2023 Form 5500 filing — Community Hospital Of San Bernardino 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 20241013155139NAL0024893153001) for Community Hospital Of San Bernardino Tax Sheltered Annuity Plan, reported by Community Hospital Of San Bernardino under EIN 95-1643373 and plan number 001. It reports 401 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241013155139NAL0024893153001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Community Hospital Of San Bernardino
- EIN
- 95-1643373
- Plan number
- 001
- Location
- San Bernardino, CA
- Participants
- 401
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $5,066,168
- Net assets (EOY)
- $5,066,168
- Total income / additions
- $566,021
- Benefits paid
- $579,937
- Administrative expenses
- $75
- Total expenses
- $580,012
- Net increase / (decrease)
- -$13,991
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Unum Life Ins. Co. Of America | NONE | $0 | $75 |