2023 Form 5500 filing — San Gorgonio Memorial Hospital Tax Sheltered Annuity 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 20250127175916NAL0013294017001) for San Gorgonio Memorial Hospital Tax Sheltered Annuity Plan, reported by San Gorgonio Memorial Hospital under EIN 33-0420041 and plan number 001. It reports 696 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)$33.1MReported net assets$33,062,221
Participants696
Provider compensation$41.6K1 Schedule C row(s)$41,553
Schedules filedSchedule H, Schedule CLoaded schedules
- EFAST2 acknowledgement
- 20250127175916NAL0013294017001
- Plan sponsor
- San Gorgonio Memorial Hospital
- EIN
- 33-0420041
- Plan number
- 001
- Location
- Banning, 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)$33.1M total assets
Net assets$33.1MLiabilities$0
Full reported line items
- Total assets (EOY)
- $33,062,221
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $33,062,221
- Employer contributions
- $1,327,665
- Participant contributions
- $2,443,189
- Total income / additions
- $7,809,656
- Benefits paid
- $4,121,708
- Administrative expenses
- $60,460
- Total expenses
- $4,185,388
- Net increase / (decrease)
- $3,624,268
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Voya Retirement Insurance & Annuity | SERVICE PROVIDER | $41,553 | $0 |