Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4D | A SELF INSURANCE PROGRAM FOR THE MEMBERS OF THE CONSORTIUM (HEALTH INSURANCE). |
| FORM 990, PAGE 6, PART VI, LINE 7A | YES, EACH PARTICIPATING MEMBER HAS ONE REPRESENTATIVE ON THE BOARD OF DIRECTORS |
| FORM 990, PAGE 6, PART VI, LINE 7B | YES, THE BOARD REPRESENTS ALL OF THE MEMBERS |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE TREASURER AND FINANCE COMMITTEE REVIEW AND APPROVE THE FORM 990 BEFORE FILING. |
| FORM 990, PAGE 6, PART VI, LINE 19 | DOCUMENTS AVAILABLE UPON REQUEST TO THE PUBLIC |
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