2023 Form 5500 filing — Capital Blue Cross Retiree Medical 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 20241008083632NAL0028170736001) for Capital Blue Cross Retiree Medical Plan, reported by Capital Blue Cross under EIN 23-0455154 and plan number 512. It reports 1,124 participants. Attached schedules in the loaded dataset include Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241008083632NAL0028170736001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Capital Blue Cross
- EIN
- 23-0455154
- Plan number
- 512
- Location
- Harrisburg, PA
- Participants
- 1,124
- Schedules available
- Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
This 2023 filing is loaded, but detailed Schedule H/I financial figures are not present for it in the current loaded dataset. Participant counts and filing identity above are reported; asset and contribution detail comes from the financial schedules where filed.
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Capital Advantage Insurance Company | CONTRACT ADMINISTRATOR | $33,743 | not reported in the loaded dataset |
| Capital Advantage Assurance Company | CONTRACT ADMINISTRATOR | $21,618 | not reported in the loaded dataset |