2023 Form 5500 filing — Great Bay Distributors, Inc. Self-Funded Employee Benefit 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 20250311151857NAL0017704993001) for Great Bay Distributors, Inc. Self-Funded Employee Benefit Plan, reported by Great Bay Distributors, Inc. under EIN 59-1196133 and plan number 501. It reports 336 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20250311151857NAL0017704993001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Great Bay Distributors, Inc.
- EIN
- 59-1196133
- Plan number
- 501
- Location
- St. Petersburg, FL
- Participants
- 336
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $369,441
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $369,441
- Employer contributions
- $1,307,470
- Participant contributions
- $1,459,946
- Total income / additions
- $2,767,416
- Benefits paid
- $3,165,363
- Administrative expenses
- $405,252
- Total expenses
- $3,570,615
- Net increase / (decrease)
- -$803,199
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Boon-Chapman | THIRD PARTY ADMIN | $131,787 | not reported in the loaded dataset |
| Bevcap Management, LLC | PROGRAM MANAGEMENT | $114,240 | not reported in the loaded dataset |
| Aetna - Ppo | INSURANCE PROVIDER | $73,326 | not reported in the loaded dataset |
| Bevcap Health Protected Cell L | PROGRAM MANAGEMENT | $29,428 | not reported in the loaded dataset |
| Retro Health, LLC | SERVICE PROVIDER | $25,375 | not reported in the loaded dataset |
| Elixir Pharmacy | BENEFITS MANAGEMENT | $11,424 | not reported in the loaded dataset |
| The Phia Group, LLC | DOCUMENT MANAGER | $9,860 | not reported in the loaded dataset |
| 98point6 | SERVICE PROVIDER | $9,811 | not reported in the loaded dataset |