2023 Form 5500 filing — Medben Employee Prescription 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 20241015094101NAL0048699904001) for Medben Employee Prescription Welfare Benefit Plan, reported by Medical Benefits Mutual Life Insurance Co. under EIN 31-4210910 and plan number 502. It reports 121 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials).

EFAST2 acknowledgement
20241015094101NAL0048699904001
Filing year
2023
Form type
2
Plan sponsor
Medical Benefits Mutual Life Insurance Co.
EIN
31-4210910
Plan number
502
Location
Newark, OH
Participants
121
Schedules available
Schedule H
Received date
not reported in the loaded dataset

Reported financial snapshot (2023)

Total assets (EOY)
$2,204
Total liabilities (EOY)
$13,031
Net assets (EOY)
-$10,827
Employer contributions
$130,917
Total income / additions
$130,917
Benefits paid
$138,363
Administrative expenses
$0
Total expenses
$138,363
Net increase / (decrease)
-$7,446
Schedule source
Schedule H

Related Form 5500 pages