2023 Form 5500 filing — Pembina County Memorial Hospital Association Safe Harbor 401(K) Profit Sharing 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 20240828103858NAL0005708419001) for Pembina County Memorial Hospital Association Safe Harbor 401(K) Profit Sharing Plan, reported by Pembina County Memorial Hospital Association under EIN 45-6013474 and plan number 001. It reports 157 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20240828103858NAL0005708419001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Pembina County Memorial Hospital Association
- EIN
- 45-6013474
- Plan number
- 001
- Location
- Cavalier, ND
- Participants
- 157
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $8,935,537
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $8,935,537
- Employer contributions
- $198,662
- Participant contributions
- $319,394
- Total income / additions
- $1,787,920
- Benefits paid
- $570,394
- Administrative expenses
- $3,163
- Total expenses
- $573,557
- Net increase / (decrease)
- $1,214,363
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Edward D Jones & Co. Lp | INVESTMENT ADVISOR | $28,725 | not reported in the loaded dataset |
| Willshire Associates Inc | INVESTMENT ADVISOR | $1,641 | not reported in the loaded dataset |
| John Hancock Life Insurance Company | RECORDKEEPER | $1,493 | not reported in the loaded dataset |