2023 Form 5500 filing — Wormtown Brewery, LLC Employee Group Medical Plan (501)
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 20250911161410NAL0000965312001) for Wormtown Brewery, LLC Employee Group Medical Plan (501), reported by Wormtown Brewery, Inc. under EIN 27-0577027 and plan number 501. It reports 27 participants. Attached schedules in the loaded dataset include Schedule I (small plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20250911161410NAL0000965312001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Wormtown Brewery, Inc.
- EIN
- 27-0577027
- Plan number
- 501
- Location
- Worcester, MA
- Participants
- 27
- Schedules available
- Schedule I, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $5,677
- Total liabilities (EOY)
- $32,631
- Net assets (EOY)
- -$26,954
- Employer contributions
- $287,406
- Participant contributions
- $0
- Total income / additions
- $288,098
- Benefits paid
- $175,153
- Administrative expenses
- $13,698
- Total expenses
- $315,052
- Net increase / (decrease)
- -$26,954
- Schedule source
- Schedule I
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Health Plans, Inc | ADMIN | $13,698 | not reported in the loaded dataset |
| Richards, Inc. | BROKER | $8,295 | not reported in the loaded dataset |
| The Benecon Group | BROKER | $5,923 | not reported in the loaded dataset |
| Connectcare3 | PATIENT ADVOCATE | $1,294 | not reported in the loaded dataset |