2023 Form 5500 filing — Four County Comprehensive Mental Health Center, Inc. Employee Health Care 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 20250814153830NAL0028234002001) for Four County Comprehensive Mental Health Center, Inc. Employee Health Care Plan, reported by Four County Comprehensive Mental Health Center Inc Dba 4c Health under EIN 35-1362298 and plan number 501. It reports 196 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20250814153830NAL0028234002001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Four County Comprehensive Mental Health Center Inc Dba 4c Health
- EIN
- 35-1362298
- Plan number
- 501
- Location
- Rochester, IN
- Participants
- 196
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $0
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $0
- Employer contributions
- $2,094,075
- Participant contributions
- $710,842
- Total income / additions
- $2,804,917
- Benefits paid
- $2,597,545
- Administrative expenses
- $207,372
- Total expenses
- $2,804,917
- Net increase / (decrease)
- $0
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Keystone Insurance Group | NONE | $63,322 | not reported in the loaded dataset |
| Auxiant | NONE | $6,200 | not reported in the loaded dataset |