Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS INCLUDE ALL ACTIVE FULL-TIME EMPLOYEES OF A PARTICIPATING EMPLOYER (SCHOOL DISTRICT), WHO ARE IN AN ELIGIBLE CLASS, AND THEIR SPOUSES AND COVERED DEPENDENTS. ELIGIBLE CLASSES OF EMPLOYEES ARE DETERMINED BY EACH SCHOOL DISTRICT BOARD POLICY. RETIRED EMPLOYEES ARE ALSO CONSIDERED MEMBERS AND ENTITLED TO SIMILAR HEALTH BENEFITS (IN EXCESS OF MEDICARE COVERAGE). | |
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF THE FORM 990 IS PROVIDED TO THE TRUST'S BOARD OF DIRECTORS FOR REVIEW AND APPROVAL PRIOR TO FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | ON AN ANNUAL BASIS EACH BOARD MEMBER IS ASKED TO REAFFIRM THEIR "NO CONFLICT" AFFIDAVIT. | |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD OF DIRECTORS APPROVE COMPENSATION OF CFO BASED ON NUMBER OF LIVES INSURED, WHICH IS APPROXIMATELY $100 PER 500 LIVES. | |
| FORM 990, PART VI, SECTION C, LINE 18 | THE TRUST MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE TRUST MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO MEMBER SCHOOL DISTRICTS UPON REQUEST. | |
| THE TRUST'S BOARD OF GOVERNORS ASSUMES ALL RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. |
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