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 8a | Monthly reviews of financials & budgets; periodic and annual reviews; and meetings with administratiors and auditors are not recorded. |
| Pt VI, Line 8b | Monthly reviews of financials & budgets; periodic and annual reviews; and meetings with administrators and auditors are not recorded. |
| Pt VI, Line 11b | The compiled and annual audited financial statements are reviewed by the trustees. Then the financials' relation with part VIII, IX, & X are reviewed for accuracy and any questions are resolved. After the above, all answers to questions in parts I,III,IV,VI,VII,XI, and schedules L. R and answers on schedule O are reviewed for accuracy. |
| Pt VI, Line 15a | The trust (or any related organizations) does not compensate its trustees for their activities. |
| Pt VI, Line 15b | The trust (or any related organizations) does not compensate its trustees for their activities. |
| Pt VI, Line 19 | Governing documents, financial statements, as well as other related documents are available to the public upon request at its offices (1 Commercial Drive) during normal business hours. |
| Pt XII, Line 2c | No: The trustees assume the responsibility for oversight of the compilation and audit of its financial statements and the selection of the CPA/Auditor. |
| Form 990, Part IX, Line 24f | PARTICIPANT DENTAL CLAIMS 43875. 43875. 0. 0. PARTICIPANT VISION CLAIMS 1287. 1287. 0. 0. PRESCRIPTION CLAIMS PAID 135364. 135364. 0. 0. PARTICIPANT GROUP LIFE PREMIUMS 6828. 6828. 0. 0. PARTICIPANT ST DISABILITY PREMIUMS 11105. 11105. 0. 0. OPTIONAL GROUP PREMIUMS 25842. 25842. 0. 0. ACA TRANS REINSURANCE FEES 7753. 7753. 0. 0. PATIENT-CENTERED OUTCOMES FEES 279. 279. 0. 0. CERTIFIED AUDITS'11,'12,'13,&'14 28500. 28500. 0. 0. COMPILED STATEMENTS & FORM 990 4500. 4500. 0. 0. I.R.S. FILING FEES 4 |
| Software ID: | 14000261 |
| Software Version: |