2023 Form 5500 filing — Tri Valley Health System Retirement 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 20241011180548NAL0023384673001) for Tri Valley Health System Retirement Plan, reported by Cambridge Memorial Hospital, Inc. Dba Tri Valley Health System under EIN 47-6028103 and plan number 003. It reports 213 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241011180548NAL0023384673001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Cambridge Memorial Hospital, Inc. Dba Tri Valley Health System
- EIN
- 47-6028103
- Plan number
- 003
- Location
- Cambridge, NE
- Participants
- 213
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $12,058,796
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $12,058,796
- Employer contributions
- $372,491
- Participant contributions
- $706,939
- Total income / additions
- $2,897,419
- Benefits paid
- $439,601
- Administrative expenses
- $42,872
- Total expenses
- $482,473
- Net increase / (decrease)
- $2,414,946
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Cbiz Financial Solutions Inc | INVESTMENT ADVISOR | $40,412 | $0 |
| T. Rowe Price | RECORDKEEPER | $2,460 | $0 |