2023
Form type
2
Plan sponsor
Medical Benefits Mutual Life Insurance Co.
EIN
31-4210910
Plan number
501
Location
Newark, OH
Participants
121
Schedules available
Schedule H, Schedule C
Received date
not reported in the loaded dataset

Reported financial snapshot (2023)

Total assets (EOY)
$23,149
Total liabilities (EOY)
$121,995
Net assets (EOY)
-$98,846
Employer contributions
$1,299,000
Participant contributions
$202,723
Total income / additions
$1,501,723
Benefits paid
$1,516,149
Administrative expenses
$21,499
Total expenses
$1,537,648
Net increase / (decrease)
-$35,925
Schedule source
Schedule H

Reported service provider compensation (Schedule C)

Compensation reported on the 2023 filing
ProviderServiceDirect comp.Indirect comp.
Quality Care PartnersCONTRACT$14,220$0

Related Form 5500 pages