Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| ALL OTHER ACHIEVEMENTS DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4D | MEDICAL BENEFITS PROVIDED TO ELIGIBLE PARTICIPANTS & THEIR BENEFICIARIES AND ADJUSTED FOR THE CHANGE IN BENEFIT OBLIGATIONS. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | COPY OF FORM 990 WAS PROVIDED TO BOARD OF TRUSTEES FOR THEIR REVIEW. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | TRUSTEES REVIEW & ASSESS IN ALL MEETINGS. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | ALL GOVERNING DOCUMENTS ARE AVAILABLE TO PUBLIC UPON REQUEST. |
| OTHER CHANGES IN NET ASSETS EXPLANATION | FORM 990, PART XI, LINE 5 | CHANGE IN CLAIMS INCURRED BUT NOT REPORTED AND HOUR BANK LIABILITY. |
| Software ID: | |
| Software Version: |