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 FORM 990 IS PROVIDED TO THE ADMINISTRATOR AND IS MADE AVAILABLE TO THE TRUSTEES PRIOR TO FILING. THE FORM IS SIGNED AND FILED AFTER THIS REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 15 | SALARIES ARE REVIEWED PERIODICALLY BY THE BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE FUND OFFICE. |
| FORM 990, PART XII, LINE 2C | THE PROCESS HAS NOT CHANGED SINCE PRIOR YEAR. |
| PART IX LINE 8 PRIOR PERIOD ADJUSTMENT | WRITE OFF LEASEHOLD IMPROVEMENTS (81,900) ACCUM. DEP LEASEHOLD IMPR WRITTEN OFF 28,665 WRITE OFF FURNITURE & EQUIPMENT (108,565) ACCUM. DEP. FURN & EQUIP WRITTEN OFF 37,864 WRITE OFF BUILDOUT LIABILITY 112,692 WRITE OFF NCR COMPUTER EQUIPMENT (4,582) ACCUM. DEP. NCR COMPUTER EQUIPMENT 4,582 ADJUSTMENT FOR EGINNING BENEFITS PAYABLE: CLAIMS AND INSURANCE PREMIUMS (1,378,975) CLAIMS INCURRED AND NOT REPORTED (5,067,467) PRESCRIPTION BENEFITS PAYABLE (919,683) DENTAL FEES PAYABLE (2,725) TOTAL (7,380,094) BEGINNING NET ASSETS AVAILABLE FOR BENEFITS IS BEING REDUCED BY BEGINNING CLAIMS PAYABLE, WHICH HAD NOT BEEN PREVIOUSLY RECORDED AS WELL AS AN ADJUSTMENT FOR CERTAIN TRANSACTIONS RELATED TO THE FUND'S LEASE AGREEMENT. |
| FORM 990, PART XI, LINE 10 | THE CURRENT YEAR INCREASE IN THE EXCESS FUNDED STATUS FOR THE SINGLE EMPLOYER PENSION PLAN IN THE AMOUNT OF $304,750 HAS BEEN NETTED AGAINST THE TOTAL PENSION EXPENSE OF $325,620 |
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