2023 Form 5500 filing — Bacon County Hospital Tax Sheltered Annuity 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 20240925191648NAL0014870785001) for Bacon County Hospital Tax Sheltered Annuity Plan, reported by Bacon County Health Services, Inc. under EIN 58-2224545 and plan number 002. It reports 575 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20240925191648NAL0014870785001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Bacon County Health Services, Inc.
- EIN
- 58-2224545
- Plan number
- 002
- Location
- Alma, GA
- Participants
- 575
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $9,972,500
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $9,972,500
- Employer contributions
- $288,506
- Participant contributions
- $626,089
- Total income / additions
- $2,378,767
- Benefits paid
- $968,917
- Administrative expenses
- $83,168
- Total expenses
- $1,052,085
- Net increase / (decrease)
- $1,326,682
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Edward Jones | INVESTMENT ADVISORY | $0 | $29,005 |
| Orenda Retirement | CONTRACT ADMINISTRATOR | $4,650 | $7,284 |
| Principal Life Insurance Company | CONTRACT ADMINISTRATOR | $0 | $0 |
| Wilshire Associates Incorporated | INVESTMENT ADVISORY | $0 | $0 |