2023 Form 5500 filing — Siu Pacific District Seafarers' Medical Center Fund

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 20250415072644NAL0001335923001) for Siu Pacific District Seafarers' Medical Center Fund, reported by Board Of Trustees Of Siu Pacific District Seafarers' Medical Center under EIN 94-2430964 and plan number 501. It reports 418 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).

Form 5500 1 · 2023

Filing snapshot

Net assets (EOY)-$58.6KReported net assets-$58,565

Participants418

Provider compensation$664.5K13 Schedule C row(s)$664,542

Schedules filedSchedule H, Schedule CLoaded schedules

EFAST2 acknowledgement: 20250415072644NAL0001335923001
Plan sponsor: Board Of Trustees Of Siu Pacific District Seafarers' Medical Center
EIN: 94-2430964
Plan number: 501
Location: San Francisco, 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)$165.7K total assets

Net assets-$58.6KLiabilities$224.3K

Money in vs. money out

Total income / additions$775.2K

Total expenses$824K

Benefits paid / distributions$533.9K

Contributions

Employer$774.9K

ParticipantNot reported

Full reported line items

Total assets (EOY): $165,707
Total liabilities (EOY): $224,272
Net assets (EOY): -$58,565
Employer contributions: $774,864
Total income / additions: $775,157
Benefits paid: $533,928
Administrative expenses: $290,070
Total expenses: $823,998
Net increase / (decrease): -$48,841

Schedule C

Reported service provider compensation

Compensation reported on the 2023 filing, ranked by reported total.

1
Siu Pd Supp Benefits Fund, Inc.$160.4K
COMMON TRUSTEES · Direct $160.4K
2
Ruslana Boychuk$117.1K
EMPLOYEE · Direct $117.1K
3
Occupational Health Centers Of - Co$91.7K
NONE · Direct $91.7K
4
Norma Ambriz$82.6K
EMPLOYEE · Direct $82.6K
5
Mercy Doctors Medical Group$48.7K
NONE · Direct $48.7K
6
Urgent Care Clinic Of Waikiki$40.2K
NONE · Direct $40.2K
7
Kaiser Foundation Health Plan Of Wa$38.1K
NONE · Direct $38.1K
8
Make You Well$24.2K
NONE · Direct $24.2K
9
Medtox Labs$17.9K
NONE · Direct $17.9K
10
Withumsmith+Brown, Pc$17K
NONE · Direct $17K
11
Dr. Carl Bricca, Do$12K
NONE · Direct $12K
12
Bay Area Networking$9.2K
NONE · Direct $9.2K
13
U.S Bank$5.4K
NONE · Direct $5.4K

What to inspect next

Frequently asked questions

What does EFAST2 acknowledgement 20250415072644NAL0001335923001 cover?: It is the 2023 Form 5500 filing for Siu Pacific District Seafarers' Medical Center Fund, reported by Board Of Trustees Of Siu Pacific District Seafarers' Medical Center (EIN 94-2430964).
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).