Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 01-01-2017 , and ending 12-31-2017
BCheck if applicable:
CName of organization
UAW RETIREE MEDICAL BENEFITS TRUST
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
200 WALKER STREET
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
DETROIT, MI48207
D Employer identification number

90-0424876
E Telephone number

G Gross receipts $ 66,388,719,606
F Name and address of principal officer:
MARY BETH KUDERIK
200 WALKER STREET
DETROIT,MI48207
I
Tax-exempt status: ( 9 ) LeftBullet (insert no.) or
J
Website:MediumBullet
N/A
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 2008
M State of legal domicile: MI
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: A VOLUNTARY EMPLOYEE BENEFICIARY ASSOCIATION ("VEBA") ORGANIZED TO HOLD, INVEST, AND ADMINISTER FUNDS FOR POST-RETIREMENT MEDICAL BENEFITS. THE PRIMARY MISSION OF THE RMBT IS TO SERVE AS A SOURCE FOR RETIREE HEALTH CARE COVERAGE FOR ITS' MEMBERS.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 11
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 11
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 146
6 Total number of volunteers (estimate if necessary) ............. 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 19,793,724
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 10,952,493
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 769,183,793 704,167,703
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,760,340,418 3,453,273,819
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 91,755,350 134,221,175
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 2,621,279,561 4,291,662,697
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 3,977,279,561 3,763,623,367
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 23,150,642 24,619,486
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 460,433,168 414,570,410
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 4,460,863,371 4,202,813,263
19 Revenue less expenses. Subtract line 18 from line 12....... -1,839,583,810 88,849,434
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 58,966,480,912 63,225,855,634
21 Total liabilities (Part X, line 26)............. 2,240,969,939 1,937,702,423
22 Net assets or fund balances. Subtract line 21 from line 20..... 56,725,510,973 61,288,153,211
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
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Signature of officer Date
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Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2019)
Form 990 (2019)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: A VOLUNTARY EMPLOYEE BENEFICIARY ASSOCIATION ORGANIZED TO HOLD, INVEST, AND ADMINISTER FUNDS FOR POST-RETIREMENT MEDICAL BENEFITS. THE PRIMARY MISSION OF THE RMBT IS TO SERVE AS A SOURCE FOR RETIREE HEALTH CARE COVERAGE FOR ITS' MEMBERS.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
THE UAW RETIREE MEDICAL BENEFITS TRUST (THE "TRUST") PROVIDES HEALTH CARE BENEFITS TO ELIGIBLE CURRENT AND FUTURE UAW RETIREES FROM GENERAL MOTORS, FORD, AND CHRYSLER, ALONG WITH THEIR ELIGIBLE DEPENDENTS. THE TRUST IS AN INDEPENDENT ENTITY AND IS NOT GOVERNED BY, OR A PART OF, THE UAW OR THE AUTO COMPANIES. THIS ARRANGEMENT WAS ESTABLISHED THROUGH A PROVISION IN THE 2007 COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE UAW AND THE THREE AUTO COMPANIES. UNDER THESE AGREEMENTS, ALL OF THE RETIREE HEALTH CARE LIABILITIES WERE TRANSFERRED TO A NEW AND INDEPENDENT VOLUNTARY EMPLOYEES' BENEFICIARY ASSOCIATION (VEBA). THE FEDERAL COURTS APPROVED THESE AGREEMENTS IN A SERIES OF CLASS ACTION SETTLEMENTS, AND THE ARRANGEMENTS WERE ALSO APPROVED BY THE BANKRUPTCY COURTS IN THE GENERAL MOTORS AND CHRYSLER CHAPTER 11 BANKRUPTCY PROCEEDINGS DURING 2009. THE TRUST IS GOVERNED BY AN 11-PERSON COMMITTEE COMPRISED OF SIX INDEPENDENT MEMBERS AND FIVE MEMBERS APPOINTED BY THE UAW. ADDITIONAL SUBCOMMITTEES OF THE COMMITTEE EXIST FOR PLAN ADMINISTRATION, INVESTMENT, AND AUDIT. ALL COMMITTEE MEMBERS AND TRUST STAFF ADHERE TO A STRICT CODE OF ETHICS.THE PURPOSE OF THE TRUST IS TO SERVE AS A SOURCE FOR RETIREE HEALTH CARE COVERAGE FOR ITS MEMBERS. SEPARATE TRUST ACCOUNTS ARE MAINTAINED FOR EACH AUTO PLAN (GM, FORD, AND CHRYSLER) FROM WHICH BENEFITS ARE PAID. WHEN THE TRUST LAUNCHED IN JANUARY 2010, IT BECAME THE LARGEST NON-GOVERNMENTAL PURCHASER OF RETIREE HEALTH CARE IN THE UNITED STATES, PROVIDING HEALTH CARE BENEFITS TO MORE THAN 860,000 PERSONS. IN 2017, THE TRUST PROVIDED COVERAGE FOR APPROXIMATELY 680,000 MEMBERS.THE TRUST CONTINUES TO SERVE ITS MISSION OF PROVIDING HEALTH CARE BENEFITS TO RETIREES AND REVIEWS THE BENEFIT DESIGN EACH YEAR TO MAKE ANY ADJUSTMENTS THAT ARE NECESSARY. IN 2017, THE TRUST PAID APPROXIMATELY $3.8 BILLION PROVIDING HEALTH CARE FOR ITS RETIREES AND DEPENDENTS, INCLUDING FILLING OVER 17 MILLION PRESCRIPTIONS FOR MEMBERS DURING THE PLAN YEAR. SINCE THE LAUNCH THE TRUST HAS MADE GREAT STRIDES IN FINDING WAYS TO CONTROL COSTS WHILE IMPROVING HEALTH CARE BENEFITS. FOR 2017, THE TRUST WAS PLEASED TO MAINTAIN BENEFIT LEVELS WHILE ADDING COVERAGE FOR PREVENTIVE IMMUNIZATIONS AND ADVANCE CARE PLANNING FOR ALL MEMBERS. MEMBER COST SHARE HAD SLIGHT INCREASES IN DEDUCTIBLES AND OUT OF POCKET MAXIMUMS IN COMMERCIAL AND TRADITIONAL PLANS AND AN INCREASE IN BRAND PRESCRIPTION COPAYS. THE TRUST MEMBERSHIP IS GEOGRAPHICALLY AND DEMOGRAPHICALLY DIVERSE. THE TRUST MAINTAINS ROBUST COMMUNICATION WITH MEMBERSHIP IN ORDER TO OPERATE IN A TRANSPARENT FASHION. THE GOAL IS TO KEEP BENEFICIARIES INFORMED ON THE TRUST ACTIVITIES, AS WELL AS THE BENEFITS PROVIDED BY THE TRUST.SIGNIFICANT COMMUNICATION EFFORTS WERE MADE TO ASSIST 76 PERCENT OF TRUST MEMBERS WITH MEDICARE TO UNDERSTAND THEIR BENEFITS AND PLAN OPTIONS. THE TRUST EXPANDED MEDICARE ADVANTAGE PRODUCTS IN ADDITIONAL 20 STATES TO MAKE THEM AVAILABLE FOR MEMBERS THROUGHOUT THE COUNTRY. THE TRUST AND CARRIERS SENT A SERIES OF COMMUNICATIONS TO MEMBERS REGARDING 2018 ENROLLMENT AND PLAN OFFERINGS. MEDICARE MEMBERS WERE PROVIDED AN AUTOMATIC ENROLLMENT OPTION FOR AVAILABLE MEDICARE ADVANTAGE PLANS. RETIREE HEALTH CARE CONNECT, THE CALL CENTER FOR TRUST MEMBERS, HANDLED MORE THAN 387,000 CALLS IN 2017. PRINTED MAILINGS WERE DISTRIBUTED BY THE TRUST TO NEARLY 463,000 CONTRACT HOLDER PARTICIPANTS DURING 2017. THESE MAILINGS UPDATE THE TRUST MEMBERSHIP ON BENEFITS PROVIDED BY THE TRUST AND INFORMATION REGARDING THE TRUST'S FINANCIAL POSITION. TRUST PARTNERS ALSO COMMUNICATED DIRECTLY WITH MEMBERS, ON BEHALF OF THE TRUST, DURING THE COURSE OF 2017 REGARDING BENEFITS, PREVENTION, CHRONIC CONDITIONS AND DISEASE MANAGEMENT WHERE APPROPRIATE. ADDITIONALLY, MEMBERS WITH SPECIFIC GAPS IN CARE WERE SENT LETTERS ENCOURAGING THEM TO TAKE PREVENTIVE MEASURES TO MANAGE THEIR CONDITION(S), IMPROVE THEIR HEALTH STATUS, AND ENGAGE WITH THEIR PRIMARY CARE PHYSICIAN. SPECIFICALLY THE TRUST SENT OFFICE VISIT BENEFIT REMINDERS TO APPROXIMATELY 23,500 MEMBERS AGED 40-64 WHO HAD NOT SEEN A PRIMARY CARE PHYSICIAN IN THE PAST 12 MONTHS. A REVIEW OF CLAIMS FOR THESE MEMBERS FOUND 62 PERCENT OF THOSE MEMBERS WENT TO A PCP AFTER RECEIVING THIS INFORMATION. A SIMILAR CAMPAIGN FOR DIABETIC EYE EXAMS INCREASED APPROPRIATE UTILIZATION 21 PERCENT.THE TRUST CONTINUES TO LEVERAGE COMMUNICATION FORMATS TO COMPLEMENT MAILINGS, INCLUDING THE TRUST-BRANDED WEBSITE (WWW.UAWTRUST.ORG), VIDEOS, AND PRESENTATIONS AT RETIREE MEETINGS THROUGHOUT THE COUNTRY. THE TRUST AND ASSOCIATED PARTNERS CONDUCTED PRESENTATIONS AT 1,366 MEETINGS WITH AN ESTIMATED OUTREACH TO OVER 105,000 MEMBERS
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet  
Form 990 (2019)
Form 990 (2019)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule A.....................
1
 
