2023 Form 5500 filing — Mavis Tire Supply 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 20241218142635NAL0002382291001) for Mavis Tire Supply Health Plan, reported by Mavis Tire Supply LLC under EIN 45-5259604 and plan number 502. It reports 3,147 participants. Attached schedules in the loaded dataset include Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241218142635NAL0002382291001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Mavis Tire Supply LLC
- EIN
- 45-5259604
- Plan number
- 502
- Location
- White Plains, NY
- Participants
- 3,147
- Schedules available
- Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
This 2023 filing is loaded, but detailed Schedule H/I financial figures are not present for it in the current loaded dataset. Participant counts and filing identity above are reported; asset and contribution detail comes from the financial schedules where filed.
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Cvs Caremark | not reported in the loaded dataset | $13,219,197 | $212,700 |
| Luminare Health Benefits, Inc. | not reported in the loaded dataset | $2,526,253 | not reported in the loaded dataset |
| Empire Healthchoice Assurance, Inc. | not reported in the loaded dataset | $472,785 | not reported in the loaded dataset |
| Teladoc | not reported in the loaded dataset | $58,292 | not reported in the loaded dataset |
| Acs - A Xerox Company | not reported in the loaded dataset | $17,115 | not reported in the loaded dataset |
| Heathcare Bluebook | not reported in the loaded dataset | $11,543 | not reported in the loaded dataset |