2023 Form 5500 filing — Pacific Northwest Employers Life Health Insurance Trust
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 20241011085408NAL0022446401001) for Pacific Northwest Employers Life Health Insurance Trust, reported by The Trustees Of The Pacific Northwest Employers Life Health Insurance under EIN 93-6033740 and plan number 501. It reports 461 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
Form 5500 3 · 2023
Filing snapshot
Net assets (EOY)$221.9KReported net assets$221,874
Participants461
Provider compensation$55.4K3 Schedule C row(s)$55,400
Schedules filedSchedule H, Schedule CLoaded schedules
- EFAST2 acknowledgement
- 20241011085408NAL0022446401001
- Plan sponsor
- The Trustees Of The Pacific Northwest Employers Life Health Insurance
- EIN
- 93-6033740
- Plan number
- 501
- Location
- Salem, OR
- Received date
- not reported in the loaded dataset
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)$291.1K total assets
Net assets$221.9KLiabilities$69.3K
Full reported line items
- Total assets (EOY)
- $291,130
- Total liabilities (EOY)
- $69,256
- Net assets (EOY)
- $221,874
- Employer contributions
- $3,680,475
- Total income / additions
- $3,688,608
- Benefits paid
- $3,572,319
- Administrative expenses
- $68,406
- Total expenses
- $3,640,725
- Net increase / (decrease)
- $47,883
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Cascade Employers Association | RELATED PARTY | $30,000 | not reported in the loaded dataset |
| Jones & Roth, P.C. | ACCOUNTANT | $13,400 | not reported in the loaded dataset |
| Csnw Benefits | CONSULTANT | $12,000 | not reported in the loaded dataset |