2023 Form 5500 filing — Marietta Country Club, Inc. Group Medical Plan (502)
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 20250122083502NAL0007334768001) for Marietta Country Club, Inc. Group Medical Plan (502), reported by Marietta Country Club, Inc. under EIN 58-0336450 and plan number 502. It reports 65 participants. Attached schedules in the loaded dataset include Schedule I (small plan financials), Schedule C (service provider compensation).
Form 5500 2 · 2023
Filing snapshot
Net assets (EOY)-$12.7KReported net assets-$12,663
Participants65
Provider compensation$51.6K4 Schedule C row(s)$51,558
Schedules filedSchedule I, Schedule CLoaded schedules
- EFAST2 acknowledgement
- 20250122083502NAL0007334768001
- Plan sponsor
- Marietta Country Club, Inc.
- EIN
- 58-0336450
- Plan number
- 502
- Location
- Kennesaw, GA
- Received date
- not reported in the loaded dataset
Schedule I · 2023
Reported financial snapshot
Reported figures as filed, in whole dollars. Only fields the filing reports are shown.
Reported balance (end of year)$23.1K total assets
Net assets-$12.7KLiabilities$35.8K
Full reported line items
- Total assets (EOY)
- $23,101
- Total liabilities (EOY)
- $35,764
- Net assets (EOY)
- -$12,663
- Employer contributions
- $409,740
- Participant contributions
- $175,141
- Total income / additions
- $585,825
- Benefits paid
- $323,191
- Administrative expenses
- $2,691
- Total expenses
- $598,488
- Net increase / (decrease)
- -$12,663
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Capstone Hire Benefits Consulting L | BROKER | $30,160 | not reported in the loaded dataset |
| The Benecon Group | BROKER | $14,590 | not reported in the loaded dataset |
| Connectcare3 | PATIENT ADVOCATE | $4,117 | not reported in the loaded dataset |
| Meritain Health, An Aetna Company | ADMIN | $2,691 | not reported in the loaded dataset |