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Original filing (PDF)20251007175444NAL0008379696001
CAMBRIDGE MEMORIAL HOSPITAL, INC. DBA TRI VALLEY HEALTH SYSTEM
Form 5500
FILING_RECEIVED
TRI VALLEY HEALTH SYSTEM RETIREMENT PLAN
403(b) retirement plan
Active participants
187
Accounts w/ balance
217
Plan assets (EOY)
$13.0M
Net assets (EOY)
$13.0M
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 (directional)
95
/ 100
Grade A
Top-tier plan health
Directional indicator computed from public Form 5500 data — compliance, concentration, cost, vendor stack and participation. Not a fiduciary tool.
Compliance & disclosures
100
Concentration risk
100
Total plan cost
80
Vendor stack
100
Participation health
100
Knocking points off
- 39 bps in Schedule C fees — modestly above peer band of 29 bps.
Decision-maker contacts
CFO / Head of HR / Benefits Manager — verified email + LinkedIn for CAMBRIDGE MEMORIAL HOSPITAL, INC. DBA TRI VALLEY HEALTH SYSTEM.
Plan sponsor
Name
CAMBRIDGE MEMORIAL HOSPITAL, INC. DBA TRI VALLEY HEALTH SYSTEM
EIN
47-6028103
Address
PO BOX 488 · CAMBRIDGE, NE · 690220488
Phone
(308) 697-1478
Industry
Health Care & Social Assistancesee all
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)
Auditor
EIDE BAILLY LLP
Trustee / custodian
—
Trustee phone
—
Service providers (Schedule C)
2 rowsRecordkeeper
1| Name | EIN | Location | Relation | Direct comp | Indirect comp |
|---|---|---|---|---|---|
| T. ROWE PRICE | 52-1309931 | — | RECORDKEEPER | $3K | — |
Advisor / Consultant
1| 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)
| PI | Investment | Type | Shares / units | Cost | Current value | % of plan |
|---|---|---|---|---|---|---|
| American Century One Choice 2030 Mutual Fund N/A | — | — | — | $1.4M | 10.7% | |
| AB Large Cap Growth Fund Class Z Mutual Fund N/A | — | — | — | $1.2M | 9.2% | |
| American Funds New Perspective Mutual Fund N/A | — | — | — | $1.2M | 9.1% | |
| American Century One Choice 2040 Mutual Fund N/A | — | — | — | $930K | 7.1% | |
| American Century One Choice 2060 Mutual Fund N/A | — | — | — | $806K | 6.2% | |
| MFS Value Mutual Fund N/A | — | — | — | $763K | 5.9% | |
| American Century One Choice 2035 Mutual Fund N/A | — | — | — | $704K | 5.4% | |
| American Funds Capital World Growth & Income Mutual Fund N/A | — | — | — | $652K | 5.0% | |
| American Century One Choice In Ret Mutual Fund N/A | — | — | — | $610K | 4.7% | |
| Principal Midcap Mutual Fund N/A | — | — | — | $574K | 4.4% | |
| Fidelity Extended Market Index Mutual Fund N/A | — | — | — | $573K | 4.4% | |
| Fidelity 500 Index Mutual Fund N/A | — | — | — | $518K | 4.0% | |
| The Standard's Stable Asset II Guaranteed Investment Contract N/A | — | — | — | $502K | 3.9% | |
| American Century One Choice 2050 Mutual Fund N/A | — | — | — | $463K | 3.6% | |
| American Century One Choice 2025 Mutual Fund N/A | — | — | — | $426K | 3.3% | |
| American Century One Choice 2045 Mutual Fund N/A | — | — | — | $425K | 3.3% | |
| Blackrock Total Return Mutual Fund N/A | — | — | — | $352K | 2.7% | |
| American Century One Choice 2055 Mutual Fund N/A | — | — | — | $231K | 1.8% | |
| Notes receivable from participants Maturing 2025 - 2052 at interest rates of 4.25% - 9.50% - | — | — | — | $120K | 0.9% | |
| DFA US TAR Mutual Fund N/A | — | — | — | $112K | 0.9% | |
| Janus Henderson Venture Mutual Fund N/A | — | — | — | $100K | 0.8% | |
| Fidelity Global Ex US Index Mutual Fund N/A | — | — | — | $92K | 0.7% | |
| Principal Real Estate Securities Fund Mutual Fund N/A | — | — | — | $84K | 0.6% | |
| Alliance Berstein Global Bond Mutual Fund N/A | — | — | — | $70K | 0.5% | |
| American Century Mid Cap Value Mutual Fund N/A | — | — | — | $53K | 0.4% | |
| Fidelity US Bond Index Mutual Fund N/A | — | — | — | $42K | 0.3% | |
| American Funds American Balanced Mutual Fund N/A | — | — | — | $34K | 0.3% |