2023 Form 5500 filing — Kelley Automotive Group Health & Welfare 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 20250310133007NAL0031896386001) for Kelley Automotive Group Health & Welfare Plan, reported by Kelley Automotive Group LLC under EIN 35-1707660 and plan number 501. It reports 287 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
Form 5500 2 · 2023
Filing snapshot
Net assets (EOY)$1.6MReported net assets$1,642,117
Participants287
Provider compensation$776.3K6 Schedule C row(s)$776,306
Schedules filedSchedule H, Schedule CLoaded schedules
- EFAST2 acknowledgement
- 20250310133007NAL0031896386001
- Plan sponsor
- Kelley Automotive Group LLC
- EIN
- 35-1707660
- Plan number
- 501
- Location
- Fort Wayne, IN
- Received date
- not reported in the loaded dataset
Schedule H · 2023
Reported financial snapshot
Reported figures as filed, in whole dollars. Only fields the filing reports are shown.
Reported balance (end of year)$2M total assets
Net assets$1.6MLiabilities$351.2K
Full reported line items
- Total assets (EOY)
- $1,993,318
- Total liabilities (EOY)
- $351,201
- Net assets (EOY)
- $1,642,117
- Employer contributions
- $2,591,843
- Participant contributions
- $1,117,207
- Total income / additions
- $3,791,212
- Benefits paid
- $3,939,037
- Administrative expenses
- $130,267
- Total expenses
- $4,069,304
- Net increase / (decrease)
- -$278,092
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Tokio Marine Hhs | REINSURANCE PREMIUMS | $522,531 | not reported in the loaded dataset |
| Unified Group Services, Inc. | ADMINISTRATIVE FEES | $113,703 | not reported in the loaded dataset |
| Cigna Oap | PPO FEES | $76,571 | not reported in the loaded dataset |
| Star Insurance Agency | INSURANCE BROKER FEES | $53,872 | not reported in the loaded dataset |
| Active Health Management | CARE ENGINE FEES | $6,102 | not reported in the loaded dataset |
| Teladoc | ORGAN TRANSPLANT PREMIUMS | $3,527 | not reported in the loaded dataset |