2023 Form 5500 filing — Excellus 401(K) 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 20241016132437NAL0053264016001) for Excellus 401(K) Plan, reported by Excellus Health Plan Inc. under EIN 15-0329043 and plan number 002. It reports 5,487 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241016132437NAL0053264016001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Excellus Health Plan Inc.
- EIN
- 15-0329043
- Plan number
- 002
- Location
- Rochester, NY
- Participants
- 5,487
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $751,275,360
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $751,275,360
- Employer contributions
- $29,772,776
- Participant contributions
- $36,158,279
- Total income / additions
- $192,559,141
- Benefits paid
- $59,705,461
- Administrative expenses
- $246,395
- Total expenses
- $59,989,651
- Net increase / (decrease)
- $132,569,490
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Fidelity Investments Institutional | RECORDKEEPER | $244,349 | $0 |
| Wealth Management Systems Inc | NONE | $0 | $0 |