2023 Form 5500 filing — Evans Memorial Hospital 401(K) 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 20241015074257NAL0027774097001) for Evans Memorial Hospital 401(K) Retirement Plan, reported by Evans Memorial Hospital under EIN 58-0979172 and plan number 001. It reports 133 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)$3.7MReported net assets$3,707,258
Participants133
Provider compensation$2.9K2 Schedule C row(s)$2,915
Schedules filedSchedule H, Schedule CLoaded schedules
- EFAST2 acknowledgement
- 20241015074257NAL0027774097001
- Plan sponsor
- Evans Memorial Hospital
- EIN
- 58-0979172
- Plan number
- 001
- Location
- Claxton, GA
- 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)$3.7M total assets
Net assets$3.7MLiabilities$0
Full reported line items
- Total assets (EOY)
- $3,707,258
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $3,707,258
- Participant contributions
- $219,159
- Total income / additions
- $696,527
- Benefits paid
- $426,692
- Administrative expenses
- $2,054
- Total expenses
- $428,746
- Net increase / (decrease)
- $267,781
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Principal Life Insurance Company | CONTRACT ADMINISTRATOR | $2,053 | $0 |
| Odell, Kevin S. | OTHER SERVICES | $0 | $862 |