Evans Memorial Hospital 401(K) Retirement Plan — Form 5500 plan (Evans Memorial Hospital)
Plain-English plan 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, Evans Memorial Hospital 401(K) Retirement Plan is a benefit plan reported by Evans Memorial Hospital under EIN 58-0979172 and plan number 001. The latest loaded filing year is 2023. The filing reports 133 participants and $3,707,258 in end-of-year plan assets, where available in the loaded dataset.
Form 5500 plan profile · 2023
Key reported metrics
Net assets (EOY)$3.7MPlan net assets, end of year$3,707,258
Participants133Covered participants reported
Assets / participant$27.9KComputed: assets ÷ participants$27,874 (computed)
Provider compensation$2.9K2 Schedule C provider row(s)$2,915
- Plan sponsor
- Evans Memorial Hospital
- EIN
- 58-0979172
- Plan number
- 001
- Plan type
- 2
- Location
- Claxton, GA
- Latest filing year
- 2023
Form 5500 filing history
| Filing year | Participants | Schedules | Filing |
|---|---|---|---|
| 2023 | 133 | H, C | 20241015074257NAL0027774097001 |
Schedule H · 2023
Reported financial statement
Reported figures as filed, in whole dollars. Only fields the filing reports are shown; others are marked not reported.
Reported balance (end of year)$3.7M total assets
Net assets$3.7MLiabilities$0
Full reported line items
Net assets
- Total assets (EOY)
- $3,707,258
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $3,707,258
- Net assets (BOY)
- $3,439,477
Income & contributions
- Participant contributions
- $219,159
- Total contributions
- $219,159
- Total income / additions
- $696,527
Expenses & distributions
- Benefits paid
- $426,692
- Administrative expenses
- $2,054
- Total expenses
- $428,746
- Net increase / (decrease)
- $267,781
Computed from reported fields
Reported ratios
Derived only from this plan's own reported figures — comparisons within the filing, not benchmarks, estimates, or national averages.
Total expenses ÷ net assets12%Computed ratio
Benefits paid ÷ total income61%Computed ratio
Provider comp. ÷ net assets0%Computed ratio
Service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. | Year |
|---|---|---|---|---|
| Principal Life Insurance Company | CONTRACT ADMINISTRATOR | $2,053 | $0 | 2023 |
| Odell, Kevin S. | OTHER SERVICES | $0 | $862 | 2023 |