Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS 4,459 MEMBERS CONSISTING SOLELY OF INSURERS AND SELF-INSUREDS AND THIRD PARTY ADMINISTRATORS (TPAS). | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE VOTING MEMBERS ELECT THE BOARD OF DIRECTORS (GOVERNING BODY). THE MEMBERS OF THE BOARD OF DIRECTORS FORM FOUR 4-MEMBER SUBCOMMITTEES (EXECUTIVE, COMPENSATION & BENEFITS, AUDIT AND NOMINATING. ONLY THE GOVERNING BODY HAS THE RIGHT TO ELECT OR APPOINT BOARD MEMBERS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE CFO PROVIDES A DRAFT OF THE FORM 990 TO THE MEMBERS OF THE AUDIT COMMITTEE FOR REVIEW AND COMMENT. AFTER THIS PROCESS HAS BEEN COMPLETED, THE CFO SHARES THE REVISED FORM WITH THE REMAINING MEMBERS OF THE BOARD OF DIRECTORS FOR COMMENT AND REVIEW PRIOR TO FILING WITH THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | DIRECTORS AND OFFICERS RECEIVE THE CONFLICT OF INTEREST POLICY AND PROCEDURES DISCLOSURE FORM AND ARE REQUIRED TO SIGN AND DATE THE POLICY DISCLOSURE FORM EACH CALENDAR YEAR. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPANY USES AN INDEPENDENT PARTY (THE HAY GROUP) TO RECOMMEND THE APPROPRIATE COMPENSATION AMOUNTS FOR TOP MANAGEMENT AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE THEN REVIEWS THE RECOMMENDATIONS AND APPROVES THE COMPENSATION AND BENEFIT AMOUNTS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN OR VERBAL REQUEST. | |
| NAMES AND ADDRESSES OF BOD MEMBERS THAT CAN'T BE REACHED AT MAILING ADDRESS | FORM 990, PART VI, SECTION A, LINE 9 | ARTHUR BECKMAN: ONE STATE FARM PLAZA; A2; BLOOMINGTON, IL 61710 MIKE CAPUZZI: 6300 WILSON MILLS ROAD; MAYFIELD VILLAGE, OH 44143 JOSEPH CENTANNI: ONE NATIONWIDE PLAZA; 3-13-203; COLUMBUS, OH 43215 JOHN FOUERT: ONE STATE FARM PLAZA; A4; BLOOMINGTON, IL 61710 CYNTHIA GARTEN: 1 TOWER SQUARE; 3MS; HARTFORD, CT 06183 TED GRAMER: 175 BERKELEY STREET, MAIL STOP S2B; BOSTON, MA 02116 DANIEL HERDMANN: 210 SOUTH FOURTH STREET; PHILADELPHIA, PA 19106 DON LYONS: 3535 W. PIPKIN ROAD; LAKELAND, FL 33811 JAMES MCLAIN: 3426 TORINGDON WAY; SUITE 200; CHARLOTTE, NC 28277 DAVID NARIGON: 970 SCALLON ROAD; DERIDDER, LA 70634 WAYNE SMOLDA: 4850 E. STREET ROAD; #200; TREVOSE, PA 19053 DONNA ROSEMEYER: DIRECTOR REGRETTABLY PASSED ON DURING THE YEAR |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 781,025. DEFINED BENEFIT ACCRUAL AS REQUIRED BY ASC 715 -54,047. TOTAL TO FORM 990, PART XI, LINE 5: 726,978. |
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