2023 Form 5500 filing — Adrian Retiree Medical & Prescription Drug 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 20240501115850NAL0043439794001) for Adrian Retiree Medical & Prescription Drug Plan, reported by Adrian Retiree Medical & Prescription Drug Plan under EIN 33-1196416 and plan number 550. It reports 54 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials).
Form 5500 2 · 2023
Filing snapshot
Net assets (EOY)$1.5MReported net assets$1,474,050
Participants54
Provider compensationNone reported
Schedules filedSchedule HLoaded schedules
- EFAST2 acknowledgement
- 20240501115850NAL0043439794001
- Plan sponsor
- Adrian Retiree Medical & Prescription Drug Plan
- EIN
- 33-1196416
- Plan number
- 550
- Location
- Pittsford, MI
- Received date
- not reported in the loaded dataset
How to read this filing
- This is a single annual Form 5500 filing, identified by its EFAST2 acknowledgement id.
- Schedule chips (Sch H / I / C) show which schedules this filing includes.
- Net assets = total assets minus total liabilities (Schedule H/I).
- Fields a filing did not report are labeled not reported in the loaded dataset — never estimated.
- For the plan's full history, open the plan profile.
Schedule H · 2023
Reported financial snapshot
Reported figures as filed, in whole dollars. Only fields the filing reports are shown.
Reported balance (end of year)$1.5M total assets
Net assets$1.5MLiabilities$1.5K
Full reported line items
- Total assets (EOY)
- $1,475,530
- Total liabilities (EOY)
- $1,480
- Net assets (EOY)
- $1,474,050
- Total income / additions
- -$10,186
- Benefits paid
- $324,164
- Administrative expenses
- $29,359
- Total expenses
- $353,523
- Net increase / (decrease)
- -$363,709
Frequently asked questions
- What does EFAST2 acknowledgement 20240501115850NAL0043439794001 cover?
- It is the 2023 Form 5500 filing for Adrian Retiree Medical & Prescription Drug Plan, reported by Adrian Retiree Medical & Prescription Drug Plan (EIN 33-1196416).
- Which Form 5500 schedules are attached to this 2023 filing?
- Attached schedules in the loaded dataset include Schedule H (large plan financials).