2023 Form 5500 filing — Keystone Custom Management, LLC Group Health 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 20250827100516NAL0009269201001) for Keystone Custom Management, LLC Group Health Plan, reported by Keystone Custom Management, LLC under EIN 82-3599092 and plan number 501. It reports 56 participants. Attached schedules in the loaded dataset include Schedule I (small plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20250827100516NAL0009269201001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Keystone Custom Management, LLC
- EIN
- 82-3599092
- Plan number
- 501
- Location
- Lancaster, PA
- Participants
- 56
- Schedules available
- Schedule I, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $52,657
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $52,657
- Employer contributions
- -$251,482
- Participant contributions
- $650,232
- Total income / additions
- $399,544
- Benefits paid
- $158,894
- Administrative expenses
- $0
- Total expenses
- $158,893
- Net increase / (decrease)
- $240,651
- Schedule source
- Schedule I
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Gunn Mowery, LLC | BROKER | $12,933 | not reported in the loaded dataset |
| The Benecon Group | BROKER | $7,803 | not reported in the loaded dataset |
| Highmark, Inc | ADMIN | $2,572 | not reported in the loaded dataset |
| Connectcare3 | PATIENT ADVOCATE | $2,036 | not reported in the loaded dataset |