2023 Form 5500 filing — Door County Memorial Hospital Wrap 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 20240515101323NAL0021617827001) for Door County Memorial Hospital Wrap Plan, reported by Door County Memorial Hospital Dba Door County Medical Center under EIN 39-0806324 and plan number 504. It reports 627 participants. Attached schedules in the loaded dataset include Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20240515101323NAL0021617827001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Door County Memorial Hospital Dba Door County Medical Center
- EIN
- 39-0806324
- Plan number
- 504
- Location
- Sturgeon Bay, WI
- Participants
- 627
- 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. |
|---|---|---|---|
| Delta Dental Of Wisconsin | TPA (DENTAL BENEFIT) | $10,304 | not reported in the loaded dataset |
| Employee Benefits Corporation | CLAIMS PROCESSING | $10,146 | not reported in the loaded dataset |
| Rsc Insurance Brokerage Inc | INS AGENT OR BROKER | $1,457 | not reported in the loaded dataset |