Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS | FORM 990, PAGE 6, PART VI, LINE 4 | THE PLAN ELECTED TO TERMINATE ITS THIRD PARTY ADMINISTRATOR AND HIRE A NEW PLAN ADMINISTRATOR. THE EFFECTIVE DATE OF THIS CHANGE WAS NOVEMBER 1, 2011. THE PLAN ELECTED TO CHANGE ITS COVERAGE FOR DENTAL BENEFITS FROM A SELF- INSURED ARRANGEMENT TO A FULLY INSURED PRODUCT. THE EFFECTIVE DATE OF THIS CHANGE WAS DECEMBER 31, 2010. THE 990 HAS BEEN FILED USING THE ACCRUAL METHOD OF ACCOUNTING. THE PLAN MAINTAINS IT'S BOOKS AND RECORDS ON THE ACCRUAL METHOD OF ACCOUNTING, AND THE AUDITED FINANCIAL STATEMENTS ARE REPORTED UNDER THE ACCRUAL METHOD OF ACCOUNTING. THE 990 PREPARER ELECTED TO REPORT THE PRIOR YEAR RETURN UNDER THE CASH METHOD OF ACCOUNTING. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | RETURN REVIEWED BY MANAGER OF HR (CURRENT TRUSTEE) AND ACCOUNTING DEPARTMENT INDIVIDUALS, WHO ARE ASIGNED SUCH TASK BY TRUSTEES. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | WRITTEN REQUESTS FOR PUBLIC DOCUMENTS ARE TO BE SENT TO HR DEPARTMENT. HR DEPARTMENT WILL THEN PROVIDE AS NEEDED. |
| Software ID: | |
| Software Version: |