2023 Form 5500 filing — Ici Benefits Consortium 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 20241011134443NAL0012554035001) for Ici Benefits Consortium Health Plan, reported by Ici Benefits Consortium under EIN 84-3411649 and plan number 501. It reports 736 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241011134443NAL0012554035001
- Filing year
- 2023
- Form type
- 3
- Plan sponsor
- Ici Benefits Consortium
- EIN
- 84-3411649
- Plan number
- 501
- Location
- Indianapolis, IN
- Participants
- 736
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $7,970,680
- Total liabilities (EOY)
- $2,342,933
- Net assets (EOY)
- $5,627,747
- Employer contributions
- $10,469,869
- Participant contributions
- $49,969
- Total income / additions
- $10,848,721
- Benefits paid
- $9,739,997
- Administrative expenses
- $866,365
- Total expenses
- $10,606,362
- Net increase / (decrease)
- $242,359
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Umr, Inc. | CLAIMS PROCESSING | $430,517 | $4,340 |
| Gallagher Benefit Services | PLAN ADMINISTRATOR / ACT | $165,000 | $0 |
| Bose Mckinney & Evans Llp | LEGAL SERVICES | $69,076 | not reported in the loaded dataset |
| Save On Sp, Llp | NONE | $48,749 | not reported in the loaded dataset |
| Nonprofit Financial Solutions | ACCOUNTANT | $29,036 | not reported in the loaded dataset |
| Brady Ware & Schoenfeld Inc | AUDIT/TAX SERVICES | $21,280 | not reported in the loaded dataset |
| Rx Benefits | NONE | $8,572 | not reported in the loaded dataset |
| Perpetual LLC | BROKER | $2,173 | not reported in the loaded dataset |