Keystone Independence Management Group Medical Plan (501) — Form 5500 plan (Keystone Independence Management)
Plain-English plan 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, Keystone Independence Management Group Medical Plan (501) is a benefit plan reported by Keystone Independence Management under EIN 25-1876726 and plan number 501. The latest loaded filing year is 2023. The filing reports 33 participants and $2,701 in end-of-year plan assets, where available in the loaded dataset.
Key reported metrics
- Plan sponsor
- Keystone Independence Management
- EIN
- 25-1876726
- Plan number
- 501
- Plan type
- 2
- Location
- Hermitage, PA
- Latest filing year
- 2023
- Participants
- 33
- End-of-year plan assets
- $2,701
Form 5500 filing history
| Filing year | Participants | Schedules | Filing |
|---|---|---|---|
| 2023 | 33 | I, C | 20240923075052NAL0022959810001 |
Reported financial statement (2023 · Schedule I)
Net assets
- Total assets (EOY)
- $2,701
- Total liabilities (EOY)
- $373,319
- Net assets (EOY)
- -$370,618
- Net assets (BOY)
- -$359,652
Income & contributions
- Employer contributions
- $465,623
- Participant contributions
- $50,498
- Total income / additions
- $516,436
Expenses & distributions
- Benefits paid
- $339,528
- Administrative expenses
- $3,872
- Total expenses
- $527,402
- Net increase / (decrease)
- -$10,966
Service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. | Year |
|---|---|---|---|---|
| The Benecon Group, LLC | BROKER | $9,459 | not reported in the loaded dataset | 2023 |
| The Djb Group | BROKER | $9,175 | not reported in the loaded dataset | 2023 |
| First National Insurance Agency | BROKER | $4,000 | not reported in the loaded dataset | 2023 |
| Meritain Health, An Aetna Company | ADMIN | $3,872 | not reported in the loaded dataset | 2023 |
| Connectcare3 LLC | PATIENT ADVOCATE | $2,004 | not reported in the loaded dataset | 2023 |
Related Form 5500 pages
- All Form 5500 plans for Keystone Independence Management
- 2023 Form 5500 filing
- Form 5500 filings in PA
- 401(k) and benefit plan filings in Hermitage, PA
- The Benecon Group, LLC — Schedule C compensation
- The Djb Group — Schedule C compensation
- First National Insurance Agency — Schedule C compensation
- Meritain Health, An Aetna Company — Schedule C compensation
- Connectcare3 LLC — Schedule C compensation