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 | A COPY OF THE COMPLETED FORM 990 IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. THE PLAN ADMINISTRATOR REVIEWS AND SIGNS THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | EMPLOYEES SIGN CONFLICT OF INTEREST POLICY ON FIRST DAY OF EMPLOYMENT. IT IS REVIEWED ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE ORGANIZATION'S 990 IS AVAILABLE ON GUIDESTAR. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. THE ORGANIZATION DOES MAKE THEM AVAILABLE TO PARTICIPANTS IN THE GROUP HEALTH PLAN UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | ADMINISTRATIVE FEES 35,989. COMMISSIONS 145,398. ADMINISTRATOR FEES 13,380. |
| Software ID: | |
| Software Version: |