2023 Form 5500 filing — Medben Employee Prescription Welfare Benefit 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 20241015094101NAL0048699904001) for Medben Employee Prescription Welfare Benefit Plan, reported by Medical Benefits Mutual Life Insurance Co. under EIN 31-4210910 and plan number 502. It reports 121 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials).
Form 5500 2 · 2023
Filing snapshot
Net assets (EOY)-$10.8KReported net assets-$10,827
Participants121
Provider compensationNone reported
Schedules filedSchedule HLoaded schedules
- EFAST2 acknowledgement
- 20241015094101NAL0048699904001
- Plan sponsor
- Medical Benefits Mutual Life Insurance Co.
- EIN
- 31-4210910
- Plan number
- 502
- Location
- Newark, OH
- Received date
- not reported in the loaded dataset
Schedule H · 2023
Reported financial snapshot
Reported figures as filed, in whole dollars. Only fields the filing reports are shown.
Reported balance (end of year)$2.2K total assets
Net assets-$10.8KLiabilities$13K
Full reported line items
- Total assets (EOY)
- $2,204
- Total liabilities (EOY)
- $13,031
- Net assets (EOY)
- -$10,827
- Employer contributions
- $130,917
- Total income / additions
- $130,917
- Benefits paid
- $138,363
- Administrative expenses
- $0
- Total expenses
- $138,363
- Net increase / (decrease)
- -$7,446