Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 3 | UNTIL SEPTEMBER 1, 2017 THE TRUST SPONSORED AND MAINTAINED A HEALTH REIMBURSEMENT ARRANGEMENT (HRA) PLAN WHICH WAS INTENDED TO MEET THE REQUIREMENTS OF IRS NOTICE 2002-45 AND WHICH PROVIDED FOR THE REIMBURSEMENT OF ELIGIBLE MEDICAL EXPENSES FOR PARTICIPANTS OF THE HRA PLAN IN ACCORDANCE WITH PLAN DOCUMENTS. THE HRA PLAN WAS TERMINATED EFFECTIVE SEPTEMBER 1, 2017 AND THE TRUST WAS SUBSEQUENTLY TERMINATED EFFECTIVE NOVEMBER 30, 2017. |
| FORM 990; PART V; LINE 2A | THE TRUST DID NOT HAVE ANY EMPLOYEES, BUT FILED A FORM W-3 (TRANSMITTAL OF WAGE AND TAX STATEMENTS) WITH RESPECT TO CERTAIN TAXABLE CASH PAYMENTS MADE TO TRUST BENEFICIARIES FOLLOWING THE TERMINATION OF THE HRA PLAN, WHICH, PURSUANT TO IRS GUIDANCE, WERE SUBJECT TO TAX WITHHOLDING. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS MEMBERS WHO ARE BENEFICIARIES OF THE VEBA (TRUST) AND RECEIVED REIMBURSEMENT OF ELIGIBLE MEDICAL EXPENSES IN ACCORDANCE WITH THE HRA PLAN DOCUMENT ALTHOUGH NO SUCH REIMBURSEMENTS OCCURED DURING THE CURRENT YEAR DUE TO THE PRIOR TERMINATION OF THE HRA PLAN |
| FORM 990, PART VI, SECTION A, LINE 7A | THE VEBA COMMITTEE HAS THE AUTHORITY TO APPOINT AND REMOVE, EMPLOY AND DISCHARGE, AND PRESCRIBE THE DUTIES AND FIX THE COMPENSATION, IF ANY, OF ALL OFFICERS, AGENTS, AND THIRD PARTY SERVICE PROVIDERS OF THE TRUST. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS DISTRIBUTED TO EACH MEMBER OF THE VEBA COMMITTEE. THE COMMITTEE MEETS TO DISCUSS AND APPROVE THE FORM 990 BEFORE IT IS FILED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE TRUST AGREEMENT, HRA PLAN DOCUMENTS AND OTHER GOVERNING DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. BENEFICIARIES OR THE TRUST (AND PARTICIPANTS IN THE HRA PLAN) MAY REQUEST COPIES OF HRA PLAN DOCUMENTS AND THE FORM 5500. |
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