2023 Form 5500 filing — Uebt Retiree 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 20241015185819NAL0030693841004) for Uebt Retiree Health Plan, reported by Uebt Retiree Health Plan under EIN 94-6078804 and plan number 501. It reports 13,853 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241015185819NAL0030693841004
- Filing year
- 2023
- Form type
- 1
- Plan sponsor
- Uebt Retiree Health Plan
- EIN
- 94-6078804
- Plan number
- 501
- Location
- Concord, CA
- Participants
- 13,853
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $81,334,819
- Total liabilities (EOY)
- $6,804,873
- Net assets (EOY)
- $74,529,946
- Employer contributions
- $75,863,022
- Participant contributions
- $27,794,536
- Total income / additions
- $113,420,076
- Benefits paid
- $85,311,972
- Administrative expenses
- $9,863,918
- Total expenses
- $95,175,890
- Net increase / (decrease)
- $18,244,186
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Ufcw Group Administration LLC | SALARIED ADMINSTRATOR | $7,080,055 | not reported in the loaded dataset |
| Blue Shield Of California | NONE | $314,571 | $0 |
| Eide Bailly Llp | NONE | $314,083 | not reported in the loaded dataset |
| Segal Company | NONE | $228,460 | not reported in the loaded dataset |
| Horizon Actuarial Services, LLC | NONE | $199,735 | not reported in the loaded dataset |
| Ufcw Local 5 | SPONSOR | $186,005 | not reported in the loaded dataset |
| Vision Service Plan | NONE | $142,908 | not reported in the loaded dataset |
| Ufcw Local 8 | SPONSOR | $130,605 | not reported in the loaded dataset |
| Delta Dental | NONE | $127,231 | not reported in the loaded dataset |
| Part D Advisors, Inc. | NONE | $100,924 | not reported in the loaded dataset |
| Pharmacy Benefit Solutions | NONE | $95,776 | not reported in the loaded dataset |
| Seyfarth & Shaw | NONE | $94,962 | not reported in the loaded dataset |
| Envision Rx | NONE | $71,970 | not reported in the loaded dataset |
| Hgk Asset Management | NONE | $35,209 | $6,601 |
| Medexpert International Inc | NONE | $38,369 | not reported in the loaded dataset |
| Active Radar | NONE | $37,940 | $0 |
| Sav Rx | NONE | $33,267 | not reported in the loaded dataset |
| Ufcw Local 648 | SPONSOR | $31,908 | not reported in the loaded dataset |
| New England Pension Consultants | NONE | $16,797 | not reported in the loaded dataset |
| Mccraken, Stemmerman & Holsberry | NONE | $14,736 | not reported in the loaded dataset |
| Cobapayer Express | NONE | $12,345 | $0 |
| Cigna Dental | NONE | $9,021 | $0 |
| Podiatry Plan | NONE | $6,779 | not reported in the loaded dataset |