Original filing (PDF)20251007175444NAL0008379696001

Cambridge Memorial Hospital, Inc. DBA Tri Valley Health System

Name: Cambridge Memorial Hospital, Inc. DBA Tri Valley Health System — Form 5500 Plan 003 (2024)
Creator: Cambridge Memorial Hospital, Inc. DBA Tri Valley Health System
License: https://www.usa.gov/government-works

Form 5500

FILING_RECEIVED

Tri Valley Health System Retirement Plan

403(b) retirement plan · Cambridge Memorial Hospital, Inc. DBA Tri Valley Health System's Tri Valley Health System Retirement Plan held $13.0M in plan assets for 187 participants in 2024, with T. Rowe Price as recordkeeper.

Active participants

187

Accounts w/ balance

217

Plan assets (EOY)

$13.0M

Net assets (EOY)

$13.0M

People on this filing

Clay Jordan signed Cambridge Memorial Hospital, Inc. DBA Tri Valley Health System's 2024 Form 5500 as plan administrator.

Clay Jordan — Plan Administrator — Form 5500 signer

Get verified email & phone for these signers

Signer names are public record from the Form 5500 e-signature.

Plan identifiers

Cambridge Memorial Hospital, Inc. DBA Tri Valley Health System's EIN is 47-6028103.

EIN 47-6028103

Plan number 003

Plan year 2024

ACK ID 20251007175444NAL0008379696001

Official Form 5500 document

Download the official 2024 Form 5500 (PDF) for Cambridge Memorial Hospital, Inc. DBA Tri Valley Health System from the U.S. Department of Labor's EFAST2 system.

Download the official 2024 Form 5500 (PDF)

Plan features

Cambridge Memorial Hospital, Inc. DBA Tri Valley Health System's plan includes ERISA 404(c) participant direction, a 403(b) annuity, 403(b) custodial accounts, automatic enrollment, a default investment (QDIA).

Decision-maker contacts

One unlock reveals every key decision-maker — plan signer, CFO, HR & Benefits — with verified email + LinkedIn for CAMBRIDGE MEMORIAL HOSPITAL, INC. DBA TRI VALLEY HEALTH SYSTEM.

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How this plan invests

This plan

27 securities

funds · stocks · CUSIPs

Holdings are itemized directly on this plan's Schedule of Assets, below.

Plan health score

Above-average plan

Directional indicator from public Form 5500 data — compliance & integrity, total plan cost, participant health and vendor stack, benchmarked against same-size peers. Not a fiduciary tool.

Compliance & integrity

100

Total plan cost

Plan health

Vendor & structure

100

Plan sponsor

Name

CAMBRIDGE MEMORIAL HOSPITAL, INC. DBA TRI VALLEY HEALTH SYSTEM

EIN

all filings

Address

PO BOX 488 · CAMBRIDGE, NE · 690220488

Phone

(308) 697-1478

Industry

Health Care & Social Assistance

Plan administrator

Name

TRI VALLEY HEALTH SYSTEM RETIREMENT PLAN COMMITTEE

EIN

47-6028103

City

CAMBRIDGE, NE

Phone

(308) 697-1136

Plan characteristics

Plan number

003

Plan year

2024

Plan year begin

2024-01-01

Tax period

2024-12-31

Filed

2025-10-07

Pension benefit codes

2F · ERISA section 404(c)

2G · Total participant-directed accounts

2L · 403(b)(1) annuity

2M · 403(b)(7) custodial accounts

2S · Automatic enrollment

2T · Default investment account (QDIA)

3D · Pre-approved plan (master / prototype / VS)

Audit & trust (Schedule H)

Service providers (Schedule C)

2 rows

Recordkeeper

Name	EIN	Location	Relation	Direct comp	Indirect comp
T. ROWE PRICE	52-1309931	—	RECORDKEEPER	$3K	—

Advisor / Consultant

Name	EIN	Location	Relation	Direct comp	Indirect comp
CBIZ FINANCIAL SOLUTIONS INC	52-1396995	—	INVESTMENT ADVISOR	$47K	—

Investments

27 direct securities· $13.0M(100% of reported assets)

Other securities

$8.3M

15 holdings

Mutual Funds

$3.6M

9 holdings

Common Collective Trusts

$518K

1 holding

Stable Value

$502K

1 holding

Bonds / Notes

$120K

1 holding

					% of plan
American Century One Choice 2030 Mutual Fund N/A	Other securities	—	—	$1.4M	10.7%
AB Large Cap Growth Fund Class Z Mutual Fund N/A	Other securities	—	—	$1.2M	9.2%
American Funds New Perspective Mutual Fund N/A	Mutual Funds	—	—	$1.2M	9.1%
American Century One Choice 2040 Mutual Fund N/A	Other securities	—	—	$930K	7.1%
American Century One Choice 2060 Mutual Fund N/A	Other securities	—	—	$806K	6.2%
MFS Value Mutual Fund N/A	Mutual Funds	—	—	$763K	5.9%
American Century One Choice 2035 Mutual Fund N/A	Other securities	—	—	$704K	5.4%
American Funds Capital World Growth & Income Mutual Fund N/A	Mutual Funds	—	—	$652K	5.0%
American Century One Choice In Ret Mutual Fund N/A	Other securities	—	—	$610K	4.7%
Principal Midcap Mutual Fund N/A	Other securities	—	—	$574K	4.4%
Fidelity Extended Market Index Mutual Fund N/A	Mutual Funds	—	—	$573K	4.4%
Fidelity 500 Index Mutual Fund N/A	Common Collective Trusts	—	—	$518K	4.0%
The Standard's Stable Asset II Guaranteed Investment Contract N/A	Stable Value	—	—	$502K	3.9%
American Century One Choice 2050 Mutual Fund N/A	Other securities	—	—	$463K	3.6%
American Century One Choice 2025 Mutual Fund N/A	Other securities	—	—	$426K	3.3%
American Century One Choice 2045 Mutual Fund N/A	Other securities	—	—	$425K	3.3%
Blackrock Total Return Mutual Fund N/A	Other securities	—	—	$352K	2.7%
American Century One Choice 2055 Mutual Fund N/A	Other securities	—	—	$231K	1.8%
Notes receivable from participants Maturing 2025 - 2052 at interest rates of 4.25% - 9.50% -	Bonds / Notes	—	—	$120K	0.9%
DFA US TAR Mutual Fund N/A	Mutual Funds	—	—	$112K	0.9%
Janus Henderson Venture Mutual Fund N/A	Mutual Funds	—	—	$100K	0.8%
Fidelity Global Ex US Index Mutual Fund N/A	Mutual Funds	—	—	$92K	0.7%
Principal Real Estate Securities Fund Mutual Fund N/A	Other securities	—	—	$84K	0.6%
Alliance Berstein Global Bond Mutual Fund N/A	Other securities	—	—	$70K	0.5%
American Century Mid Cap Value Mutual Fund N/A	Other securities	—	—	$53K	0.4%
Fidelity US Bond Index Mutual Fund N/A	Mutual Funds	—	—	$42K	0.3%
American Funds American Balanced Mutual Fund N/A	Mutual Funds	—	—	$34K	0.3%