2023 Form 5500 filing — The Antler Room Self Funded Medical Reimbursement 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 20240829194505NAL0013554321002) for The Antler Room Self Funded Medical Reimbursement Plan, reported by The Antler Room under EIN 81-0808323 and plan number 501. It reports 13 participants. Attached schedules in the loaded dataset include Schedule I (small plan financials).
Form 5500 2 · 2023
Filing snapshot
Net assets (EOY)$21.8KReported net assets$21,839
Participants13
Provider compensationNone reported
Schedules filedSchedule ILoaded schedules
- EFAST2 acknowledgement
- 20240829194505NAL0013554321002
- Plan sponsor
- The Antler Room
- EIN
- 81-0808323
- Plan number
- 501
- Location
- Kansas City, MO
- 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 I · 2023
Reported financial snapshot
Reported figures as filed, in whole dollars. Only fields the filing reports are shown.
Reported balance (end of year)$21.8K total assets
Net assets$21.8KLiabilities—
Full reported line items
- Total assets (EOY)
- $21,839
- Net assets (EOY)
- $21,839
- Employer contributions
- $35,088
- Total income / additions
- $35,733
- Benefits paid
- $6,255
- Administrative expenses
- $7,639
- Total expenses
- $13,894
- Net increase / (decrease)
- $21,839
Frequently asked questions
- What does EFAST2 acknowledgement 20240829194505NAL0013554321002 cover?
- It is the 2023 Form 5500 filing for The Antler Room Self Funded Medical Reimbursement Plan, reported by The Antler Room (EIN 81-0808323).
- Which Form 5500 schedules are attached to this 2023 filing?
- Attached schedules in the loaded dataset include Schedule I (small plan financials).