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Indiana › Health care and social assistance › 250 to 499 participants

Form 5500 statement · plan year 1 Jan 2025 to 31 Dec 2025

Tri-State Orthopaedic Surgeons, Inc. 401(k) Plan

Sponsored by Tri-State Orthopaedic Surgeons, Inc., Evansville, IN

401(k) planautomatic enrollmentplan year 2025 filing

Form 5500 information is as filed by the plan administrator with the Department of Labor and may be amended. Figures reflect the plan year shown, not current balances. Form 5500 contains no individual account balances. Look up the original filing at EFAST2.

$53.5Mnet assets, end of plan year+22% on the year
252participants186 active
$212,124net assets per participantsame-size median $48,746
$8,691employer contributions per active participantsame-size median $2,017

In the plan year ending 31 Dec 2025, Tri-State Orthopaedic Surgeons, Inc. 401(k) Plan covered 252 participants and held $53.5M in net assets. The plan is a 401(k) plan sponsored by Tri-State Orthopaedic Surgeons, Inc. of Evansville, Indiana.

Net assets came to $173,144 per participant in plan year 2024, well above the $48,746 median for defined contribution plans with 250 to 499 participants and well above the $30,764 median for defined contribution plans in health care and social assistance. The figure is an average across everyone in the plan, including former employees with small balances; Form 5500 holds no individual account data.

The employer contributed $1.6M during the year, or $8,691 per active participant against a same-size median of $2,017; participants contributed $1.3M and $161K arrived as rollovers and other contributions. Benefits paid out totalled $870K.

Schedule C lists 1 service provider organisation paid $5,000 or more, with reported compensation of $3,549: $14.08 per participant, well below the same-size median of $141. Administrative expenses charged to the plan were $3,249. Schedule C does not capture every cost: fees netted from fund returns and fees the employer pays directly are outside it.

Across the filings on record, net assets went from $16.7M in 2009 to $53.5M in 2025 (up 220%), and participants from 158 to 252 (up 59%).

The independent accountant's opinion on the financial statements was unmodified (unqualified), from an audit whose scope was limited under ERISA section 103(a)(3)(C) to exclude investment information certified by a bank or insurer.

Compared with similar plans

Measure, plan year 2024This planSame sizeSame industryAll US DC plans
Net assets per participant$173,144$48,746$30,764$53,102
Employer contributions per active participant$8,595$2,017$1,536$2,175
Schedule C compensation per participant$2.46$141$93.85$123
Schedule C compensation, share of net assets0.00%0.30%0.31%0.26%
Administrative expenses per participant$0.65$133$86.53$116

Peer columns are medians for plan year 2024 across defined contribution plans with 100 or more participants: 250 to 499 participants (17,456 plans), health care and social assistance (9,402) and all US plans (63,460). Fee medians cover plans that report an amount.

Trend by plan year

2009: $16.7M2010: $19.5M2011: $19.3M2012: $19.3M2013: $22.8M2014: $25.4M2015: $22.2M2016: $40.7M2017: $42.8M2018: $23.8M2019: $29.3M2020: $33.1M2021: $38.4M2022: $34.7M2023: $39.8M2024: $44.0M2025: $53.5M$16.7M$53.5M200920122016202020242025
Net assets at year end
2009: 1582010: 1792011: 1742012: 1602013: 1922014: 1762015: 3352016: 4572017: 3352018: 2002019: 2072020: 1902021: 2202022: 2352023: 2772024: 2542025: 252158457252200920122016202020242025
Participants at year end
Plan yearParticipantsNet assetsPer participantEmployer contributionsParticipant contributionsSchedule C compensation
2025252$53.5M$212,123$1.6M$1.3M$4,000
2024254$44.0M$173,146$1.6M$1.3M$1,000
2023277$39.8M$143,556$1.5M$1.1M$1,000
2022235$34.7M$147,791$1.3M$1.0M$1,000
2021220$38.4M$174,355$1.2M$943K$0
2020190$33.1M$174,279$1.2M$858K$5,000
2019207$29.3M$141,686$1.2M$855K$62K
2018200$23.8M$118,905$1.2M$828K$60K
2017335$42.8M$127,707$1.6M$1.1M$117K
2016457$40.7M$89,140$1.6M$1.1M$89K
2015335$22.2M$66,343$1.0M$628K$49K
2014176$25.4M$144,210$1.0M$624K$47K
2013192$22.8M$118,849$932K$580K$35K
2012160$19.3M$120,844$939K$589K$7,000
2011174$19.3M$110,897$822K$598K$7,000
2010179$19.5M$108,698$976K$597K$6,000
2009158$16.7M$105,722$920K$579K$15K

Years in which the plan filed the full Form 5500 with 100 or more participants, from 2009. Plan year is the year in which the plan year began.

Statement for the year

  • Net assets, beginning of year$43,978,580
  • Employer contributions$1,616,607
  • Participant contributions$1,309,770
  • Rollovers and other contributions$161,282
  • Total contributions$3,087,659
  • Total income, including investment results$10,363,535
  • Benefits paid$870,027
  • Administrative expenses$3,249
  • Total expenses$886,888
  • Net income$9,476,647
  • Net transfers$0
  • Net assets, end of year$53,455,227

Participants

  • Active participants186
  • Retired or separated, receiving benefits66
  • Retired or separated, entitled to future benefits0
  • Participants with account balances252
  • Total participants, end of year252

Fees and service providers

$3,549Schedule C compensation to organisations$3,549 direct · $0 indirect
$14.08per participantsame-size median $141
0.01%of net assetssame-size median 0.30%
$3,249administrative expenses charged to the plan$12.89 per participant
OrganisationServices reportedDirectIndirect
Fidelity Investments Instit OpParticipant loan processing$3,549$0

Schedule C, Part I line 2: providers that received $5,000 or more, with the form's own service codes. Individuals named on Schedule C (plan employees, individual trustees) are never shown and their compensation is excluded. Eligible indirect compensation disclosed by formula carries no dollar amount. See how to read Schedule C fees.

