2023 Form 5500 filing — Village Discount Outlet, Inc. Participant Benefit 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 20250226094400NAL0000498179001) for Village Discount Outlet, Inc. Participant Benefit Health Plan, reported by Village Discount Outlet, Inc. under EIN 36-2472377 and plan number 501. It reports 72 participants. Attached schedules in the loaded dataset include Schedule I (small plan financials), Schedule C (service provider compensation).
Form 5500 2 · 2023
Filing snapshot
Net assets (EOY)$0Reported net assets
Participants72
Provider compensation$612.7K24 Schedule C row(s)$612,687
Schedules filedSchedule I, Schedule CLoaded schedules
- EFAST2 acknowledgement
- 20250226094400NAL0000498179001
- Plan sponsor
- Village Discount Outlet, Inc.
- EIN
- 36-2472377
- Plan number
- 501
- Location
- Blue Island, IL
- Received date
- not reported in the loaded dataset
Schedule I · 2023
Reported financial snapshot
Reported figures as filed, in whole dollars. Only fields the filing reports are shown.
Full reported line items
- Total assets (EOY)
- $0
- Net assets (EOY)
- $0
- Employer contributions
- $11,271
- Participant contributions
- $650,283
- Total income / additions
- $661,554
- Benefits paid
- $699,202
- Total expenses
- $699,202
- Net increase / (decrease)
- -$37,648
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Optum Rx, Inc | PHARMACY BENEFIT MANAGEM | $106,858 | $472 |
| Osf Little Company Of Mary Med | NONE | $82,464 | not reported in the loaded dataset |
| Northwestern Mem Hosp | NONE | $65,053 | not reported in the loaded dataset |
| Umr, Inc. | CLAIMS PROCESSING | $62,374 | $472 |
| Loyola University Med Ct | NONE | $35,715 | not reported in the loaded dataset |
| Advocate Illinois Masonic | NONE | $33,109 | not reported in the loaded dataset |
| Presence Saints Mary And Eliza | NONE | $29,978 | not reported in the loaded dataset |
| Central Nursing Home | NONE | $28,339 | not reported in the loaded dataset |
| The Community Hospital | NONE | $23,693 | not reported in the loaded dataset |
| University Of Chicago Medical | NONE | $23,138 | not reported in the loaded dataset |
| Franciscan Health Olympia Fiel | NONE | $19,607 | not reported in the loaded dataset |
| Presence Saint Francis Hospital | NONE | $12,264 | not reported in the loaded dataset |
| Dupage Medical Group Ltd | NONE | $10,213 | not reported in the loaded dataset |
| Swedish Hospital | NONE | $8,722 | not reported in the loaded dataset |
| Erie Family Health Ctr | NONE | $8,291 | not reported in the loaded dataset |
| Macneal Hospital | NONE | $7,850 | not reported in the loaded dataset |
| Midwest Pulmonary And Critical | NONE | $7,682 | not reported in the loaded dataset |
| Gallagher Benefit Services Inc | BROKER | $7,650 | not reported in the loaded dataset |
| Northshore University Healthsy | NONE | $7,515 | not reported in the loaded dataset |
| Laboratory Corporation Of Amer | NONE | $6,937 | not reported in the loaded dataset |
| Quest Diagnostics Wood Da | NONE | $6,575 | not reported in the loaded dataset |
| Pediatric Faculty Foundation | NONE | $6,194 | not reported in the loaded dataset |
| John H Stroger Hospital | NONE | $6,072 | not reported in the loaded dataset |
| Eldin Karaikovic | NONE | $5,450 | not reported in the loaded dataset |