2023 Form 5500 filing — Claxton-Hepburn Medical Center 403b Retirement 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 20250401140144NAL0004376259001) for Claxton-Hepburn Medical Center 403b Retirement Plan, reported by Claxton-Hepburn Medical Center under EIN 15-0559686 and plan number 004. It reports 984 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20250401140144NAL0004376259001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Claxton-Hepburn Medical Center
- EIN
- 15-0559686
- Plan number
- 004
- Location
- Ogdensburg, NY
- Participants
- 984
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $81,272,108
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $81,272,108
- Employer contributions
- $1,655,586
- Participant contributions
- $2,704,819
- Total income / additions
- $15,177,058
- Benefits paid
- $4,260,604
- Administrative expenses
- $228,323
- Total expenses
- $4,542,227
- Net increase / (decrease)
- $10,634,831
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Healthcare Community Securities Cor | REG INVESTMENT ADVISOR | $130,171 | $0 |
| Benefit Plans Administrative Svcs. | NONE | $98,137 | $0 |
| Lincoln National Corporation | SERVICE PROVIDER | $458 | $0 |
| Unum Life Ins. Co. Of America | SERVICE PROVIDER | $0 | $15 |