2023 Form 5500 filing — T. J. Samson Community Hospital, Inc. 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 20251114140625NAL0005943106001) for T. J. Samson Community Hospital, Inc. Retirement Plan, reported by T.J. Samson Community Hospital, Inc. under EIN 61-0461767 and plan number 001. It reports 942 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20251114140625NAL0005943106001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- T.J. Samson Community Hospital, Inc.
- EIN
- 61-0461767
- Plan number
- 001
- Location
- Glasgow, KY
- Participants
- 942
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $32,745,234
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $32,745,234
- Employer contributions
- $1,465,414
- Total income / additions
- $12,631,064
- Benefits paid
- $4,778,684
- Administrative expenses
- $276,683
- Total expenses
- $5,055,367
- Net increase / (decrease)
- $7,575,697
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Principal Life Insurance Company | CONTRACT ADMINISTRATOR | $252,635 | $0 |
| Principal Global Investors, LLC | INVESTMENT ADVISORY | $24,048 | not reported in the loaded dataset |