2023 Form 5500 filing — Best One Tire O-K-T Employees' 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 20241015112504NAL0016227283001) for Best One Tire O-K-T Employees' Benefit Plan, reported by Best One Tire And Service Employees Association, LLC under EIN 26-6731594 and plan number 504. It reports 2,075 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241015112504NAL0016227283001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Best One Tire And Service Employees Association, LLC
- EIN
- 26-6731594
- Plan number
- 504
- Location
- Monroe, IN
- Participants
- 2,075
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $786,942
- Net assets (EOY)
- $786,942
- Employer contributions
- $12,058,335
- Participant contributions
- $5,080,098
- Total income / additions
- $17,223,128
- Benefits paid
- $12,405,358
- Administrative expenses
- $5,117,514
- Total expenses
- $17,522,872
- Net increase / (decrease)
- -$299,744
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Ingeniorx, Inc | NONE | $0 | $1,260,237 |
| Anthem Insurance Companies, Inc. | NONE | $812,126 | not reported in the loaded dataset |
| Delta Dental Of Indiana | NONE | $482,896 | not reported in the loaded dataset |
| M&Z Llp | NONE | $285,743 | not reported in the loaded dataset |
| Hylant Group | NONE | $135,762 | not reported in the loaded dataset |
| Forvis Mazars, Llp | NONE | $18,325 | not reported in the loaded dataset |
| Gallagher Benefit Services | NONE | $0 | $1,313 |