Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Business and/or Family Relationships | Form 990, Part VI, Section A, Line 2 | A. Scott Anderson / Thomas B. Morgan - Business Relationship (EMPLOYER/EMPLOYEE RELATIONSHIP IN AN UNRELATED TAXABLE CORPORATION) BRUCE T. REESE / CHARLES W. SORENSON JR MD / DOUGLAS C. BLACK / F. ANN MILLNER / KEM C. GARDNER / MERRILL GAPPMAYER / TERESA BECK - BUSINESS RELATIONSHIP (BOARD MEMBERS AND/OR OFFICERS OF THE HEALTHCARE CAPTIVE INSURANCE COMPANY, A TAXABLE ORGANIZATION THAT IS WHOLLY-OWNED BY THE FILING ORGANIZATION'S PARENT) CHARLES W. SORENSON JR. MD / EDWARD G. KLEYN / THOMAS B. MORGAN - BUINESS RELATIONSHIP (BOARD MEMBERS OF SELECTHEALTH BENEFIT ASSURANCE COMPANY, A TAXABLE CORPORATION THAT IS WHOLLY-OWNED BY AN AFFILIATE OF THE FILING ORGANIZATION) BRUCE T. REESE / CHARLES W. SORENSON JR MD / DOUGLAS C. BLACK / F. ANN MILLNER / KEM C. GARDNER / MERRILL GAPPMAYER / TERESA BECK - BUSINESS RELATIONSHIP (BOARD MEMBERS AND/OR OFFICERS OF AFFILIATED SERVICES, INC., A TAXABLE CORPORATION WITH MINIMAL ACTIVITY THAT IS WHOLLY-OWNED BY AN AFFILIATE OF THE FILING ORGANIZATION) |
| FORM 990 REVIEW BY BOARD MEMBERS | FORM 990, PART VI, SECTION B, LINE 11B | THIS RETURN WAS NOT PROVIDED TO THE MEMBERS OF THE GOVERNING BODY PRIOR TO FILING. |
| POLICIES | Form 990, Part VI, Section B, Lines 12, 13, 14 | Although no formal resolution has been approved by the governing body, Intermountain Health Care Inc. Retiree Welfare Benefit Trust has relied on the conflict of interest, whistleblower and document retention and destruction policies of its sole member, Intermountain Health Care, Inc. |
| PUBLIC INSPECTION OF GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STMTS. | FORM 990, PART VI, SECTION A, LINE 19 | INTERMOUNTAIN HEALTH CARE, INC. RETIREE WELFARE BENEFIT TRUST DOES NOT CURRENTLY ALLOW PUBLIC INSPECTION OF ANY OF THESE DOCUMENTS. |
| RECONCILIATION OF NET ASSETS | FORM 990, PART XI, LINE 5 | $6,688,107 - NET UNREALIZED GAINS REPORTED ON AUDITED FINANCIAL STATEMENTS. |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:BETH V. COLE TITLE:TRUSTEE HOURS:4 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:BRUCE T. REESE TITLE:TRUSTEE HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:CHARLES W. SORENSON JR. MD TITLE:TRUSTEE HOURS:67 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DOUGLAS C. BLACK TITLE:TRUSTEE/VICE CHAIR/SECRETARY HOURS:10 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:EDWARD G. KLEYN TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:F. ANN MILLNER TITLE:TRUSTEE HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JANE CARLILE TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JOANN B. SEGHINI TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:KAREN W. FAIRBANKS TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:KEM C. GARDNER TITLE:TRUSTEE/CHAIR HOURS:8 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:M. ELIZABETH HAMMOND MD TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MERRILL GAPPMAYER TITLE:TRUSTEE HOURS:6 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:RANDY HORIUCHI TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:REBECCA CHAVEZ-HOUCK TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:SPENCER F. ECCLES TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:TERESA BECK TITLE:TRUSTEE HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:THOMAS B. MORGAN TITLE:TRUSTEE HOURS:3 |
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