2023 Form 5500 filing — Libertana Health Services 401(K) 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 20241119094108NAL0002252465001) for Libertana Health Services 401(K) Plan, reported by Jsi Acquisition, Inc. under EIN 20-5940887 and plan number 002. It reports 436 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)$3.9MReported net assets$3,938,475
Participants436
Provider compensation$3.9K1 Schedule C row(s)$3,944
Schedules filedSchedule H, Schedule CLoaded schedules
- EFAST2 acknowledgement
- 20241119094108NAL0002252465001
- Plan sponsor
- Jsi Acquisition, Inc.
- EIN
- 20-5940887
- Plan number
- 002
- Location
- Sherman Oaks, CA
- Received date
- not reported in the loaded dataset
How to read this filing
- This is a single annual Form 5500 filing, identified by its EFAST2 acknowledgement id.
- Schedule chips (Sch H / I / C) show which schedules this filing includes.
- Net assets = total assets minus total liabilities (Schedule H/I).
- Fields a filing did not report are labeled not reported in the loaded dataset — never estimated.
- For the plan's full history, open the plan profile.
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)$3.9M total assets
Net assets$3.9MLiabilities$0
Full reported line items
- Total assets (EOY)
- $3,938,475
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $3,938,475
- Employer contributions
- $459,608
- Participant contributions
- $965,505
- Total income / additions
- $2,006,950
- Benefits paid
- $365,551
- Administrative expenses
- $3,944
- Total expenses
- $369,495
- Net increase / (decrease)
- $1,637,455
Schedule C
Reported service provider compensation
Compensation reported on the 2023 filing, ranked by reported total.
- 1
Frequently asked questions
- What does EFAST2 acknowledgement 20241119094108NAL0002252465001 cover?
- It is the 2023 Form 5500 filing for Libertana Health Services 401(K) Plan, reported by Jsi Acquisition, Inc. (EIN 20-5940887).
- Which Form 5500 schedules are attached to this 2023 filing?
- Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).