2023 Form 5500 filing — Confederated Tribes Of Grand Ronde Employee Health 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 20240910112301NAL0012964498001) for Confederated Tribes Of Grand Ronde Employee Health Plan, reported by Confederated Tribes Of Grand Ronde Employee Welfare Benefits Trust under EIN 20-0805405 and plan number 502. It reports 1,393 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20240910112301NAL0012964498001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Confederated Tribes Of Grand Ronde Employee Welfare Benefits Trust
- EIN
- 20-0805405
- Plan number
- 502
- Location
- Grand Ronde, OR
- Participants
- 1,393
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $18,118,246
- Total liabilities (EOY)
- $1,888,363
- Net assets (EOY)
- $16,229,883
- Employer contributions
- $19,331,200
- Participant contributions
- $1,493,889
- Total income / additions
- $24,746,405
- Benefits paid
- $22,272,490
- Administrative expenses
- $1,001,331
- Total expenses
- $23,273,821
- Net increase / (decrease)
- $1,472,584
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Shasta Administrative Services | CONTRACT ADMINISTRATOR | $909,666 | not reported in the loaded dataset |
| Gallagher Benefit Services, Inc. | CONSULTANT | $27,000 | not reported in the loaded dataset |
| Optumrx/Catamaran/Restat LLC | CONTRACT ADMINISTRATOR | $20,260 | not reported in the loaded dataset |
| Redw, LLC | AUDITOR | $17,000 | not reported in the loaded dataset |
| Allegiance Benefit Plan Management | CONTRACT ADMINISTRATOR | $12,925 | not reported in the loaded dataset |
| Rsm Us Llp | AUDITOR | $6,600 | not reported in the loaded dataset |