No
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II.........
4
 
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment......................
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
Yes
 
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....Click to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....
21
 
No
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
 
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
 
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
85
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
146
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletAR , AS , AU , BE , BR , CI , CH , CO , EZ , EG , FI , FR , GM , GR , HK , HU , IN , ID , EI , IS , IT , JA , KE , KS , LU , MY , MX , MO , NL , NZ , NI , NO , PE , RP , PL , PO , QA , RS , SN , SF , SP , SW , SZ , TW , TH , TS , TU , AE , UK , CA , CJ , DA
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
 
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
 
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
 
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
No
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
 
Form 990 (2019)
Form 990 (2019)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
11
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
11
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletMARY BETH KUDERIK200 WALKER STREET SUITE 400   DETROIT,MI48207 (313) 324-5900
Form 990 (2019)
Form 990 (2019)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) JOE ASHTON......................................................................
COMMITTEE MEMBER
2.00
.................
 
X           56,100 0 0
(2) ADAM BLUMENTHAL......................................................................
COMMITTEE MEMBER
4.00
.................
 
X           51,371 0 0
(3) CINDY ESTRADA......................................................................
COMMITTEE MEMBER
2.00
.................
 
X           0 0 0
(4) TERESA GHILARDUCCI......................................................................
COMMITTEE MEMBER
2.00
.................
 
X           62,618 0 0
(5) NORWOOD JEWELL......................................................................
COMMITTEE MEMBER
2.00
.................
 
X           0 0 0
(6) DAVID BAKER LEWIS......................................................................
COMMITTEE MEMBER
2.00
.................
 
X           53,794 0 0
(7) ROBERT NAFTALY......................................................................
COMMITTEE CHAIR
4.00
.................
 
X           65,420 0 0
(8) WILLIAM PATTERSON......................................................................
COMMITTEE MEMBER
2.00
.................
 
X           57,143 0 0
(9) JAMES SETTLES......................................................................
COMMITTEE MEMBER
2.00
.................
 
X           0 0 0
(10) DENNIS WILLIAMS......................................................................
COMMITTEE MEMBER
2.00
.................
 
X           0 0 0
(11) DOUGLAS WOLL......................................................................
COMMITTEE
2.00
.................
 
X           60,392 0 0
(12) STATE STREET BANK TRUST
 
INSTITUTIONAL TRUSTEE
2.00
.................
 
  X         0 0 0
(13) HERSHEL HARPER......................................................................
CIO
60.00
.................
 
    X       911,114 0 228,915
(14) FRANCINE PARKER......................................................................
CHIEF EXECUTIVE OFFICER
60.00
.................
 
    X       454,387 0 32,081
(15) MARY BETH KUDERIK......................................................................
CHIEF FINANCIAL OFFICER
60.00
.................
 
    X       460,507 0 42,904
(16) LINDA DENOMME......................................................................
LEGAL COUNSEL
60.00
.................
1.00
      X     297,519 0 24,977
(17) RONALD BERRY......................................................................
CHIEF ADMINISTRATIVE OFFICER
60.00
.................
 
      X     358,214 0 45,239
Form 990 (2019)
Form 990 (2019)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) GARON MEIKLE........................................................................
CONTROLLER
60.00
.......................2.00
      X     291,506 0 37,344
(19) FRANCOIS GAGNON........................................................................
SR MANAGING DIRECTOR
60.00
.......................  
        X   695,334 0 17,783
(20) BENJAMIN COTTON........................................................................
MANAGING DIRECTOR
60.00
.......................  
        X   788,719 0 447,496
(21) SCOTT LUPKAS........................................................................
MANAGING DIRECTOR
60.00
.......................  
        X   759,023 0 452,432
(22) BRIAN GIMOTTY........................................................................
DIRECTOR, PRIVATE EQUITY
60.00
.......................  
        X   542,272 0 262,797
(23) DANIEL LEE........................................................................
DIRECTOR, LIQUID MARKETS
60.00
.......................  
        X   703,030 0 21,809














1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 6,668,463 0 1,613,777
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet70
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
BLUE CROSS BLUE SHIELD OF MICHIGAN

PO BOX 77000
DETROIT,MI482770017
CLAIMS ADMINISTRATION 106,014,145
MEDCO (EXPRESS SCRIPTS)

