2023 Form 5500 filing — Southwest Kansas Chambers Alliance Health Plan, Inc.
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 20250303164944NAL0011301490001) for Southwest Kansas Chambers Alliance Health Plan, Inc., reported by Southwest Kansas Chambers Alliance under EIN 85-1809543 and plan number 501. It reports 173 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20250303164944NAL0011301490001
- Filing year
- 2023
- Form type
- 3
- Plan sponsor
- Southwest Kansas Chambers Alliance
- EIN
- 85-1809543
- Plan number
- 501
- Location
- Scott City, KS
- Participants
- 173
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $28,005
- Total liabilities (EOY)
- $201,608
- Net assets (EOY)
- -$173,603
- Employer contributions
- $1,161,457
- Participant contributions
- $201,668
- Total income / additions
- $1,458,012
- Benefits paid
- $1,084,801
- Administrative expenses
- $151,052
- Total expenses
- $1,235,853
- Net increase / (decrease)
- $222,159
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Cpm, Inc. | NONE | $50,120 | not reported in the loaded dataset |
| Fovis, Llp | NONE | $47,410 | not reported in the loaded dataset |
| 6 Degrees Health | NONE | $30,072 | not reported in the loaded dataset |
| Heartland Benefits Group | NONE | $22,554 | not reported in the loaded dataset |