2023 Form 5500 filing — California Pacific Medical Center Employee Savings Incentive Deferral Plan (Esip Iii)
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 20241014113954NAL0014857091003) for California Pacific Medical Center Employee Savings Incentive Deferral Plan (Esip Iii), reported by Sutter Bay Hospitals under EIN 94-0562680 and plan number 005. It reports 1,230 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
Form 5500 2 · 2023
Filing snapshot
Net assets (EOY)$67MReported net assets$67,008,615
Participants1.2K1,230
Provider compensation$10.3K3 Schedule C row(s)$10,319
Schedules filedSchedule H, Schedule CLoaded schedules
- EFAST2 acknowledgement
- 20241014113954NAL0014857091003
- Plan sponsor
- Sutter Bay Hospitals
- EIN
- 94-0562680
- Plan number
- 005
- Location
- San Francisco, CA
- Received date
- not reported in the loaded dataset
Schedule H · 2023
Reported financial snapshot
Reported figures as filed, in whole dollars. Only fields the filing reports are shown.
Reported balance (end of year)$67.2M total assets
Net assets$67MLiabilities$228.1K
Full reported line items
- Total assets (EOY)
- $67,236,715
- Total liabilities (EOY)
- $228,100
- Net assets (EOY)
- $67,008,615
- Total income / additions
- $8,813,799
- Benefits paid
- $4,133,865
- Administrative expenses
- $10,319
- Total expenses
- $4,144,184
- Net increase / (decrease)
- $4,669,615
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Variable Annuity Life Insurance Co. | NONE | $10,214 | $0 |
| Lincoln National Corporation | NONE | $75 | $0 |
| Metropolitan Life Insurance Company | NONE | $30 | $0 |