2023 Form 5500 filing — Src Benefits Programs Trust Health Insurance Fund
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 20241111144505NAL0032267378001) for Src Benefits Programs Trust Health Insurance Fund, reported by Src Holdings Corporation under EIN 43-1274934 and plan number 502. It reports 1,155 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241111144505NAL0032267378001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Src Holdings Corporation
- EIN
- 43-1274934
- Plan number
- 502
- Location
- Springfield, MO
- Participants
- 1,155
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $97,649
- Total liabilities (EOY)
- $1,329,076
- Net assets (EOY)
- -$1,231,427
- Employer contributions
- $9,198,295
- Participant contributions
- $2,065,046
- Total income / additions
- $11,388,800
- Benefits paid
- $11,723,683
- Administrative expenses
- $740,670
- Total expenses
- $12,464,353
- Net increase / (decrease)
- -$1,075,553
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Med-Pay, Inc. | CONTRACT ADMINISTRATOR | $196,506 | $106,851 |
| Payd Health | SPECIALTY RX ADMIN FEES | $74,240 | not reported in the loaded dataset |
| Zelis Claims Integrity Inc | PPO NETWORK ACCESS FEES | $56,366 | not reported in the loaded dataset |
| Healthlink | PPO NETWORK ACCESS FEES | $49,356 | not reported in the loaded dataset |
| Mercy Corporate Health & Wellness | WELLNESS COORDINATOR | $36,388 | not reported in the loaded dataset |
| Warrier Cost Management LLC | PPO NETWORK ACCESS FEES | $30,025 | not reported in the loaded dataset |
| Tellus Wellness, LLC | WELLNESS COORDINATOR | $25,518 | not reported in the loaded dataset |
| One America | EMPLOYEE ASSISTANCE PROGR | $16,038 | not reported in the loaded dataset |
| Valenz Claim | PPO NETWORK ACCESS FEES | $15,685 | not reported in the loaded dataset |
| Leaf Health | PRESCRIPTION ADMIN MKTING | $0 | $13,777 |
| Reliant Health Partners LLC | PPO NETWORK ACCESS FEES | $9,688 | not reported in the loaded dataset |
| Mercy Health Springfield Communitie | ONLINE DOCTOR/MEDICAL | $9,586 | not reported in the loaded dataset |
| National Bill Audit Services LLC | CLAIM AUDIT FEES | $6,617 | not reported in the loaded dataset |
| Mercy Corporate Health & Wellness | FLU SHOTS | $6,412 | not reported in the loaded dataset |