2023 Form 5500 filing — Siskiyou Community Health Center, Inc. 403(B) 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 20241011154311NAL0022251825001) for Siskiyou Community Health Center, Inc. 403(B) Plan, reported by Siskiyou Community Health Center under EIN 93-0628804 and plan number 001. It reports 271 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241011154311NAL0022251825001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Siskiyou Community Health Center
- EIN
- 93-0628804
- Plan number
- 001
- Location
- Grants Pass, OR
- Participants
- 271
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $13,968,692
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $13,968,692
- Employer contributions
- $493,674
- Participant contributions
- $1,027,961
- Total income / additions
- $3,542,417
- Benefits paid
- $852,392
- Administrative expenses
- $82,600
- Total expenses
- $934,992
- Net increase / (decrease)
- $2,607,425
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Principal Life Insurance Company | CONTRACT ADMINISTRATOR | $82,640 | $0 |
| Independent Financial Group LLC | INVESTMENT ADVISORY | $0 | $41,115 |