2023 Form 5500 filing — Montana Retail Store Employees Health And Welfare 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 20250715164903NAL0002476769002) for Montana Retail Store Employees Health And Welfare Plan, reported by Montana Retail Store Employees Health And Welfare Plan Board Of Truste under EIN 81-0305103 and plan number 501. It reports 875 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20250715164903NAL0002476769002
- Filing year
- 2023
- Form type
- 1
- Plan sponsor
- Montana Retail Store Employees Health And Welfare Plan Board Of Truste
- EIN
- 81-0305103
- Plan number
- 501
- Location
- Spokane, WA
- Participants
- 875
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $17,635,711
- Total liabilities (EOY)
- $2,872,214
- Net assets (EOY)
- $14,763,497
- Employer contributions
- $12,144,030
- Participant contributions
- $763,554
- Total income / additions
- $14,054,748
- Benefits paid
- $11,722,579
- Administrative expenses
- $688,880
- Total expenses
- $12,411,459
- Net increase / (decrease)
- $1,643,289
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| A.W. Rehn & Associates | NONE | $370,231 | not reported in the loaded dataset |
| Medical Rehabilitation Consultants, | NONE | $227,082 | $0 |
| Smith Health Inc. | NONE | $134,123 | $0 |
| Alliant Insurance Services, Inc. | NONE | $88,000 | not reported in the loaded dataset |
| Reinhart Boerner Van Deuren S.C. | NONE | $84,102 | not reported in the loaded dataset |
| First Choice Health Network, Inc. | NONE | $80,274 | not reported in the loaded dataset |
| Interlink Care Management, Inc. | NONE | $40,330 | not reported in the loaded dataset |
| Quantify Health LLC | NONE | $38,269 | not reported in the loaded dataset |
| Lawton Printing, Inc. | NONE | $24,063 | not reported in the loaded dataset |
| Legacy Professionals Llp | NONE | $23,955 | not reported in the loaded dataset |
| Health Risk Strategies | NONE | $5,700 | $18,000 |
| Multiplan Corporation | NONE | $18,581 | $0 |
| Washington Trust Bank | NONE | $17,785 | not reported in the loaded dataset |
| Frsecure LLC | NONE | $12,375 | not reported in the loaded dataset |
| Paulette Duryee | ALTERNATE TRUSTEE | $8,256 | not reported in the loaded dataset |
| Vision Service Plan | NONE | $7,781 | not reported in the loaded dataset |
| Nicolai Cocergine | TRUSTEE | $6,230 | not reported in the loaded dataset |
| Usi Consulting Group, Inc. | NONE | $5,600 | not reported in the loaded dataset |