Nebraska › Health care and social assistance › 100 to 249 participants
Form 5500 statement · plan year 1 Jan 2024 to 31 Dec 2024
Tri Valley Health System Retirement Plan
Sponsored by Cambridge Memorial Hospital, Inc. DBA Tri Valley Health System, Cambridge, NE
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.
In the plan year ending 31 Dec 2024, Tri Valley Health System Retirement Plan covered 224 participants and held $13.0M in net assets. The plan is a 403(b) plan sponsored by Cambridge Memorial Hospital, Inc. DBA Tri Valley Health System of Cambridge, Nebraska.
Net assets came to $58,075 per participant, close to the $60,185 median for defined contribution plans with 100 to 249 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 $395K during the year, or $2,113 per active participant against a same-size median of $2,447; participants contributed $740K and $13K arrived as rollovers and other contributions. Benefits paid out totalled $1.7M.
Schedule C lists 2 service provider organisations paid $5,000 or more, with reported compensation of $50K: $225 per participant, above the same-size median of $194. Administrative expenses charged to the plan were $50K. 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 $2.2M in 2009 to $13.0M in 2024 (up 505%), and participants from 229 to 224 (down 2%).
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 | This plan | Same size | Same industry | All US DC plans |
|---|---|---|---|---|
| Net assets per participant | $58,075 | $60,185 | $30,764 | $53,102 |
| Employer contributions per active participant | $2,113 | $2,447 | $1,536 | $2,175 |
| Schedule C compensation per participant | $225 | $194 | $93.85 | $123 |
| Schedule C compensation, share of net assets | 0.39% | 0.32% | 0.31% | 0.26% |
| Administrative expenses per participant | $225 | $176 | $86.53 | $116 |
Peer columns are medians for plan year 2024 across defined contribution plans with 100 or more participants: 100 to 249 participants (21,996 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
| Plan year | Participants | Net assets | Per participant | Employer contributions | Participant contributions | Schedule C compensation |
|---|---|---|---|---|---|---|
| 2024 | 224 | $13.0M | $58,076 | $395K | $740K | $50K |
| 2023 | 223 | $12.1M | $54,076 | $372K | $707K | $43K |
| 2022 | 213 | $9.6M | $45,277 | $359K | $671K | $41K |
| 2021 | 209 | $11.3M | $54,206 | $323K | $622K | $43K |
| 2020 | 197 | $10.7M | $54,533 | $311K | $579K | $35K |
| 2019 | 204 | $8.8M | $43,294 | $299K | $534K | $52K |
| 2018 | 211 | $6.9M | $32,905 | $303K | $553K | $63K |
| 2017 | 208 | $7.6M | $36,380 | $301K | $536K | $52K |
| 2016 | 209 | $4.8M | $22,780 | $244K | $432K | $37K |
| 2015 | 206 | $4.3M | $20,733 | $221K | $388K | $39K |
| 2014 | 208 | $4.0M | $19,471 | $0 | $312K | $21K |
| 2013 | 215 | $3.6M | $16,930 | $0 | $288K | $14K |
| 2012 | 215 | $3.0M | $14,181 | $0 | $260K | $11K |
| 2011 | 212 | $2.6M | $12,358 | $0 | $249K | $13K |
| 2010 | 209 | $2.5M | $12,014 | $0 | $222K | $12K |
| 2009 | 229 | $2.2M | $9,393 | $0 | $202K | $11K |
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$12,058,796
- Employer contributions$395,129
- Participant contributions$740,077
- Rollovers and other contributions$13,301
- Total contributions$1,148,507
- Total income, including investment results$2,652,183
- Benefits paid$1,651,975
- Administrative expenses$50,313
- Total expenses$1,702,288
- Net income$949,895
- Net transfers$0
- Net assets, end of year$13,008,691
Participants
- Active participants187
- Retired or separated, receiving benefits1
- Retired or separated, entitled to future benefits36
- Participants with account balances217
- Total participants, end of year224
Fees and service providers
| Organisation | Services reported | Direct | Indirect |
|---|---|---|---|
| CBIZ Financial Solutions Inc. | Investment advisory (plan) | $46,853 | $0 |
| T. Rowe Price | Recordkeeping and information management | $3,460 | $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
- Investment advisory and management fees$46,813
- Recordkeeping fees$3,500
- Total administrative expenses$50,313
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)$12.4M · 95.2%
- Insurance company general account$502K · 3.9%
- Participant loans$120K · 0.9%
Audit and compliance answers, as filed
- Accountant's opinionUnmodified (unqualified)
- Audit scope limited under ERISA section 103(a)(3)(C)Yes
- Accounting firmEide Bailly 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
2FERISA section 404(c) plan2GTotal participant-directed account plan2LCode section 403(b)(1) arrangement (annuity contracts)2MCode section 403(b)(7) accounts (custodial accounts for regulated investment company stock)2S401(k) plan or 403(b) plan that provides for automatic enrollment2TTotal or partial participant-directed account plan with a default investment account3DPre-approved pension plan
Codes entered on Form 5500 line 8a, with the labels from the official instructions. Business code 622000: Hospitals.
Similar plans in Nebraska
| Plan | Sponsor | Participants | Net assets | Per participant |
|---|---|---|---|---|
| Chadron Community Hospital and Health Services Employees Retirement Plan | Chadron Community Hospital and Health Services | 225 | $5.1M | $22,469 |
| Total Respiratory & Rehab Inc. 401(k) Profit Sharing Plan & Trust | Total Respiratory & Rehab Inc. | 224 | $4.9M | $21,804 |
| Advanced Medical Imaging, LLC 401(k) Profit Sharing Plan | Advanced Medical Imaging, LLC | 249 | $17.0M | $68,188 |
| Cancer Partners of Nebraska 401(k) Profit Sharing Plan | Cancer Partners of Nebraska, P.C. | 221 | $32.8M | $148,616 |
| Visiting Nurse Association of the Midlands Retirement Plan | Visiting Nurse Association of the Midlands | 250 | $17.1M | $68,251 |
| Charles Drew Health Center, Inc. 401(k) Retirement Plan | Charles Drew Health Center, Inc. | 215 | $6.7M | $31,237 |
Defined contribution plans in health care and social assistance closest in size.
Questions and answers
How big is Tri Valley Health System Retirement Plan?
224 participants at the end of the plan year ending 31 Dec 2024, of whom 187 were active employees, with net assets of $13,008,691. Among defined contribution plans that places it in the 100 to 249 participants band, which held 21,996 plans in plan year 2024.
What does Cambridge Memorial Hospital, Inc. DBA Tri Valley Health System contribute per participant?
The filing reports $395,129 in employer contributions for the year, which is $2,113 per active participant; the median for plans of the same type and size was $2,447 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 $50,313 in compensation to service provider organisations, $225 per participant or 0.39% of net assets. The same-size median among plans reporting any Schedule C compensation was $194 per participant. Administrative expenses on Schedule H were $50,313. 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 Cambridge Memorial Hospital, Inc. DBA Tri Valley Health System. Recordkeeping or administration: T. Rowe Price. Investment advisory or management: CBIZ Financial Solutions Inc.. The financial statements were audited by Eide Bailly 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 2024 to 31 Dec 2024, received by the Department of Labor on 7 Oct 2025. 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 47-6028103, plan 003, received 7 Oct 2025; 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.