-
TIN:
SCHEDULE O
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is atwww.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Inspection
Name of the organization
THE MCLEAN HOSPITAL CORPORATION EMPLOYEE
RETIREE MEDICAL TRUST
RETIREE MEDICAL TRUST
Employer identification number
04-3362620
04-3362620
| Return Reference | Explanation |
|---|---|
| FORM 990, PART III - PROGRAM SERVICE | THE SOLE PURPOSE OF THE MCLEAN HOSPITAL CORPORATION EMPLOYEE AND RETIREE MEDICAL TRUST (THE "TRUST"), WHICH BECAME EFFECTIVE AUGUST 15, 1995, IS TO FUND POST-RETIREMENT MEDICAL COVERAGES PROVIDED TO ELIGIBLE PARTICIPANTS UNDER THE MEDICAL BENEFITS PLAN FOR RETIREES OF THE MCLEAN HOSPITAL CORPORATION (THE "PLAN"). PARTICIPATION IN THE TRUST IS VOLUNTARY AND CONSISTS OF RETIRED FORMER EMPLOYEES OF THE MCLEAN HOSPITAL CORPORATION AND ANY OTHER RELATED EMPLOYER WHO PARTICIPATES IN THE PLAN WITH THE APPROVAL OF THE BOARD OF TRUSTEES OF THE MCLEAN HOSPITAL CORPORATION (THE "HOSPITAL"). THE TRUST IS INTENDED TO QUALIFY AS A "VOLUNTARY EMPLOYEES' BENEFITS ASSOCIATION:, WHICH IS EXEMPT FROM TAXATION UNDER SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE (THE "CODE"). POST-RETIREMENT MEDICAL BENEFITS PROVIDED BY THE PLAN ARE FUNDED BY THE TRUST. OTHER BENEFITS FOR CURRENT OR RETIRED EMPLOYEES OF THE HOSPITAL MAY BE ADDED IN THE FUTURE TO THE EXTENT SUCH BENEFITS QUALIFY UNDER SECTION 501(C)(9) OF THE CODE. ANY BENEFIT ADDED WOULD BE OFFERED IN A NONDISCRIMINATORY MANNER AS PROVIDED IN SECTION 1.501(C)(9) OF THE TREASURY REGULATIONS. THE HOSPITAL MAY EXPAND OR LIMIT THE BENEFITS FUNDED THROUGH THE TRUST AND CHANGE ITS CONTRACTUAL ARRANGEMENTS WITH THE MEDICAL INSURANCE COMPANIES AND HMO'S THAT ADMINISTER OR PROVIDE SUCH BENEFITS UNDER THE PLAN. THE TRUST IS CURRENTLY FUNDED BY CONTRIBUTIONS FROM THE HOSPITAL. THE PRESENT TRUSTEE OF THE TRUST IS STATE STREET BANK AND TRUST OF NEW HAMPSHIRE, N.A. (THE "TRUSTEE"). THE HOSPITAL'S CONTRIBUTIONS TO THE TRUST ARE BASED ON PERIODIC ACTUARIAL VALUATIONS PERFORMED BY A NATIONAL CONSULTING FIRM, WHICH DETERMINES THE COST UNDER THE PLAN OF PROVIDING POST-RETIREMENT MEDICAL BENEFITS TO THE HOSPITAL'S CURRENT AND FUTURE RETIREES. WHEN THE TRUST REACHES THE ACTUARIALLY DETERMINED FULL FUNDING LEVEL, THE TRUSTEE WILL BEGIN PAYING THE PREMIUM CONTRIBUTIONS AND BENEFIT CLAIMS UNDER THE PLAN FROM TRUST ASSETS. POST-RETIREMENT MEDICAL BENEFITS ARE PROVIDED IN ACCORDANCE WITH THE ADMINISTRATIVE SERVICES AGREEMENT AND GROUP BENEFIT CONTRACTS MAINTAINED BY THE HOSPITAL UNDER THE PLAN. |
| FORM 990, PART VI, SECTION B, LINE 11 | FORM 990 & COPY TO MEMBERS OF ITS GOVERNING BODY A COPY OF THE FINAL RETURN WILL BE MADE AVAILABLE TO THE APPROPRIATE MEMBERS OF THE GOVERNING BODY. FORM 990 REVIEW THE FORM 990 WAS PREPARED AND REVIEWED BY THE PARTNERS HEALTHCARE SYSTEM, INC. (PHS) TAX DEPARTMENT. THE TREASURER REVIEWED AND SIGNED THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12 | FOR PURPOSES OF ITS ANNUAL TAX FILING, PARTNERS HEALTHCARE HAS AN ANNUAL QUESTIONNAIRE PROCESS FOR OBTAINING INFORMATION ON INTERESTS THAT MAY GIVE RISE TO CONFLICTS FROM ALL OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES. IN ADDITION, IN CONNECTION WITH PARTNERS' CONFLICT OF INTEREST POLICY, THE PARTNERS OFFICE OF COMPLIANCE AND BUSINESS INTEGRITY AND OFFICE OF GENERAL COUNSEL WORK TOGETHER TO PERIODICALLY DISTRIBUTE,COLLECT AND REVIEW DISCLOSURE STATEMENTS FROM THESE INDIVIDUALS. THE INFORMATION ON EACH SUCH DISCLOSURE IS REVIEWED BY EACH INDIVIDUAL'S SUPERVISOR (WHO IN THE CASE OF DIRECTORS AND TRUSTEES IS DEEMED TO CONSIST OF THE CHAIRMAN OF THE BOARD, THE ENTITY'S PRESIDENT/CEO, AND THE GENERAL COUNSEL OR ATTORNEY REPRESENTATIVES OF HIS OFFICE. IN ADDITION, UNDER THE PARTNERS CONFLICT OF INTEREST POLICY, ANY TIME AN OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE IS AWARE OF A TRANSACTION IN WHICH HIS/HER INTEREST MAY CREATE A CONFLICT, HE/SHE IS REQUIRED TO PROVIDE FULL DISCLOSURE OF THE INTEREST, AND MAY NOT BE INVOLVED IN THE INSTITUTIONAL DECISION-MAKING ABOUT THE TRANSACTION. IN ADDITION, WITH RESPECT TO SUCH TRANSACTIONS, IN APPROPRIATE CIRCUMSTANCES, (I) THE CORPORATION MUST CONSIDER AT LEAST TWO ALTERNATIVE DISINTERESTED COMPETITIVE PROPOSALS; OR MUST DETERMINE THAT TWO SUCH COMPETITIVE PROPOSALS DO NOT EXIST OR THAT IT WOULD BE IMPRACTICAL TO ELICIT OR CONSIDER SUCH COMPETITIVE PROPOSALS; AND (II) THE CORPORATION MUST DETERMINE THAT, NOTWITHSTANDING THE APPARENT CONFLICT, THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION AND IS IN THE BEST INTERESTS OF THE CORPORATION. A WRITTEN RECORD MUST BE MADE OF THESE DETERMINATIONS. FURTHERMORE, TRANSACTIONS THAT PRESENT PARTICULARLY SIGNIFICANT CONFLICTS ARE REVIEWED BY AN INDEPENDENT COMMITTEE OF THE PARTNERS BOARD FOR APPROPRIATE ACTION, WHICH REVIEW IS ALSO DOCUMENTED. PUBLIC AVAILABILITY OF FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS UPON REQUEST, THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART VI, SECTION C, LINE 19 | UPON REQUEST, THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015
Additional Data
| Software ID: | |
| Software Version: |