Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE EXTERNAL TAX CONSULTANT PREPARES THE FORM 990 WITH ASSISTANCE FROM THE HEALTH PLAN ADMINISTRATOR. THE HEALTH PLAN ADMINISTRATOR REVIEWS THE DRAFT FORM 990 COMPARING THE INFORMATION TO THE FORM 5500, FINANCIAL ROLL-UPS AND RECONCILIATIONS, TO ENSURE ACCURACY. THE CFO THEN REVIEWS THE FORM 990. THE FORM 990 IS PROVIDED TO THE BOARD'S EMPLOYEE BENEFITS COMMITTEE WHEN THE AD HOC COMMITTEE IS CONVENED. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY THE OFFICER AND DIRECTORS ARE REQUIRED TO DISCLOSE INTERESTS THAT COULD POTENTIALLY GIVE RISE TO CONFLICTS. THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE POLICY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
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