Administrative expenses on Schedule H

  • Recordkeeping fees$3,249
  • Total administrative expenses$3,249

Investment structure

Assets at year end by Schedule H category. The form shows the kind of vehicle holding the money, not the funds on the menu.

  • Registered investment companies (mutual funds)$47.1M · 88.1%
  • Common/collective trusts$2.7M · 5.1%
  • Insurance company general account$2.7M · 5.0%
  • Participant loans$449K · 0.8%
  • U.S. Government securities$229K · 0.4%
  • Cash (interest and non-interest bearing)$185K · 0.3%
  • Corporate stocks$104K · 0.2%
  • Receivables$131 · 0.0%

Audit and compliance answers, as filed

  • Accountant's opinionUnmodified (unqualified)
  • Audit scope limited under ERISA section 103(a)(3)(C)Yes
  • Accounting firmForvis Mazars, LLP
  • Participant contributions reported as transmitted lateNo
  • Covered by a fidelity bondYes, $500,000
  • Blackout period during the yearNo

These are the plan administrator's own answers on Schedule H, Part IV. A reported late transmittal is the filer's disclosure of a timing lapse, usually corrected through the Department of Labor's voluntary program; the amount is the total involved, not a loss.

Plan characteristics

  • 2AAge/service weighted or new comparability or similar plan
  • 2EProfit-sharing plan
  • 2GTotal participant-directed account plan
  • 2JCode section 401(k) feature
  • 2KCode section 401(m) arrangement
  • 2RParticipant-directed brokerage accounts provided as an investment option under the plan
  • 2S401(k) plan or 403(b) plan that provides for automatic enrollment
  • 2TTotal or partial participant-directed account plan with a default investment account
  • 3BPlan covering self-employed individuals
  • 3DPre-approved pension plan
  • 3FPlan sponsor(s) received services of leased employees

Codes entered on Form 5500 line 8a, with the labels from the official instructions. Business code 621111: Offices of Physicians (except mental health specialists).

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Peabody Retirement Community Retirement Savings PlanEstelle Peabody Memorial Home, Inc.254$2.4M$9,310
Visiting Nurse & Hospice Home Retirement PlanVisiting Nurse & Hospice Home251$6.5M$25,756
South Bend Medical Foundation, Inc. 403(b) Retirement PlanSouth Bend Medical Foundation, Inc.254$17.1M$67,329
Westminster Village Muncie Inc. 403(b) Retirement PlanWestminster Village Muncie Inc.250$4.7M$18,973

Defined contribution plans in health care and social assistance closest in size.

Questions and answers

How big is Tri-State Orthopaedic Surgeons, Inc. 401(k) Plan?

252 participants at the end of the plan year ending 31 Dec 2025, of whom 186 were active employees, with net assets of $53,455,227. Among defined contribution plans that places it in the 250 to 499 participants band, which held 17,456 plans in plan year 2024.

What does Tri-State Orthopaedic Surgeons, Inc. contribute per participant?

The filing reports $1,616,607 in employer contributions for the year, which is $8,691 per active participant; the median for plans of the same type and size was $2,017 in plan year 2024. Form 5500 reports the total only. It does not state the match formula, and the per-participant figure is an average, not any one person's contribution.

What fees does the plan pay and how do they compare?

Schedule C reports $3,549 in compensation to service provider organisations, $14.08 per participant or 0.01% of net assets. The same-size median among plans reporting any Schedule C compensation was $141 per participant. Administrative expenses on Schedule H were $3,249. Investment costs deducted inside mutual funds and other pooled vehicles are not itemised on Form 5500, so these figures are a floor rather than a full cost.

Who runs the plan?

The sponsor is Tri-State Orthopaedic Surgeons, Inc.. Recordkeeping or administration: Fidelity Investments Instit Op. The financial statements were audited by Forvis Mazars, LLP. Form 5500 also names the plan administrator's signer and other individuals; this site publishes organisations only.

Was the audit opinion unqualified?

The filing reports an unmodified (unqualified) opinion from a limited-scope audit, in which the accountant did not audit investment information certified by a bank or insurance company. Unmodified (formerly "unqualified") is the standard clean opinion.

How current is this, and does it show my balance?

This is the Form 5500 for the plan year 1 Jan 2025 to 31 Dec 2025, received by the Department of Labor on 28 Jul 2026. Filings are due seven months after the plan year ends, or nine and a half with an extension, so the public record always runs a year or more behind. It contains plan-level totals only: no individual balances, contributions or names of participants exist in the data.

Provenance

Source: U.S. Department of Labor, Employee Benefits Security Administration, Form 5500 research files (Form 5500, Schedule H, Schedule C) for plan years 2009 to 2025, public domain, with filings received through 24 Aug 2026. This page shows the latest filing on record for EIN 35-1284898, plan 001, received 28 Jul 2026; an amended filing replaces it at the next build. Medians and percentiles are computed by this site; see the methodology. Report an error through corrections.