Form 5500 · Retirement plan · ERLANGER, KY
COMMUNITY HOSPITAL OF SAN BERNARDINO
The filing calls this plan COMMUNITY HOSPITAL OF SAN BERNARDINO TAX SHELTERED ANNUITY PLAN.
COMMUNITY HOSPITAL OF SAN BERNARDINO of ERLANGER, KY files a Form 5500 for its retirement plan. Schedule A discloses 2 annuity or guaranteed-interest contracts held by the plan, written by THE VARIABLE ANNUITY LIFE INSURANCE CO. and 1 other insurer. These are investment and funding contracts, not group health or welfare coverage. No medical, dental or life benefit is reported on this filing.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 95-1643373 · plan 001 · plan year 2024, filed Oct 10, 2025
Plan brief
Schedule A lists 2 insurance contracts held by the plan — annuities, guaranteed-interest accounts or similar funding vehicles. The largest number are with THE VARIABLE ANNUITY LIFE INSURANCE CO..
The contracts held $2,687,795 at the end of the plan year, as reported on Schedule A.
$723 in agent commissions is disclosed across the contracts; ROSENBAUM JR, TOM L is the agent of record.
A Schedule A is filed for a retirement plan when plan assets sit in an insurance company contract. It reports the contract's balances and any agent commission. It does not report a health, dental or life premium, and it does not give a group renewal date.
The contract year ended in December.
Schedule A insurance contracts
| Carrier | Contract type | Covered | Year ends | Contract value | Commission |
|---|---|---|---|---|---|
| THE VARIABLE ANNUITY LIFE INSURANCE CO. | Annuity / GIC | 302 | December | $2,020,075 | $723 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Annuity / GIC | 70 | December | $667,720 | $0 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. The service providers are named on Schedule C of this filing. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 1,365 employees, 92 recordable cases, 1,278 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
What the plan holds
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H
Who runs the plan
The recordkeeper and the accountant are named on Schedule C of this filing. The opinion and the fee are from Schedule H.
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