2023 Form 5500 filing — Elevance Health Retirees' Life Insurance 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 20241015203310NAL0015378339001) for Elevance Health Retirees' Life Insurance Plan, reported by Ath Holding Company LLC under EIN 11-3713086 and plan number 534. It reports 4,335 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241015203310NAL0015378339001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Ath Holding Company LLC
- EIN
- 11-3713086
- Plan number
- 534
- Location
- Indianapolis, IN
- Participants
- 4,335
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $16,994,989
- Total liabilities (EOY)
- $2,536,314
- Net assets (EOY)
- $14,458,675
- Employer contributions
- $556,647
- Participant contributions
- $618,486
- Total income / additions
- $3,597,295
- Benefits paid
- $3,711,447
- Administrative expenses
- $24,764
- Total expenses
- $3,736,211
- Net increase / (decrease)
- -$138,916
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Elevance Health, Inc. | PLAN ADMINISTRATOR | $24,108 | not reported in the loaded dataset |
| Jpmorgan Chase Bank, N.A. | TRUSTEE | $656 | $0 |