3585 ATLANTA AVENUE
HAPEVILLE,GA30354
CLAIMS ADMINISTRATION 38,199,825
AQR MULTI-STRATEGY FUND IV LP

2 GREENWICH PLAZA
GREENWICH,CT06830
INVESTMENT MANAGER 23,212,902
ALIGHT SOULTIONS (AON HEWITTTEMPO)

PO BOX 95135
CHICAGO,IL606945135
CONSULTANT, TPA 21,481,508
DELTA DENTAL OF MICHIGAN

16082 COLLECTION CENTER DRIVE
CHICAGO,IL606930001
CLAIMS ADMINISTRATION 11,491,347
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet182
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet  
 Program Service RevenueAmt Business Code
2a EGWP FEDERAL SUBSIDY 525100 595,851,494 595,851,494    
b PARTICIPANT CONTRIBUTI 525100 108,316,209 108,316,209    
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 704,167,703
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 1,132,463,680     1,132,463,680
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents     6a
b Less: rental expenses     6b
c Rental income or (loss)     6c
d Net rental income or (loss).......MediumBullet        
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   64,417,867,048 7a
b Less: cost or other basis and sales expenses   62,097,056,909 7b
c Gain or (loss)   2,320,810,139 7c
d Net gain or (loss).........MediumBullet 2,320,810,139     2,320,810,139
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a INCOME ON ALT. INVESTM   110,543,307   19,793,724 90,749,583
b OTHER   16,012,727     16,012,727
c SECURITIES LENDING   7,665,141     7,665,141
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 134,221,175
12 Total revenue. See instructions.....MediumBullet 4,291,662,697 704,167,703 19,793,724 3,567,701,270
Form 990 (2019)
Form 990 (2019)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....    
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members ....... 3,763,623,367  
5 Compensation of current officers, directors, trustees, and key employees ........... 3,591,545      
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........        
7 Other salaries and wages........ 16,951,689      
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,315,802      
9 Other employee benefits ....... 1,630,911      
10 Payroll taxes ........... 1,129,539      
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 2,166,052      
c Accounting ........... 3,684,248      
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 136,839,061      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 205,909,138      
12 Advertising and promotion ....        
13 Office expenses ....... 557,971      
14 Information technology ...... 4,303,074      
15 Royalties ..        
16 Occupancy ........... 1,123,801      
17 Travel ............ 610,258      
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 142,747      
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 1,327,975      
23 Insurance ... 2,833,247      
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a INVESTMENT FUND EXPENSE 28,603,609      
b LIQUID INV. FOREIGN TAX 17,446,879      
c ACA FEES 8,371,974      
d OTHER 650,376      
e All other expenses        
25 Total functional expenses. Add lines 1 through 24e 4,202,813,263      
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2019)
Form 990 (2019)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........   1  
2 Savings and temporary cash investments ......... 2,834,679,570 2 4,641,357,722
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 581,168,438 4 439,503,762
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ........... 175,000,000 7 0
8 Inventories for sale or use ............   8  
9 Prepaid expenses and deferred charges ...... 3,435,581 9 3,008,609
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 8,786,248
b Less: accumulated depreciation 10b 6,464,541 3,649,683 10c 2,321,707
11 Investments—publicly traded securities . 32,437,651,913 11 32,547,086,289
12 Investments—other securities. See Part IV, line 11 ..... 21,317,495,985 12 24,268,104,245
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 1,613,399,742 15 1,324,473,300
16 Total assets. Add lines 1 through 15 (must equal line 33)... 58,966,480,912 16 63,225,855,634
Liabilities 17 Accounts payable and accrued expenses ..... 350,268,968 17 328,592,103
18 Grants payable ...   18  
19 Deferred revenue ......... 258,977 19 211,019
20 Tax-exempt bond liabilities .........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 1,890,441,994 25 1,608,899,301
26 Total liabilities. Add lines 17 through 25.. 2,240,969,939 26 1,937,702,423
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions ..........   27  
28 Net assets with donor restrictions ...........   28  
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 56,725,510,973 32 61,288,153,211
33 Total liabilities and net assets/fund balances ........ 58,966,480,912 33 63,225,855,634
Form 990 (2019)
Form 990 (2019)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
4,291,662,697
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
4,202,813,263
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
88,849,434
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
56,725,510,973
5
Net unrealized gains (losses) on investments ...............
5
4,473,792,804
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
0
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
61,288,153,211
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2019)
Form 990 (2019)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
UAW RETIREE MEDICAL BENEFITS TRUST
 
Employer identification number

90-0424876
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
 
(ii) Related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment)
(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....      
b Buildings ....        
c Leasehold improvements   423,095 379,638 43,457
d Equipment ....   1,300,965 583,683 717,282
e Other .....   7,062,188 5,501,220 1,560,968
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 2,321,707
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 3
Part VII
Investments—Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3) Other
(A) HEDGE FUNDS AND LIQUID ASSET PARTNERSHIPS
10,095,701,967 F

(B) GENERAL MOTORS COMPANY COMMON STOCK
5,744,748,500 F

(C) REAL ESTATE AND REAL ASSETS
4,325,770,972 F

(D) PRIVATE EQUITY
2,269,722,675 F

(E) PRIVATE CREDIT
1,832,160,131 F
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 24,268,104,245
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 1,608,899,301
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 8,790,380,517
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a 4,496,219,339
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d 2,498,481
e Add lines 2a through 2d ..................... 2e 4,498,717,820
3 Subtract line 2e from line 1.................. 3 4,291,662,697
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c 0
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 4,291,662,697
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 4,203,524,087
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d 710,824
e Add lines 2a through 2d.................... 2e 710,824
3 Subtract line 2e from line 1................... 3 4,202,813,263
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c 0
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 4,202,813,263
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART X, LINE 2: U.S. GAAP REQUIRE TRUST MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE TRUST AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE TRUST HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE US GOVERNMENT AND STATE OF MICHIGAN (OR OTHER STATES APPLICABLE). MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE TRUST AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2017 AND 2016, THERE WERE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE TRUST IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, NO AUDITS FOR ANY TAX PERIODS ARE CURRENTLY IN PROGRESS. THE TRUST ADMINISTRATOR BELIEVES THE 2014 THROUGH 2017 TAX YEARS ARE OPEN TO TAX EXAMINATION. SOME STATES MAY HAVE A SLIGHTLY LONGER STATUTE OF LIMITATIONS PERIOD.
PART XI, LINE 2D - OTHER ADJUSTMENTS: INCOME FROM ALTERNATIVE INVESTMENTS 2,157,573. REALIZED GAIN ON FOREIGN CURRENCY 340,531. OTHER 377.
PART XII, LINE 2D - OTHER ADJUSTMENTS: OTHER 710,824.
Schedule D (Form 990) 2019


Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
UAW RETIREE MEDICAL BENEFITS TRUST
 
Employer identification number

90-0424876
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in the region (d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in the region
(f) Total expenditures
for and investments
in the region
EUROPE (INCLUDING ICELAND AND GREENLAND) 0 0 INVESTMENTS   1,080,242,786
CENTRAL AMERICA & THE CARIBBEAN 0 0 INVESTMENTS   5,705,711,300
EAST ASIA AND THE PACIFIC 0 0 INVESTMENTS   274,583,176
EAST ASIA AND THE PACIFIC 0 1 INVESTMENTS   26,145
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .... 0 1 7,060,563,407
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 1 7,060,563,407
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)
(c) Region (d) Purpose of
grant
(e) Amount of
cash grant
(f) Manner of
cash
disbursement
(g) Amount
of noncash
assistance
(h) Description
of noncash
assistance
(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
 
3 Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant
(e) Manner of cash
disbursement
(f) Amount of
noncash
assistance
(g) Description
of noncash
assistance
(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
ReturnReference Explanation
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2019
Additional Data


Software ID:  
Software Version:  



Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
UAW RETIREE MEDICAL BENEFITS TRUST
 
Employer identification number

90-0424876
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
 
b
Any related organization? .......................
5b
 
 
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
 
b
Any related organization? ......................
6b
 
 
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
 
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
 
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1HERSHEL HARPER
CIO
(i)

(ii)
510,124
-------------
0
400,000
-------------
0
990
-------------
0
207,676
-------------
0
21,239
-------------
0
1,140,029
-------------
0
0
-------------
0
2FRANCINE PARKER
CHIEF EXECUTIVE OFFICER
(i)

