2023 Form 5500 filing — Evergreen Teachers Association Health & Welfare Tr
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 20250611150051NAL0012307827001) for Evergreen Teachers Association Health & Welfare Tr, reported by Board Of Trustees Evergreen Teacher Association Health & Welfare Trust under EIN 77-6019718 and plan number 501. It reports 882 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20250611150051NAL0012307827001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Board Of Trustees Evergreen Teacher Association Health & Welfare Trust
- EIN
- 77-6019718
- Plan number
- 501
- Location
- San Jose, CA
- Participants
- 882
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $10,316,988
- Total liabilities (EOY)
- $115,367
- Net assets (EOY)
- $10,201,621
- Employer contributions
- $599,649
- Participant contributions
- $355,019
- Total income / additions
- $2,612,406
- Benefits paid
- $1,266,327
- Administrative expenses
- $140,972
- Total expenses
- $1,407,299
- Net increase / (decrease)
- $1,205,107
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| United Administrative Services | NONE | $87,657 | not reported in the loaded dataset |
| Wells Fargo Advisors | NONE | $24,379 | not reported in the loaded dataset |
| Milliman Usa | NONE | $12,500 | not reported in the loaded dataset |
| Ineich & Company, Llp | NONE | $11,000 | not reported in the loaded dataset |