Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| ADDITIONAL INFORMATION | FORM 990 | PART IV, LINE 34 - THE FUND IS A MULTIEMPLOYER FUND AS DEFINED BY THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED, WITH MANY ENTITIES THAT MIGHT BE 'SPONSORING ORGANIZATIONS OF A VEBA' OR 'CONTRIBUTING EMPLOYERS OF A VEBA'. ONLY THOSE ENTITIES THAT CONTRIBUTED 10% OR MORE OF THE CONTRIBUTIONS TO THE FUND FOR THE PLAN YEAR ARE REPORTED ON SCHEDULE R. |
| ALL OTHER ACHIEVEMENTS DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4D | TO PROVIDE HEALTH AND LIFE INSURANCE TO PARTICIPANTS |
| ADDITIONAL INFORMATION | FORM 990, PART V | LINE 2A - 7 ISSUED W-2S REPRESENT DISABILITY PAYMENTS TO FUND PARTICIPANTS. AS NOTED IN PART I, LINE 5, THE FUND DOES NOT HAVE EMPLOYEES. |
| ADDITIONAL INFORMATION | FORM 990, PART VI | LINE 2 - THE RELATIONSHIP BETWEEN THE TRUSTEES OF THE FUND IS A 'BUSINESS RELATIONSHIP'. THE FUND IS ESTABLISHED AND MAINTAINED PURSUANT TO ERISA. THE FUND, AS A TAFT-HARTLEY FUND, IS ADMINISTERED BY A BOARD OF TRUSTEES WHICH IS COMPOSED OF AN EQUAL NUMBER OF UNION AND EMPLOYER REPRESENTATIVES. BECAUSE OF THIS ORGANIZATIONAL REQUIREMENT, THERE IS A BUSINESS RELATIONSHIP BETWEEN THE TRUSTEES. LINE 12B - ANNUALLY EACH TRUSTEE MUST ANSWER THE FIDUCIARY LIABILITY INSURANCE RENEWAL QUESTIONAIRE WHICH CONTAINS QUESTIONS REGARDING POTENTIAL AND ACTUAL CONFLICTS OF INTEREST. |
| SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS | FORM 990, PAGE 6, PART VI, LINE 4 | THE FUND'S BOARD OF TRUSTEES ADOPTED AN AMENDMENT TO ITS PLAN DOCUMENT DURING THE TAX YEAR TO REFLECT THAT THE FUND HAD ENTERED INTO AN AGREEMENT FOR SERVICES WITH A NEW PHARMACY BENEFITS MANAGER AND TO COMPLY WITH THE AFFORDABLE CARE ACT. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS PRESENTED AND APPROVED AT A MEETING OF THE BOARD OF TRUSTEES, SUBJECT TO REVIEW BY AND APPROVAL OF THE FUND LEGAL COUNSEL. IN ADDITION, EACH TRUSTEE IS PROVIDED A COPY OF THE FUND'S FINAL FORM 990 (INCLUDING REQUIRED SCHEDULES), AS ULTIMATELY FILED WITH THE IRS, PRIOR TO ITS FILING WITH THE IRS. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | FORM 990, PART VI, LINE 15A - THE FUND DID NOT HAVE ANY EMPLOYEES IN THE PLAN YEAR. IF THE FUND DID HAVE EMPLOYEES THAT MET THE LISTED DEFINITIONS, THEN ANY COMPENSATION WOULD HAVE BEEN ESTABLISHED IN ACCORDANCE WITH THE PROCESS DESCRIBED IN PART VI, LINE 15 OF FORM 990. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | THE FUND DID NOT HAVE ANY EMPLOYEES IN THE PLAN YEAR. IF THE FUND DID HAVE EMPLOYEES THAT MET THE LISTED DEFINITIONS, THEN ANY COMPENSATION WOULD HAVE BEEN ESTABLISHED IN ACCORDANCE WITH THE PROCESS DESCRIBED IN PART VI, LINE 15 OF FORM 990. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE FUND IS ESTABLISHED AND AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT INCOME SECURITY AND DISCLOSURE ACT OF 1974, AS AMENDED. IT OPERATES IN COMPLIANCE WITH THE REPORTING AND DISCLOSURE REQUIREMENTS OF SUBTITLE B, PART 1 OF ERISA WITH RESPECT TO DISCLOSURE OF ITS GOVERNING DOCUMENTS AND FINANCIAL INFORMATION. IT OPERATES IN COMPLIANCE WITH THE FIDUCIARY RESPONSIBILITY REQUIREMENTS OF SUBTITLE B, PART 4 OF ERISA. THE FUND DOES NOT HAVE A CONFLICT OF INTEREST POLICY. |
| OTHER CHANGES IN NET ASSETS EXPLANATION | FORM 990, PART XI, LINE 5 | INCREASE IN RESERVE FOR EXTENDED ELIGIBILITY. |
| ADDITIONAL INFORMATION | FORM 990, PART XII | LINE 1A - THE TRUSTEES OF THE FUND SERVE WITHOUT COMPENSATION FROM THE FUND BUT ARE COMPENSATED AS EMPLOYEES OF ENTITIES THAT MIGHT BE 'SPONSORING ORGANIZATIONS OF A VEBA' OR 'CONTRIBUTING EMPLOYERS OF A VEBA'. |
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