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 - ORGANIZATION'S MISSION | THE FUND IS CREATED, ESTABLISHED, AND MAINTAINED FOR THE PURPOSE OF PROVIDING ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS AND/OR BENEFICIARIES WITH MEDICAL, SURGICAL, AND HOSPITAL CARE; BENEFITS IN THE EVENT OF SICKNESS, ACCIDENT, DISABILITY, DEATH, OR UNEMPLOYMENT; AND DENTAL, OPTICAL, AND PRESCRIPTION DRUG CARE; AND FOR THE PURPOSE OF DEFRAYING REASONABLE COST OF ADMINISTRATION. |
| FORM 990, PART VI | LINE 2 - FAMILY RELATIONSHIP OR BUSINESS RELATATIONSSHIP - THE RELATIONSHIP BETWEEN THE TRUSTEES OF THE FUNDS IA A 'BUSINESS RELATIONHIP'. THE FUND IS ESTABLISHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED. THE FUND, AS A TAFT-HARTLEY FUND, IS ADMINISTERED BY A BOARD OF TRUSTEES WHICH IS COMPOSED OF FOUR TRUSTEES (2 UNION AND 2 EMPLOYER). BECAUSE OF THIS ORGANIZATION REQUIREMENT, THERE IS A BUSINESS RELATIONSHIP BETWEEN THE TRUSTEES. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE FUND IS ADMINISTERED BY A BOARD OF THREE TRUSTEES, COMPRISED OF FOUR TRUSTEES (TWO UNION AND TWO EMPLOYER). THE UNION TRUSTEES ARE APPOINTED BY THE PRESIDENT OF SEIU LOCAL 1 THE EMPLOYER TRUSTEE IS APPOINTED BY THE CONTRIBUTING EMPLOYERS, WITH THE WRITTEN APPROVAL OF THE CONTRIBUTING EMPLOYERS WHO ARE MAKING CONTRIBUTIONS FOR AT LEAST 66% OF THE PARTICIPATING EMPLOYEES. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS PRESENTED AND APPROVED AT A MEETING OF THE BOARD OF TRUSTEES, SUBJECT TO APPROVAL BY AND REVIEW OF THE FUND'S LEGAL COUNSEL. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ANNUALLY, EACH TRUSTEE MUST ANSWER THE FIDUCIARY LIABILITY INSURANCE RENEWAL QUESTIONAIRE, WHICH CONTAINS QUESTIONS REGARDING POTENTIAL AND ACTUAL CONFLICTS OF INTEREST. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE FUND IS ESTABLIZHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED. IT OPERATES IN COMPLIANCE WITH THE REPORTING AND DISCLOSURE REQUIREMNTS OF SUBTITLE B, PART 1 OF ERISA WITH RESPECT TO DISCLOSURE OF ITS GOVERNING DOCUMENTS AND FINANCIAL INFORMATION. IT OPERATES IN COMPLIANCE WITH THE FIDUCIARY RESPONSIBILITY REQUIREMENTS OF SUBTITLE B, PART 4 OF ERISA. THE FUND DOES NOT HAVE CONFILICT OF INTEREST POLICY. |
| FORM 990, PART VII | THE TRUSTEES OF THE FUND SERVE WITHOUT COMPENSATION FROM THE FUND FOR THEIR SERVICES. HOWEVER, THE TRUSTEES WERE COMPENSATED AS EMPLOYEES OF CONTRIBUTING EMPLOYERS TO THE FUND, WHICH ARE CONSIDERED RELATED ORGANIZATIONS TO THE FUND FOR PURPOSES OF FORM 990. |
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