2023 Form 5500 filing — Sidney Regional Medical Center Salary Reduction 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 20240920103653NAL0007302785002) for Sidney Regional Medical Center Salary Reduction Plan, reported by Cheyenne County Hospital Association, Inc under EIN 47-0408242 and plan number 002. It reports 455 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20240920103653NAL0007302785002
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Cheyenne County Hospital Association, Inc
- EIN
- 47-0408242
- Plan number
- 002
- Location
- Sidney, NE
- Participants
- 455
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $30,507,609
- Net assets (EOY)
- $30,507,609
- Employer contributions
- $978,471
- Participant contributions
- $1,763,816
- Total income / additions
- $7,676,428
- Benefits paid
- $2,783,436
- Administrative expenses
- $60,083
- Total expenses
- $2,843,519
- Net increase / (decrease)
- $4,832,909
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Principal Life Insurance Company | CONTRACT ADMINISTRATOR | $60,083 | $0 |
| Usi Advisors, Inc. | INVESTMENT ADVISORY | $0 | $10,000 |