Qualtrics Health & Welfare Plan — Form 5500 plan (Qualtrics, LLC)
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, Qualtrics Health & Welfare Plan is a benefit plan reported by Qualtrics, LLC under EIN 45-4964116 and plan number 501. The latest loaded filing year is 2023. The filing reports 4,009 participants and not reported in the loaded dataset in end-of-year plan assets, where available in the loaded dataset.
Key reported metrics
- Plan sponsor
- Qualtrics, LLC
- EIN
- 45-4964116
- Plan number
- 501
- Plan type
- 2
- Location
- Provo, UT
- Latest filing year
- 2023
- Participants
- 4,009
- End-of-year plan assets
- not reported in the loaded dataset
Form 5500 filing history
| Filing year | Participants | Schedules | Filing |
|---|---|---|---|
| 2023 | 4,009 | C | 20240816161329NAL0014807825001 |
Reported financial statement
This plan is loaded, but Schedule H / I financial-statement detail is not present for it in the current loaded dataset.
Service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. | Year |
|---|---|---|---|---|
| Aetna Life Insurance Company | CONTRACT ADMINISTRATOR | $1,503,992 | not reported in the loaded dataset | 2023 |
| Umr, Inc | CLAIMS PROCESSING | $412,283 | $17,036 | 2023 |
| Optumrx, Inc. | PHARMACY BENEFIT MANAGEME | $55,683 | $1,296 | 2023 |