(ii)
450,031
-------------
0
0
-------------
0
4,356
-------------
0
24,000
-------------
0
8,081
-------------
0
486,468
-------------
0
0
-------------
0
3MARY BETH KUDERIK
CHIEF FINANCIAL OFFICER
(i)

(ii)
457,669
-------------
0
0
-------------
0
2,838
-------------
0
24,000
-------------
0
18,904
-------------
0
503,411
-------------
0
0
-------------
0
4LINDA DENOMME
LEGAL COUNSEL
(i)

(ii)
294,741
-------------
0
0
-------------
0
2,778
-------------
0
24,000
-------------
0
977
-------------
0
322,496
-------------
0
0
-------------
0
5RONALD BERRY
CHIEF ADMINISTRATIVE OFFICER
(i)

(ii)
356,696
-------------
0
0
-------------
0
1,518
-------------
0
24,000
-------------
0
21,239
-------------
0
403,453
-------------
0
0
-------------
0
6GARON MEIKLE
CONTROLLER
(i)

(ii)
290,863
-------------
0
0
-------------
0
643
-------------
0
18,000
-------------
0
19,344
-------------
0
328,850
-------------
0
0
-------------
0
7FRANCOIS GAGNON
SR MANAGING DIRECTOR
(i)

(ii)
278,493
-------------
0
415,639
-------------
0
1,202
-------------
0
0
-------------
0
17,783
-------------
0
713,117
-------------
0
415,639
-------------
0
8BENJAMIN COTTON
MANAGING DIRECTOR
(i)

(ii)
377,704
-------------
0
410,025
-------------
0
990
-------------
0
426,257
-------------
0
21,239
-------------
0
1,236,215
-------------
0
410,025
-------------
0
9SCOTT LUPKAS
MANAGING DIRECTOR
(i)

(ii)
360,759
-------------
0
397,274
-------------
0
990
-------------
0
431,193
-------------
0
21,239
-------------
0
1,211,455
-------------
0
397,274
-------------
0
10BRIAN GIMOTTY
DIRECTOR, PRIVATE EQUITY
(i)

(ii)
321,825
-------------
0
218,929
-------------
0
1,518
-------------
0
241,558
-------------
0
21,239
-------------
0
805,069
-------------
0
218,929
-------------
0
11DANIEL LEE
DIRECTOR, LIQUID MARKETS
(i)

(ii)
77,901
-------------
0
0
-------------
0
625,129
-------------
0
18,000
-------------
0
3,809
-------------
0
724,839
-------------
0
0
-------------
0
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 4A DURING THE TAXABLE YEAR, DANIEL LEE RECEIVED A SEVERANCE PAYMENT OF $625,000.
SCHEDULE J, PART III: THE ORGANIZATION CONTRIBUTED TO UAW RETIREE MEDICAL BENEFITS TRUST INVESTMENT STAFF INCENTIVE COMPENSATION PLAN AND THE FOLLOWING INDIVIDUALS RECEIVED PAYMENT. THIS IS REPORTED AS DEFERRED COMPENSATION ON SCHEDULE J, PART II, COLUMN C: HERSHAL HARPER: 189,676 BENJAMIN COTTON: 408,257 SCOTTT LUPKAS: 413,193 BRIAN GIMOTTY: 231,839
Schedule J (Form 990) 2019

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(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.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
UAW RETIREE MEDICAL BENEFITS TRUST
 
