Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| ADDITIONAL INFORMATION | FORM 990, PART VI | SECTION B, LINE 13: THE TRUST FUND DOES NOT RETAIN A WRITTEN WHISTLEBLOWER POLICY, BUT THE BOARD OF TRUSTEES AND THE TRUST FUND CONFORM WITH ERISA RULES AND REGULATIONS WITH REGARDS TO THE WHISTLEBLOWER POLICY. SECTION C, LINE 18: THE BOARD OF TRUSTEES AND THE TRUST FUND CONFORM WITH ERISA RULES AND REGULATIONS WITH REGARDS TO MAKING ITS FORMS 1023 AND 990 AVAILABLE FOR PUBLIC INSPECTION. |
| MANAGEMENT DELEGATED | FORM 990, PAGE 6, PART VI, LINE 3 | THE BOARD OF TRUSTEES HAS OUTSOURCED THE DAY TO DAY ADMINISTRATION OF THE TRUST FUND TO HEALTHSMART BENEFIT SOLUTIONS TPA. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | FORM 990 IS AVAILABLE TO EACH TRUSTEE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | THE BOARD OF TRUSTEES AND THE TRUST FUND CONFORM WITH ERISA RULES AND REGULATIONS WITH RESPECT TO REGULARLY AND CONSISTENTLY MONITORING AND ENFORCING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE TRUST FUND MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE TRUST FUND AND THE BOARD OF TRUSTEES CONFORM WITH ERISA RULES AND REGULATIONS RELATING TO THIS MATTER. |
| OTHER CHANGES IN NET ASSETS EXPLANATION | FORM 990, PART XI, LINE 5 | CURRENT YEAR ACTUARIAL CHANGE IN BENEFIT OBLIGATION : 561,504 NET CHANGE IN UNREALIZED APPRECIATION IN FAIR VALUE OF INVESTMENTS : 377,032 TOTAL OTHER CHANGES IN NET ASSETS OR FUND BALANCES: 938,536 |
| Software ID: | |
| Software Version: |