Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Pt VI, Line 3 | THE ORGANIZATION UTILIZES THE SERVICES OF I.E. SHAFFER, |
| Pt VI, Line 3 | A THIRD PARTY ADMINISTRATOR, AND FABIAN & BYRN, LLC, |
| Pt VI, Line 3 | A CLAIMS ADMINISTRATOR. |
| Pt VI, Line 11b | A COPY OF THE FORM 990 IS PROVIDED TO EACH TRUSTEE AT A MEETING |
| Pt VI, Line 11b | PRIOR TO THE FILING DATE, WHERE QUESTIONS THAT A TRUSTEE HAS |
| Pt VI, Line 11b | ARE ADDRESSED. |
| Pt VI, Line 12c | THE ORGANIZATION HAS A REGULARLY SCHEDULED QUARTERLY |
| Pt VI, Line 12c | MEETING WHERE IT MONITORS COMPLIANCE WITH THE POLICY. |
| Pt VI, Line 15a | NO COMPENSATION - EMPLOYEE BENEFIT PLAN |
| Pt VI, Line 19 | THE DOCUMENTS ARE AVAILABLE TO PARTICIPANTS AND THE PUBLIC UPON REQUEST |
| Form 990, Part IX, Line 24f | COLLECTION FEES - LEGAL 36166. 36166. 0. 0. COLLECTION FEES REIMB-102 PENSION/SURETY 17486. 17486. 0. 0. DISCOUNT CLAIM FEES 12184. 12184. 0. 0. PATIENT CENTERED OUTCOME FEE 6890. 6890. 0. 0. PAYROLL AUDIT FEES 33439. 33439. 0. 0. |
| Software ID: | 13000178 |
| Software Version: |