2023 Form 5500 filing — Ely-Bloomenson Community Hospital Tax Deferred 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 20241010140654NAL0020252657001) for Ely-Bloomenson Community Hospital Tax Deferred Annuity Plan, reported by Ely-Bloomenson Community Hospital under EIN 41-0808719 and plan number 010. It reports 157 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)$10.9MReported net assets$10,924,005
Participants157
Provider compensation$38.8K1 Schedule C row(s)$38,766
Schedules filedSchedule H, Schedule CLoaded schedules
- EFAST2 acknowledgement
- 20241010140654NAL0020252657001
- Plan sponsor
- Ely-Bloomenson Community Hospital
- EIN
- 41-0808719
- Plan number
- 010
- Location
- Ely, MN
- Received date
- not reported in the loaded dataset
How to read this filing
- This is a single annual Form 5500 filing, identified by its EFAST2 acknowledgement id.
- Schedule chips (Sch H / I / C) show which schedules this filing includes.
- Net assets = total assets minus total liabilities (Schedule H/I).
- Fields a filing did not report are labeled not reported in the loaded dataset — never estimated.
- For the plan's full history, open the plan profile.
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)$10.9M total assets
Net assets$10.9MLiabilities$0
Full reported line items
- Total assets (EOY)
- $10,924,005
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $10,924,005
- Employer contributions
- $322,318
- Participant contributions
- $751,550
- Total income / additions
- $2,566,386
- Benefits paid
- $1,559,288
- Administrative expenses
- $549
- Total expenses
- $1,559,837
- Net increase / (decrease)
- $1,006,549
Schedule C
Reported service provider compensation
Compensation reported on the 2023 filing, ranked by reported total.
- 1
Frequently asked questions
- What does EFAST2 acknowledgement 20241010140654NAL0020252657001 cover?
- It is the 2023 Form 5500 filing for Ely-Bloomenson Community Hospital Tax Deferred Annuity Plan, reported by Ely-Bloomenson Community Hospital (EIN 41-0808719).
- Which Form 5500 schedules are attached to this 2023 filing?
- Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).