2023 Form 5500 filing — Family Health Center 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 20251014153850NAL0001627955001) for Family Health Center 403(B) Plan, reported by Good Samaritan Family Health Center under EIN 82-2966384 and plan number 001. It reports 185 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20251014153850NAL0001627955001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Good Samaritan Family Health Center
- EIN
- 82-2966384
- Plan number
- 001
- Location
- Vincennes, IN
- Participants
- 185
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $1,001,531
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $1,001,531
- Employer contributions
- $136,802
- Participant contributions
- $260,253
- Total income / additions
- $1,011,713
- Benefits paid
- $9,268
- Administrative expenses
- $914
- Total expenses
- $10,182
- Net increase / (decrease)
- $1,001,531
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Empower Annuity Insurance Company | RECORDKEEPER | $905 | $0 |
| Empower Advisory Group, LLC | INVESTMENT MGMT | $9 | not reported in the loaded dataset |