2023 Form 5500 filing — California Pacific Medical Center Voluntary 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 20241014114123NAL0052091538001) for California Pacific Medical Center Voluntary Plan, reported by Sutter Bay Hospitals under EIN 94-0562680 and plan number 010. It reports 974 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)$43.5MReported net assets$43,460,202
Participants974
Provider compensation$7.8K3 Schedule C row(s)$7,823
Schedules filedSchedule H, Schedule CLoaded schedules
- EFAST2 acknowledgement
- 20241014114123NAL0052091538001
- Plan sponsor
- Sutter Bay Hospitals
- EIN
- 94-0562680
- Plan number
- 010
- Location
- San Francisco, CA
- 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)$43.7M total assets
Net assets$43.5MLiabilities$226K
Full reported line items
- Total assets (EOY)
- $43,686,182
- Total liabilities (EOY)
- $225,980
- Net assets (EOY)
- $43,460,202
- Total income / additions
- $5,869,121
- Benefits paid
- $3,270,378
- Administrative expenses
- $7,823
- Total expenses
- $3,278,201
- Net increase / (decrease)
- $2,590,920
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Variable Annuity Life Insurance Co. | NONE | $6,522 | $0 |
| Lincoln National Corporation | NONE | $701 | $0 |
| Metlife Insurance Company | NONE | $600 | $0 |