Employer identification number

90-0424876
Return Reference Explanation
FORM 990 AMENDED RETURN THIS RETURN WAS AMENDED TO CORRECT THE TITLE FOR DANIEL LEE ON PART VII, SCH J, AND SUPPORTING STATEMENTS.
FORM 990, PART VI, SECTION A, LINE 2 RMBT MEMBERS NORWOOD JEWELL, DENNIS WILLIAMS, JAMES SETTLES, AND CINDY ESTRADA ARE ALL MEMBERS OR OFFICERS OF THE INTERNATIONAL UNION, UNITED AUTOMOBILE, AEROSPACE AND AGRICULTURAL IMPLEMENT WORKERS OF AMERICA ("UAW").
FORM 990, PART VI, SECTION A, LINE 7A THE UAW MEMBERS WHO ARE APPOINTED TO THE RMBT COMMITTEE SERVE AT THE DISCRETION OF THE UAW INTERNATIONAL PRESIDENT, AND MAY BE REMOVED OR REPLACED, AND A SUCCESSOR DESIGNATED, AT ANY TIME BY WRITTEN NOTICE FROM THE UAW INTERNATIONAL PRESIDENT TO THE COMMITTEE.
FORM 990, PART VI, SECTION B, LINE 11B A PROFESSIONAL TAX PREPARER IS ENGAGED TO PREPARE THE FORM 990. THE TRUST'S CHIEF FINANCIAL OFFICER, AS WELL AS EXTERNAL COUNSEL, REVIEW THE FORM 990 PRIOR TO SUBMITTING TO THE AUDIT SUBCOMMITTEE OF THE TRUST FOR THEIR REVIEW. A DRAFT COPY OF FORM 990 IS PROVIDED TO THE MEMBERS OF THE COMMITTEE (I.E. THE GOVERNING BODY OF THE TRUST) FOR REVIEW PRIOR TO FINALIZATION AND FILING WITH THE INTERNAL REVENUE SERVICE. THE INDEPENDENT CPA FIRM PREPARING THE RETURN IS AVAILABLE FOR THE COMMITTEE MEMBERS TO ASK QUESTIONS.
FORM 990, PART VI, SECTION B, LINE 12C THE TRUST'S CONFLICT OF INTEREST POLICY IS APPLIED TO ALL EMPLOYEES AND COMMITTEE MEMBERS. EACH OF THESE INDIVIDUALS MUST DISCLOSE CERTAIN OWNERSHIP INTERESTS, COMPENSATION ARRANGEMENTS AND BOARD MEMBERSHIPS TO THE TRUST'S COMPLIANCE OFFICIAL UPON COMMENCEMENT OF THEIR ROLE AND PERIODICALLY THEREAFTER REGARDING MATERIAL CHANGES IN THEIR DISCLOSURES. THE TRUST'S COMPLIANCE OFFICIAL REVIEWS ALL CONFLICT OF INTEREST DISCLOSURE FORMS. IF A CONFLICT OF INTEREST EXISTS, RECUSALS MAY BE APPROPRIATE.
FORM 990, PART VI, SECTION B, LINE 15 UPON FORMATION, THE UAW RETIREE MEDICAL BENEFITS TRUST ENGAGED INDEPENDENT CONSULTANTS AND EXECUTIVE SEARCH FIRMS TO CONSULT WITH MEMBERS OF THE TRUST'S GOVERNING BODY ("THE COMMITTEE") TO ESTABLISH STAFFING NEEDS, JOB REQUIREMENTS, COMPENSATION BENCHMARKS AND SALARY RANGES. THE INDEPENDENT CONSULTANTS INITIALLY WORKED WITH THE COMMITTEE CHAIRMAN AND THEN SUBSEQUENTLY WITH THE OTHER MEMBERS OF THE COMMITTEE TO IDENTIFY NECESSARY JOB POSITIONS, DEVELOP AN ORGANIZATION CHART, PREPARE JOB DESCRIPTIONS, ASSIGN A PAY GRADE TO EACH POSITION, AND BENCHMARK SALARY SURVEYS FOR VARIOUS JOB POSITIONS. SALARY SURVEYS CONSIDERED HEALTH CARE ORGANIZATIONS, INVESTMENT MANAGEMENT FIRMS, AND OTHER TRUST ORGANIZATIONS. THIS BENCHMARK DATA WAS USED BY THE COMMITTEE TO ESTABLISH AND APPROVE COMPENSATION OFFERED TO THE TRUST'S FIRST EXECUTIVE DIRECTOR, CFO AND CIO, AS WELL AS ESTABLISHING PAY RANGES FOR EACH LOWER PAY GRADE. THE COMMITTEE HAS SINCE BEEN ADVISED ON A PERIODIC BASIS OF STAFFING STATUS AND ACTIVITIES. SINCE INCEPTION INDEPENDENT PERIODIC COMPENSATION STUDIES ARE PERFORMED FOR KEY POSITIONS AND FOR NEW HIRES AT HIGHER PAY GRADES. ANNUAL MERIT FUNDING IS BASED ON INDEPENDENT STUDY FROM A COMPENSATION CONSULTANT.
FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE FOR PUBLIC INSPECTION UPON WRITTEN REQUEST MADE DIRECTLY TO THE ORGANIZATION.
FORM 990 PART VII AN INDEPENDENT FIDUCIARY HAS BEEN APPOINTED FOR GENERAL MOTORS COMPANY. THE INDEPENDENT FIDUCIARY IS NOT REQUIRED TO BE REPORTED IN PART VII BUT IS BEING DISCLOSED IN SCHEDULE O DUE TO THE IMPORTANT ROLE IN ADMINISTERING THE NON-CASH INVESTMENTS IN THE GENERAL MOTORS' PLAN. AN INDEPENDENT FIDUCIARY WAS APPOINTED FOR FCA US LLC; HOWEVER, THAT INDEPENDENT FIDUCIARY IS NO LONGER NESCESSARY AS ALL RELEVANT CASH HAS BEEN TRANSFERRED TO THE TRUST. THE FOLLOWING EXPLAINS THE ROLE AND RESPONSIBILITIES OF THE INDEPENDENT FIDUCIARY IN MORE DETAIL: PURSUANT TO ARTICLE XI OF THE TRUST AGREEMENT, THE COMMITTEE, IN ITS SOLE DISCRETION, IS INSTRUCTED TO SELECT AND APPOINT AN INDEPENDENT FIDUCIARY AS NAMED FIDUCIARY AND INVESTMENT MANAGER WHO, FROM AND AFTER THE DATE OF THE SETTLEMENT AGREEMENTS WITH GENERAL MOTORS COMPANY, SHALL HAVE AND EXERCISE ALL DISCRETIONARY POWER AND AUTHORITY OF THE TRUST WITH RESPECT TO THE MANAGEMENT, DISPOSITION AND VOTING OF THE RESPECTIVE SECURITIES CONTRIBUTED BY THE AUTOMOTIVE COMPANY. PURSUANT TO ITS AUTHORITY UNDER THE TRUST AGREEMENT, THE COMMITTEE HAS THE AUTHORITY TO RETAIN THE INDEPENDENT FIDUCIARY AND MONITOR THE PERFORMANCE OF ITS SERVICES. THE COMMITTEE HAS THE POWER TO REMOVE AND REPLACE AN INDEPENDENT FIDUCIARY FOR CAUSE. THE INDEPENDENT FIDUCIARY IS AUTHORIZED AS FOLLOWS FOR THE RESPECTIVE SECURITIES: 1. EXERCISE DIRECTLY OR ON BEHALF OF THE TRUST, OR DIRECT THE TRUSTEE TO EXERCISE AS APPROPRIATE, ALL OF THE TRUST'S LEGAL AND CONTRACTUAL AUTHORITY AND RESPONSIBILITY AS OWNER OF THE NOTES, THE SHARES, AND ANY FUTURE SECURITIES (AS APPLICABLE) (HEREIN COLLECTIVELY REFERRED TO AS "AUTO SECURITIES") ACQUIRED BY THE TRUST, INCLUDING: A. EXERCISING ALL RIGHTS OF THE TRUST IN ITS SOLE DISCRETION INCLUDING BUT NOT LIMITED TO INITIATION OR PARTICIPATION IN THE REGISTRATION OF ANY AUTO SECURITIES; EXERCISING ALL VOTING RIGHTS WITH RESPECT TO AUTO SECURITIES, AND NEGOTIATING AND ACCEPTING ANY AMENDMENTS TO THE TRANSACTION AGREEMENTS; B. ACCEPTING ANY CONTRIBUTION OF ADDITIONAL AUTO SECURITIES; C. VALUING THE AUTO SECURITIES; D. MAKING ANY DECISION TO SELL, LOAN, HYPOTHECATE, PLEDGE AS SECURITY FOR A LOAN, EXCHANGE, CONVERT OR OTHERWISE DISPOSE OF ALL OR ANY OF THE AUTO SECURITIES; E. COMPLYING WITH ANY CONDITIONS OR LIMITATIONS IN ANY FINAL PROHIBITED TRANSACTION EXEMPTION ("PTE") ISSUED BY THE DEPARTMENT OF LABOR; F. COMPLYING OR ASSISTING AUTO IN COMPLYING AS REQUIRED IN ANY TRANSACTION AGREEMENT, WITH ANY REGULATORY OR OTHER REQUIREMENTS, INCLUDING FILING OBLIGATIONS; G. INITIATING OR PARTICIPATING IN ANY CLAIM OR SUIT AGAINST A PARTY TO ANY OF THE TRANSACTION AGREEMENTS ARISING OUT OF BREACH, OR RELATED TO THE ISSUANCE AND OWNERSHIP OF, THE AUTO SECURITIES; H. THE INDEPENDENT FIDUCIARY MAY ALSO SELECT AND CONTRACT ON BEHALF OF THE TRUST WITH SUCH AUDITORS, APPRAISERS, ACTUARIES, INVESTMENT ADVISORS, BROKERS, DEALERS AND UNDERWRITERS, AND OUTSIDE LEGAL COUNSEL AS THE INDEPENDENT FIDUCIARY DEEMS APPROPRIATE TO ASSIST THE INDEPENDENT FIDUCIARY IN THE PERFORMANCE OF ITS DUTIES. 2. ADVISE THE COMMITTEE WITH RESPECT TO THE MANNER IN WHICH AUTO SECURITIES SHOULD BE REFLECTED OR INCORPORATED INTO THE FUNDING POLICY TO BE ADOPTED BY THE COMMITTEE. 3. REPORT AT LEAST ONCE A YEAR TO THE COMMITTEE AS A WHOLE, AND PERIODICALLY REPORT AS NECESSARY TO THE INVESTMENT COMMITTEE.
FORM 990 PART VIII AND PART IX THIS FORM 990 IS FOR THE TRUST THAT ENCOMPASSES THREE PLANS. THE FORM 990 IS REPORTED AT THE TRUST LEVEL AND INCLUDES THE SUM OF THE THREE PLANS' FINANCIAL STATEMENTS.
FORM 990, PART X COMMON STOCK-GM: AS OF DECEMBER 31, 2017 AND 2016, THE PLAN HOLDS 140.15 MILLION SHARES OF GM'S COMMON STOCK REPRESENTING A 9.9% AND 9.3% OWNERSHIP INTEREST, RESPECTIVELY. THE PLAN HAS THE RIGHT, UNDER THE DIRECTION OF THE INDEPENDENT FIDUCIARY, TO REQUIRE GM, IN CERTAIN CIRCUMSTANCES, TO FILE REGISTRATION STATEMENTS UNDER THE SECURITIES ACT COVERING ADDITIONAL RESALES OF GM'S COMMON STOCK AND THE RIGHT TO PARTICIPATE IN OTHER REGISTERED OFFERINGS MADE BY GM IN CERTAIN CIRCUMSTANCES. THE FAIR VALUE OF THE GM COMMON STOCK WAS VALUED AT $5,745 MILLION AND $4,883 MILLION AS OF DECEMBER 31, 2017, AND DECEMBER 31, 2016, RESPECTIVELY, BASED ON GM'S PUBLICLY TRADED COMMON STOCK PRICE FROM THE ACTIVE MARKET IN WHICH THE SECURITY TRADES OF $40.99 AND $34.84 PER SHARE, RESPECTIVELY. NOTE RECEIVABLE - FCA: IN CONNECTION WITH THE 2014 SALE OF THE CHRYSLER MEMBERSHIP INTEREST, THE TRUST WAS THE BENEFICIARY OF AN AGREEMENT BETWEEN FCA AND THE UAW PURSUANT TO WHICH FCA SHALL MAKE CASH CONTRIBUTIONS AGGREGATING $700 MILLION TO THE TRUST IN FOUR EQUAL ANNUAL INSTALLMENTS. THE INITIAL PAYMENT OF $175 MILLION UNDER AGREEMENT WAS RECEIVED ON JANUARY 21, 2014, AND ADDITIONAL PAYMENTS OF $175 MILLION EACH WILL BE RECEIVABLE ON THE NEXT THREE ANNIVERSARIES OF THE INITIAL PAYMENT. THE RECEIVABLE AS OF DECEMBER 31, 2017 AND 2016, WAS $0 MILLION AND $175 MILLION, RESPECTIVELY, AND IS INCLUDED IN NOTES RECEIVABLE IN THE STATEMENTS OF NET ASSETS AVAILABLE FOR PLAN BENEFITS. THE TRUST RECEIVED THE FINAL INSTALLMENT OF $175 MILLION ON JANUARY 20, 2017.
FORM 990 PART X DURING 2014, THE TRUST ESTABLISHED WHOLLY OWNED CONSOLIDATED FOREIGN HOLDING COMPANIES IN THE UNITED KINGDOM TO FACILITATE FOREIGN INVESTMENTS THROUGH A DEDICATED HOLDING COMPANY. FINANCIAL ASSETS HELD BY THE FOREIGN HOLDING COMPANIES WERE INCLUDED IN THE CONSOLIDATED TRUST FINANCIAL STATEMENTS. THE AMOUNTS REPORTED ON THE FORM 990 INCLUDE ONLY ACCOUNT BALANCES FROM U.S. COMPANIES INCLUDED IN THE TRUST. ACCOUNT BALANCES RELATED TO THE FOREIGN HOLDING COMPANIES THAT WERE NOT REPORTED ON THE FORM 990 ARE INCLUDED BELOW TO RECONCILE AMOUNTS REPORTED ON THE FORM 990 TO THE AUDITED FINANCIAL STATEMENTS. TOTAL ASSETS REPORTED ON FORM 990, PART X 63,225,855,634 FHC CASH 354,724 INTERCOMPANY RECEIVABLE ELIMINATIONS (377,000) FHC REAL ASSETS 140,442,254 ELIMINATION TO INVESTMENT IN FHC (101,808,455) TOTAL ASSETS PER TRUST FINANCIALS 63,264,467,157 TOTAL LIABILITIES REPORTED ON FORM 990, PART X 1,937,702,423 FHC ACCOUNTS PAYABLE 446,712 INTERCOMPANY PAYABLE ELIMINATIONS (377,000) TOTAL LIABILITIES PER TRUST FINANCIALS 1,937,772,135 TOTAL NET ASSETS REPORTED ON FORM 990, PART X 61,288,153,211 FHC NET ASSETS 38,541,811 TOTAL NET ASSETS PER TRUST FINANCIALS 61,326,695,022
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
UAW RETIREE MEDICAL BENEFITS TRUST
 
