2023 Form 5500 filing — Mt. San Rafael Hospital Matching 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 20241015121123NAL0029559169001) for Mt. San Rafael Hospital Matching Retirement Plan, reported by Trinidad Area Health Association under EIN 84-0586742 and plan number 001. It reports 273 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241015121123NAL0029559169001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Trinidad Area Health Association
- EIN
- 84-0586742
- Plan number
- 001
- Location
- Trinidad, CO
- Participants
- 273
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $2,529,271
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $2,529,271
- Employer contributions
- $291,045
- Participant contributions
- $0
- Total income / additions
- $632,156
- Benefits paid
- $206,258
- Administrative expenses
- $3,517
- Total expenses
- $219,464
- Net increase / (decrease)
- $412,692
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| American United Life Insurance Co | NONE | $155 | $7,638 |