Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990 - ORGANIZATION'S MISSION | THE FUND IS CREATED, ESTABLISHED, AND MAINTAINED FOR THE PURPOSE OF PROVIDING ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS AND/OR BENEFICIATIES WITH MEDICAL, SURGICAL, AND HOSPITAL CARE; BENEFITS IN THE EVENT OF SICKNESS, ACCIDENT, DISABILITY, DEATH, OR UNEMPLOYMENT; AND DENTAL, OPTICAL, AND PRESCRIPTION DRUG CARE; AND FOR THE PURPOSE OF DEFRAYING REASONABLE COSTS OF ADMINISTRATION. |
| ADDITIONAL INFORMATION | FORM 990, PART VI | LINE 2 - FAMILY RELATIONSHIP OR BUSINESS RELATIONSHIP - THE RELATIONSHIP BETWEEN THE TRUSTEES OF THE FUND IS A 'BUSINESS RELATIONSHIP'. THE FUND IS ESTABLISHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED. 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 12 - ANNUALLY, EACH TRUSTEE MUST ANSWER THE FIDUCIARY LIABILITY INSURANCE REVEWAL QUESTIONAIRE, WHICH CONTAINS QUESTIONS REGARDING POTENTIAL AND ACTUAL CONFLICTS OF INTEREST. LINE 15 - THE FUND DID NOT HAVE A CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL, OR OTHER OFFICERS OR KEY EMPLOYEES, AS THOSE TERMS ARE DEFINED. |
| SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS | FORM 990, PAGE 6, PART VI, LINE 4 | THE FUND RESTATED THE SPD TO INCORPORATE THE CHANGES REQUIRED BY THE HEALTH CARE REFORM LAW. |
| 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 APPROVAL BY AND REVIEW OF THE FUND'S LEGAL COUNSEL. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE FUND IS ESTABLISHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT SECURITY ACT OF 1974, AS AMENDED. IT OPERATES IN COMPLIANCE WITH THE REPORTING AND DISCLOSURE REQUIREMENTS OF SUBTITLE B, PART 1 ERISA WITH RESPECT TO DISCLOSURE OF ITS GOVERNING DOCUMENTS AND FINANCIAL INFORMATION. IT OPERATES IN COMPLIANCE WITH FIDUCIARY RESPONSIBILITY REQUIREMENTS OF SUBTITLE B, PART 4 OF ERISA. THE FUND DOES NOT HAVE A CONFLICTS OF INTEREST POLICY. |
| ADDITIONAL INFORMATION | FORM 990, PART VII | LINE 1A - THE TRUSTEES OF THE FUND SERVE WITHOUT COMPENSATION FROM THE FUND FOR THEIR SERVICES, HOWEVER, SOME OF THE TRUSTEES WERE COMPENSATED AS EMPLOYEES OF CONTRIBUTING EMPLOYERS TO THE FUND, WHICH ARE CONSIDERED RELATED ORGANIZTIONS TO THE FUND FOR PURPOSES OF FORM 990. |
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