Employer identification number

90-0424876
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) BLACKROCK CCT - SUBORDINATE TRUST OF UAW RMBT
400 HOWARD STREET
SAN FRANCISCO,CA94105
30-6265747
GRANTOR TRUST MI 25,826,496 793,979,993 UAW RETIREE MEDICAL BENEFITS TRUST
 
(2) WELLINGTON - GLOBAL MANAGED RISK PLUS II
280 CONGRESS STREET
BOSTON,MA02210
46-3079916
LIQUID ASSET PARTNER MI 3,636,728 705,185,230 UAW RETIREE MEDICAL BENEFITS TRUST
 








Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No












For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) AMERRA AGRI MULTI STRATEGY FUND LP

1185 AVENUE OF THE AMERICAS 17TH FL
NEW YORK,NY10036
46-5521189
REAL ASSETS DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -13,229,365 287,418,913   No -1,663,382   No 99.780 %
(2) AQR MULTI-STRATEGY FUND VI LP

2 GREENWICH PLAZA 3RD FLOOR
GREENWICH,CT06830
32-0412569
LIQUID ASSET PARTNER DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN 121,077,541 2,075,746,588   No     No 99.800 %
(3) BLACK RIVER AGRICULTURAL FUND 21

9320 EXCELSIOR BOULEVARD MS 143-5-2
HOPKINS,MN55343
47-2322335
REAL ASSETS DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -2,248,896 159,567,515   No -82,759   No 99.990 %
(4) BLACK RIVER AGRICULTURE COINVEST FUND A LP

33 SOUTH SIXTH STREET SUITE 4100
MENNEAPOLIS,MN55402
47-1295276
REAL ASSETS DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -489,129 141,106,536   No     No 98.970 %
(5) BLUE ISLE FUTURES FUND LTD (ABBEY CAPITAL)

VICTORIA PLACE 31 VICTORIA STREET
HAMILTON   HM 10
BD
98-1261928
HEDGE FUND BM UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN 11,058,922 170,642,352   No     No 98.690 %
(6) BRIGHTWOOD CAPITAL CO-INVEST FUND LP

810 SEVENTH AVENUE
NEW YORK,NY10019
82-2816560
PRIVATE CREDIT NY UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -44,290 28,601,766   No     No 99.010 %
(7) BTG PACTUAL BRAZIL TIMBERLAND FUND I D LP

PO BOX 309 UGLAND HOUSE
GRAND CAYMAN   KY1-1104
CJ
REAL ASSETS CJ UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -1,963,759 76,237,344   No     No 88.260 %
(8) CASPIAN SELECT CREDIT FUND LP

10 EAST 53RD STREET 53RD FLOOR
NEW YORK,NY10022
26-1425545
PRIVATE CREDIT DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN 12,899,994 300,532,330   No 204,903   No 53.090 %
(9) C-III RECOVERY FUND II CO-INVESTMENT LP

5221 N O CONNOR BLVD STE 800
IRVING,TX75039
47-3031134
REAL ESTATE DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -27,094 49,133,184   No     No 97.990 %
(10) HIG ADVANTAGE BUYOUT FUND LP

1450 BRICKELL AVENUE 31ST FLOOR
MIAMI,FL33131
36-4867059
PRIVATE EQUITY DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -1,111,319 105,006   No     No 83.840 %
(11) HARBOURVEST REAL ASSETS ENERGY FUND II LP

ONE FINANCIAL CENTER 44TH FLOOR
BOSTON,MA02111
47-2184367
REAL ASSETS DE UAW RETIREE MEDICAL BENEFITS TRUST
 
UNRELATED -25,453,092 655,244,377   No -34,811,848   No 96.220 %
(12) HARBOURVEST REAL ASSETS-ENERGY FUND LP

ONE FINANCIAL CENTER 44TH FLOOR
BOSTON,MA02111
46-5164921
REAL ASSETS DE UAW RETIREE MEDICAL BENEFITS TRUST
 
UNRELATED -15,119,808 166,989,780   No -10,438,915   No 99.990 %
(13) HV SPECIAL SITUATIONS FUND LP (DOVER STREET VIII - CO-INVESTMENT)

