2023 Form 5500 filing — Fallon Community Health Plan, Inc. 401(K) 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 20241010141021NAL0020264721001) for Fallon Community Health Plan, Inc. 401(K) Plan, reported by Fallon Community Health Plan under EIN 23-7442369 and plan number 003. It reports 1,683 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241010141021NAL0020264721001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Fallon Community Health Plan
- EIN
- 23-7442369
- Plan number
- 003
- Location
- Worcester, MA
- Participants
- 1,683
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $148,906,286
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $148,906,286
- Employer contributions
- $3,888,113
- Participant contributions
- $8,597,155
- Total income / additions
- $33,557,241
- Benefits paid
- $15,590,569
- Administrative expenses
- $194,088
- Total expenses
- $15,888,745
- Net increase / (decrease)
- $17,668,496
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Empower Annuity Insurance Company O | RECORDKEEPER | $192,475 | $0 |
| Qdro Consultants Company, LLC | OTHER | $1,200 | not reported in the loaded dataset |
| Empower Advisory Group, LLC | INVESTMENT MGMT | $413 | not reported in the loaded dataset |