2023 Form 5500 filing — Kohl'S Group Health 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 20241015105930NAL0057111490001) for Kohl'S Group Health Plan, reported by Kohl'S, Inc. under EIN 13-3357362 and plan number 501. It reports 111,393 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241015105930NAL0057111490001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Kohl'S, Inc.
- EIN
- 13-3357362
- Plan number
- 501
- Location
- Menomonee Falls, WI
- Participants
- 111,393
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $15,335,444
- Total liabilities (EOY)
- $19,465,294
- Net assets (EOY)
- -$4,129,850
- Employer contributions
- $130,717,598
- Participant contributions
- $68,158,133
- Total income / additions
- $199,273,802
- Benefits paid
- $188,786,312
- Administrative expenses
- $12,488,200
- Total expenses
- $201,274,512
- Net increase / (decrease)
- -$2,000,710
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Cvs Health | PHARMACY MGMT | $38,539,448 | not reported in the loaded dataset |
| Blue Cross Blue Shield Of Wisconsin | CONTRACT ADMIN. | $6,114,799 | not reported in the loaded dataset |
| United Healthcare Services, Inc. | CLAIMS PROCESSING | $5,637,980 | not reported in the loaded dataset |
| Delta Dental Of Wisconsin | DENTAL ADMIN. | $512,908 | not reported in the loaded dataset |
| Prudentrx | NONE | $382,516 | not reported in the loaded dataset |
| Centivo | NONE | $206,198 | not reported in the loaded dataset |