ONE FINANCIAL CENTER 44TH FLOOR
BOSTON,MA02111
47-4289568
PRIVATE EQUITY DE UAW RETIREE MEDICAL BENEFITS TRUST
 
UNRELATED 36,326,113 181,038,844   No -98,606   No 99.570 %
(14) INVESCO INSTITUTIONAL TRUST GLOBAL ASSET ALLOCATION STRATEGY FUND

20 TRAFALGAR SQUARE SUITE 449
NASHUA,NH03063
46-3402278
LIQUID ASSET PARTNER DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN 91,333,159 1,005,945,140   No     No 100.000 %
(15) IP IV AIV (E) LP - ARCHWAY SERIES

1345 AVENUE OF THE AMERICAS 42ND FL
NEW YORK,NY10105
81-2603756
PRIVATE CREDIT DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -245,080 5,095,065   No     No 100.000 %
(16) IP IV AIV (E) LP - NEWPORT SERIES

1345 AVENUE OF THE AMERICAS 42ND FL
NEW YORK,NY10105
81-2590336
PRIVATE CREDIT DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -138,328 2,630,440   No     No 100.000 %
(17) IP IV AIV (E) LP - PLANET SERIES

1345 AVENUE OF THE AMERICAS 42ND FL
NEW YORK,NY10105
81-2618631
PRIVATE CREDIT DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -980,305 10,548,944   No     No 100.000 %
(18) IP IV AIV (E) LP - YOST UNBLOCKED SERIES

1345 AVENUE OF THE AMERICAS 42ND FL
NEW YORK,NY10105
81-2630795
PRIVATE CREDIT DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN 742,368 4,896,940   No     No 100.000 %
(19) KAYNE ANDERSON REAL ESTATE V PARALLEL FUND LP

1800 AVENUE OF THE STARS 3RD FLOOR
LOS ANGELES,CA90067
82-3171847
REAL ESTATE DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN 259,611 35,823,075   No 16,429   No 99.000 %
(20) KAYNE PRIVATE ENERGY INCOME FUND

811 MAIN STREET 14TH FLOOR
HOUSTON,TX77002
30-0887747
REAL RETURNS DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -10,308,874 365,234,753   No -7,250,683   No 98.990 %
(21) NEW MOUNTAIN PARTNERS IV CAYMAN (AIV-A) LP

787 SEVENTH AVENUE 49TH FLOOR
NEW YORK,NY10019
46-1202173
PRIVATE ENERGY DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -436,956 32,644,642   No     No 98.530 %
(22) NORTHWOOD REAL ESTATE PARTNERS 2012 LP

1819 WAZEE STREET 2ND FLOOR
DENVER,CO80202
32-0396964
REAL ASSETS DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -970,513 20,599,270   No 144,315   No 99.290 %
(23) OAKTREE TBMR STRATEGIC CREDIT FUND C LLC

333 SOUTH GRANDE AVE 28TH FL
LOS ANGELES,CA90071
47-1169920
PRIVATE CREDIT DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN 9,002,456 100,296,786   No 7,545   No 99.800 %
(24) OAKTREE-TMBR STRATEGIC CREDIT FUND F LLC

333 SOUTH GRANDE AVE 28TH FL
LOS ANGELES,CA90071
47-1189792
PRIVATE CREDIT DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN 14,043,618 162,538,989   No 58,185   No 99.800 %
(25) OAKTREE-TMBR STRATEGIC CREDIT FUND G LLC

333 SOUTH GRANDE AVE 28TH FL
LOS ANGELES,CA90071
47-1179049
PRIVATE CREDIT DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN 21,779,349 255,744,426   No 80,931   No 99.800 %
(26) PROTERRA BRAZIL OPPORTUNITY DIRECT FUND LP

33 SOUTH SIXTH STREET SUITE 4100
MINNEAPOLIS,MN55402
82-1198066
REAL RETURNS DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -115,457 45,444,681   No     No 99.000 %
(27) PROTERRA BRAZIL OPPORTUNITY FUND B LP

33 SOUTH SIXTH STREET SUITE 4100
MINNEAPOLIS,MN55402
82-1199572
REAL RETURNS DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -1,066,997 65,044,712   No     No 98.520 %
(28) SALTUS SEPARATE ACCOUNT LP (GMORR)

40 ROWES WHARF
BOSTON,MA02110
47-3397090
REAL RETURNS DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -1,767,791 176,551,055   No     No 99.490 %
(29) SSP 2017 LP

1133 AVENUE OF THE AMERICAS 30TH FL
NEW YORK,NY10036
82-0886132
PRIVATE EQUITY DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN 364,735 44,382,130   No     No 98.630 %
(30) TARAWA CO-INVEST FUND (ALTERNA CCA FUND II)

15 RIVER ROAD SUITE 320
WILTON,CT06897
61-1844543
REAL ASSETS DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN 431,557 31,962,724   No     No 99.000 %
(31) VIRTUS MYERS CO-INVESTMENT FUND LP

835 W 6TH STREET SUITE 1500
AUSTIN,TX78703
81-4906557
REAL RETURNS DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN 73,938 10,786,277   No     No 99.000 %
(32) VISTA CO-INVEST FUND 2017-1 LP

111 BROADWAY SUITE 1980
OAKLAND,CA94607
82-2972696
PRIVATE EQUITY DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -35,568 99,464,432   No     No 99.000 %
(33) WELLINGTON-GLOBAL MANAGED RISK PLUS II

280 CONGRESS STREET
BOSTON,MA02210
46-3079916
LIQUID ASSET PARTNER MA UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN 7,778,247 705,479,394   No     No 100.000 %
(34) Z CAPITAL SPECIAL SITUATIONS FUND II-B LP

TWO CONWAY PARK 150 FIELD DRIVE SUI
LAKE FOREST,IL60565
45-5179518
PRIVATE CREDIT DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN 852,115 96,575,321   No -3,444,740   No 87.080 %
(35) ALPINVEST A2 INVESTMENT FUND LP

299 PARK AVENUE 35TH FLOOR
NEW YORK,NY10171
46-2426430
PRIVATE EQUITY DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN 17,877,311 205,892,135   No 3,988,017   No 99.010 %
(36) ALPINVEST A2 INVESTMENT FUND II LP

299 PARK AVENUE 35TH FLOOR
NEW YORK,NY10171
47-1663811
PRIVATE EQUITY DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN 251,950 79,555,968   No -58,563   No 99.010 %
(37) OAK STREET EMERGING MANAGER U1 LP

125 S WACKER DR STE 1220
CHICAGO,IL60606
82-1482783
REAL ESTATE DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN -1,838,045 33,795,068   No -287,441   No 99.000 %
(38) OAK STREET EMERGING MANAGER U1A LP

125 S WACKER DR STE 1220
CHICAGO,IL60606
82-1519293
REAL ESTATE DE UAW RETIREE MEDICAL BENEFITS TRUST
 
EXCLUDED FROM TAX UN 55,928 15,012,131   No     No 99.000 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) A & Q ABSOLUTE STRATEGIES II LTD (UBS GLOBAL ASSET MGT)

