Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Pt VI, Line 10b | Form 990 reviewed by each member of the board |
| Pt VI, Line 7a | Board members have the power to elect member(s) to governing board by majority vote |
| Pt VI, Line 8b | President and members with concent of the president have authority to act on behalf of organization |
| Pt VI, Line 11b | Board members are presented with a copy of 990 during next board meeting following the filing of the return. |
| Form 990, Part IX, Line 24e | Benefits paid to participants 1905722. 1905722. |
| Form 990, Part IX, Line 24e | Reinsurance/Stop Loss fees 182070. 182070. |
| Form 990, Part IX, Line 24e | Third party admin fees 23788. 23788. |
| Form 990, Part IX, Line 24e | HRA Claims 5500. 5500. |
| Form 990, Part IX, Line 24e | PPO network access fees 3875. 3875. |
| Form 990, Part IX, Line 24e | Agent fees 55328. 55328. |
| Form 990, Part IX, Line 24e | Bank fees 38. 38. |
| Form 990, Part IX, Line 24e | Dues & fees 9194. 9194. |
| Form 990, Part IX, Line 24e | YM Fees (AHH) 4701. 4701. |
| Software ID: | 16000371 |
| Software Version: |