2023 Form 5500 filing — Amberwell Health 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 20241015201517NAL0030838769001) for Amberwell Health 403(B) Plan, reported by Hiawatha Community Hospital under EIN 48-0577658 and plan number 001. It reports 426 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241015201517NAL0030838769001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Hiawatha Community Hospital
- EIN
- 48-0577658
- Plan number
- 001
- Location
- Hiawatha, KS
- Participants
- 426
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $15,552,734
- Net assets (EOY)
- $15,552,734
- Employer contributions
- $212,607
- Participant contributions
- $690,420
- Total income / additions
- $3,014,537
- Benefits paid
- $1,104,121
- Administrative expenses
- $60,949
- Total expenses
- $1,173,517
- Net increase / (decrease)
- $1,841,020
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Variable Annuity Life Insurance Co. | NONE | $36,290 | $0 |
| Valic Retirement Services Company | NONE | $24,161 | $0 |