PO BOX 897 REGATTA OFFICE PARK WE
GEORGETOWN,GRAND CAYMANKY1-1103
CJ
HEDGE FUND CJ UAW RETIREE MEDICAL BENEFITS TRUST
 
C 235,307 5,583,920 100.000 %   No
(2) COLLER INT'L PARTNERS VI FEEDER FUND E LP

TRAFALGAR COURT LES BANQUES ST PE
CHANNEL ISLANDS   GY1 3QL
CJ
PRIVATE EQUITY CJ UAW RETIREE MEDICAL BENEFITS TRUST
 
C -15,755 134,982,665 99.990 %   No
(3) CORE INVESTMENT CO-INVESTMENT TRUST

2800 POST OAK BLVD SUITE 4800
HOUSTON,TX77056
20-1092763
RENTAL REAL ESTATE TX UAW RETIREE MEDICAL BENEFITS TRUST
 
C -15,000 1,421,000 94.540 %   No
(4) FINANCIAL RISK MANAGEMENT DIVERSIFIED FUND LTD (FRM)

190 ELGIN AVENUE
GEORGETOWN,GRAND CAYMANKY1-9005
CJ
HEDGE FUND CJ UAW RETIREE MEDICAL BENEFITS TRUST
 
C -61,725 1,412,452 100.000 %   No
(5) GOLDMAN SACHS MULTI STRATEGY PORTFOLIO II LTD

190 ELGIN AVENUE
GEORGETOWN,GRAND CAYMANKY1-9005
CJ
HEDGE FUND CJ UAW RETIREE MEDICAL BENEFITS TRUST
 
C 242,244,229 53,202,793 99.000 %   No
(6) LAE (LANCASTER) BPI FUND LTD

PO BOX 309 UGLAND HOUSE
GRAND CAYMAN   KY1-1104
CJ
HEDGE FUND CJ UAW RETIREE MEDICAL BENEFITS TRUST
 
C -2,884,994 213,264,888 100.000 %   No
(7) RMBT UK-C CORP LIMITED

20 CHURCHILL PLACE CANARY WHARF
LONDON   E14 5HJ
UK
REAL ASSETS UK UAW RETIREE MEDICAL BENEFITS TRUST
 
C 5,045,683 29,089,222 100.000 %   No
(8) RMBT UK-F CORP LIMITED

20 CHURCHILL PLACE CANARY WHARF
LONDON   E14 5HJ
UK
REAL ASSETS UK UAW RETIREE MEDICAL BENEFITS TRUST
 
C 8,306,617 47,645,701 100.000 %   No
(9) RMBT UK-G CORP LIMITED

20 CHURCHILL PLACE CANARY WHARF
LONDON   E14 5HJ
UK
REAL ASSETS UK UAW RETIREE MEDICAL BENEFITS TRUST
 
C 11,255,868 64,426,739 100.000 %   No
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
Yes
 
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) ALPINVEST A2 INVESTMENT FUND II LP

B 13,764,816 FMV
(2) ALPINVEST A2 INVESTMENT FUND II LP

S 3,621,646 FMV
(3) ALPINVEST A2 INVESTMENT FUND LP

B 578,085 FMV
(4) ALPINVEST A2 INVESTMENT FUND LP

S 46,987,404 FMV
(5) AMERRA AGRI MULTI STRATEGY FUND LP

B 81,330,561 FMV
(6) AMERRA AGRI MULTI STRATEGY FUND LP

S 36,952,550 FMV
(7) BLACK RIVER AGRICULTURAL FUND 21

B 24,898,464 FMV
(8) BLACK RIVER AGRICULTURAL FUND 21

S 544,800 FMV
(9) BLACK RIVER AGRICULTURE CO-INVEST FUND A LP

B 19,919,662 FMV
(10) BTG PACTUAL BRAZIL TIMBERLAND FUND I D LP

B 39,996,304 FMV
(11) COLLER INT'L PARTNERS VI FEEDER FUND E LP

S 92,300,945 FMV
(12) HARBOURVEST REAL ASSETS-ENERGY FUND LP

S 10,961,871 FMV
(13) HARBOURVEST REAL ASSETS-ENERGY FUND II LP

B 181,590,000 FMV
(14) HARBOURVEST REAL ASSETS-ENERGY FUND II LP

S 18,873,000 FMV
(15) HV SPECIAL SITUATIONS FUND LP (DOVER STREET VIII - CO-INVESTMENT)

B 10,500,000 FMV
(16) HV SPECIAL SITUATIONS FUND LP (DOVER STREET VIII - CO-INVESTMENT)

S 64,146,000 FMV
(17) KAYNE PRIVATE ENERGY INCOME PARALLEL FUND LP

B 264,756,405 FMV
(18) KAYNE PRIVATE ENERGY INCOME PARALLEL FUND LP

S 22,338,430 FMV
(19) NORTHWOOD REAL ESTATE PARTNERS 2012 LP

B 20,357,677 FMV
(20) NORTHWOOD REAL ESTATE PARTNERS 2012 LP

S 11,556,361 FMV
(21) OAKTREE-TMBR STRATEGIC CREDIT FUND C LLC

B 26,797,785 FMV
(22) BRIGHTWOOD CAPITAL CO-INVEST FUND LP

B 28,500,000 FMV
(23) RMBT UK-C CORP LIMITED

F 389,087 FMV
(24) RMBT UK-G CORP LIMITED

F 900,586 FMV
(25) RMBT UK-F CORP LIMITED

F 658,823 FMV
(26) AQR MULTI-STRATEGY FUND VI LP

S 501,000,000 FMV
(27) BLUE ISLE FUTURES FUND LTD

S 56,000,000 FMV
(28) C-III RECOVERY FUND II CO-INVESTMENT LP

S 148,018 FMV
(29) HIG ADVANTAGE BUYOUT FUND LP

B 1,354,460 FMV
(30) KAYNE REAL ESTATE PARTNERS V PARALLEL FUND LP

B 40,560,274 FMV
(31) KAYNE REAL ESTATE PARTNERS V PARALLEL FUND LP

S 560,274 FMV
(32) NEW MOUNTAIN PARTNERS IV CAYMAN (AIV-A) LP

S 6,125,989 FMV
(33) OAKTREE-TMBR STRATEGIC CREDIT FUND F LLC

B 4,500,000 FMV
(34) OAKTREE-TMBR STRATEGIC CREDIT FUND G LLC

B 7,500,000 FMV
(35) PROTERRA BRAZIL OPPORTUNITY DIRECT FUND LP

B 26,636,827 FMV
(36) PROTERRA BRAZIL OPPORTUNITY DIRECT FUND B LP

B 43,626,030 FMV
(37) SALTUS SEPARATE ACCOUNT LP

B 94,675,000 FMV
(38) SSP 2017 LP

B 42,000,000 FMV
(39) TARAWA CO-INVESTMENT FUND LP

B 31,671,804 FMV
(40) VIRTUS MYERS CO-INVESTMENT FUND LP

B 10,712,456 FMV
(41) VISTA CO-INVEST FUND 2017-1 LP

B 99,648,500 FMV
(42) WELLINGTON-GLOBAL MANAGED RISK PLUS II

B 11,698,781 FMV
(43) WELLINGTON-GLOBAL MANAGED RISK PLUS II

S 11,698,781 FMV
(44) Z CAPITAL SPECIAL SITUATIONS FUND II-B

B 21,282,398 FMV
(45) Z CAPITAL SPECIAL SITUATIONS FUND II-B

S 7,921,742 FMV
(46) OAK STREET EMERGING MANAGER U1 LP

B 35,157,772 FMV
(47) OAK STREET EMERGING MANAGER U1 LP

S 340,523 FMV
(48) OAK STREET EMERGING MANAGER U1A LP

B 15,438,967 FMV
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2019

Additional Data


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