2023 Form 5500 filing — Health Benefits For Employees Of Tomah Memorial Hospital
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 20240529175000NAL0025097698001) for Health Benefits For Employees Of Tomah Memorial Hospital, reported by Tomah Memorial Hospital under EIN 39-0799566 and plan number 506. It reports 199 participants. Attached schedules in the loaded dataset include Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20240529175000NAL0025097698001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Tomah Memorial Hospital
- EIN
- 39-0799566
- Plan number
- 506
- Location
- Tomah, WI
- Participants
- 199
- Schedules available
- Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
This 2023 filing is loaded, but detailed Schedule H/I financial figures are not present for it in the current loaded dataset. Participant counts and filing identity above are reported; asset and contribution detail comes from the financial schedules where filed.
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Ingenio Rx Inc | NONE | not reported in the loaded dataset | $229,626 |
| Compcare Health Services Insurance | NONE | $87,832 | not reported in the loaded dataset |