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, PAGE 6, PART VI, LINE 11B | FORM WAS PRESENTED TO AND REVIEWED BY THE BOARD IN THE MONTH PRIOR TO THE FILING DEADLINE. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ANNUAL DISCLOSURE BY BOARD MEMBERS OF ANY CONFLICT OF INTEREST, AS SET FORTH IN THE POLICIES, IS REQUIRED. FOR ANY POSSIBLE CONFLICT OF INTEREST IDENTIFIED, THE REMAINING BOARD DETERMINES IF IT ACTUALLY CONSTITUTES A CONFLICT OF INTEREST WITHOUT THE CONFLICTED BOARD MEMBER PRESENT. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE BOARD, LESS THE CONFLICTED MEMBER, WILL THEN DECIDE THE LEVEL OF INVOLVEMENT OF THE MEMBER IN DECISION MAKING FOR THE ENTITY, IF THERE IS AN ALTERNATIVE ARRANGEMENT THAT WILL ELIMINATE THE CONFLICT OF INTEREST, AND THE APPROPRIATENESS OF THE CONFLICTED MEMBER CONTINUING AS A BOARD MEMBER. FAILURE TO DISCLOSE A CONFLICT OF INTEREST CAN RESULT IN DISCIPLINARY AND CORRECTIVE ACTION FOR THE CONFLICTED MEMBER. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS AND POLICIES ARE MADE AVAILABLE TO THE PUBLIC THROUGH BEING POSTED ON THE WEBSITE. |
| FORM 990, PART XI, LINE 9 | NETDECREASE IN BENEFIT OBLIGATIONS FOR HEALTH CLAIMS 506,992 NET DECREASE IN CLAIMS INCURRED BUT NOT REPORTED 0 NET INCREASE IN BENEFIT OBLIGATIONS FOR HEALTH CLAIMS 0 NET INCREASE IN CLAIMS INCURRED BUT NOT REPORTED -1,295,517 |
| Software ID: | |
| Software Version: |