Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| ALL OTHER ACCOMPLISHMENT DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4D | PROVIDE HEALTH BENEFITS TO PARTICIPANTS AND THEIR ELIGIBLE DEPENDENTS |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF FORM 990 IS REVIEWED BY TWO TRUSTEES. ANY QUESTIONS RAISED UPON REVIEW ARE RESOLVED PRIOR TO FILING. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | LEGAL COUNCEL FOR THE PLAN MONITORS RELATIONSHIPS AND AGREEMENTS WITH SEVICE PROVIDERS TO SEE THAT APPRPRIATE PROTECTIONS ARE IN PLACE AND ADHERED TO. TRANSACTIONS ARE SCRUTANIZED BY TRUSTEES AND LEGAL COUNSEL TO PREVENT POTENTIAL CONFLICTS OF INTEREST. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | NO COMPENSATION IS PAID. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | NO COMPENSATION IS PAID. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
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