Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF THE FORM 990 IS PROVIDED TO MEMBERS OF THE BENEFIT COMMITTEE VIA EMAIL. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DISTRIBUTES THE HEALTH PLAN DOCUMENT TO ALL PLAN PARTICIPANTS. A CONFLICT OF INTEREST POLICY IS NOT APPLICABLE TO SELF-INSURED HEALTH TRUSTS. SUMMARY ANNUAL REPORT FROM THE CURRENTLY FILED FORM 5500 IS DELIVERED TO PARTICIPANTS AND POSTED ON THE SPONSOR INTRANET WEBSITE. FORM 5500, WHICH CONTAINS SCHEDULE H FINANCIAL STATEMENTS CAN BE ACCESSED ON FREERISA.COM BY THE GENERAL PUBLIC. | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 90,022. CHANGE IN OBLIGATION CLAIMS -453,000. TOTAL TO FORM 990, PART XI, LINE 5: -362,978. |
| FORM 990, PART XI, LINE 2C | THE COMMITTEE PROCESSES FOR OVERSEEING THE AUDIT HAVE NOT CHANGED FROM THE PRIOR YEAR. | |
| REPORTABLE COMPENSATION FROM THE ORGANIZATION - | FORM 990, PART V, LINE 1A AND 1C AND PART VII, COLUMN D, INDIVIDUAL 1 | THE ORGANIZATION COMPENSATED FIRST INTERSTATE BANK FOR SERVICES RENDERED AS TRUSTEE. A THIRD PARTY, ALLEGIANCE, FILES 1099'S ON BEHALF OF FIRST INTERSTATE BANKSYSTEM INC. HEALTH BENEFITS PLAN. |
| FILING OF FORM 990-T | FORM 990, PART V, LINE 3A AND 3B | THE ORGANIZATION IS ELECTING TO SET ASIDE INVESTMENT INCOME FOR THE PURPOSE OF PAYMENTS FOR HEALTH BENEFITS TO ITS MEMBERS. THE SET ASIDE ELECTION HAS BEEN MADE BY FILING SCHEDULE G OF FORM 990-T, IN ADDITION TO COMPLETING A SCHEDULE IN SUPPORT OF INCOME SET ASIDE AS ATTACHED TO THE 990-T. |
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