TIN:
SCHEDULE O
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Inspection
Name of the organization
SPECIAL AGENTS MUTUAL BENEFIT ASSOCIATION
Employer identification number
52-1074154
52-1074154
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6: | MEMBERSHIP IN THE CORPORATION SHALL BE OPEN TO INDIVIDUALS WHO ARE ACTIVE EMPLOYEES OF A SAMBA ELIGIBLE EMPLOYING AGENCY OR WHO ARE RETIRED FROM A SAMBA ELIGIBLE EMPLOYING AGENCY, UNDER ANY ESTABLISHED RETIREMENT PROGRAM. THE TERM SAMBA ELIGIBLE EMPLOYING AGENCY MEANS ANY BRANCH, DEPARTMENT OR AGENCY OF THE UNITED STATES GOVERNMENT, INCLUDING WITHOUT LIMITATION, THE US POSTAL SERVICE AND US COURTS. MEMBERSHIP IN THE CORPORATION SHALL CONSIST OF TWO CLASSES: A) REGULAR MEMBERSHIP - ELIGIBLE INDIVIDUALS MAY ELECT REGULAR MEMBERSHIP BY ENROLLING IN THE HEALTH BENEFIT PLAN. REGULAR MEMBERS ALSO MAY ENROLL IN OTHER PLAN PROGRAMS IN ACCORDANCE WITH AND AS PERMITIED BY THE PLAN DOCUMENTS. REGULAR MEMBERSHIP SHALL TERMINATE CONTEMPORANEOUSLY WITH THE TERMINATION OF THE HEALTH BENEFIT PLAN COVERAGE. MEMBERSHIP AT THAT TIME WILL CONVERT TO ASSOCIATE MEMBERSHIP IF THE INDIVIDUAL REMAINS ENROLLED IN ANY OTHER PLAN PROGRAM. B) ASSOCIATE MEMBERSHIP - ELIGIBLE INDIVIDUALS MAY ELECT ASSOCIATE MEMBERSHIP BY ENROLLING IN A PLAN PROGRAM OTHER THAN THE HEALTH BENEFIT PLAN IN ACCORDANCE WITH AND AS PERMITIED BY THE PLAN DOCUMENTS. ASSOCIATE MEMBERSHIP SHALL TERMINATE CONTEMPORANEOUSLY WITH THE TERMINATION OF PLAN COVERAGE UNLESS THE INDIVIDUAL TRANFERS EMPLOYMENT TO ANOTHER AGENCY, IN WHICH CASE HE OR SHE MAY CONTINUE HIS OR HER ENROLLMENT AND ASSOCIATE MEMBERSHIP WHILE SO EMPLOYED. FOR PERSONS WHO DO NOT MEET THE CRITERIA FOR REGULAR OR ASSOCIATE MEMBERSHIP, THE BOARD OF DIRECTORS MAY IN ITS DISCRETION DEFINE A SPECIAL CLASS OF MEMBERSHIP BY VIRTUE OF (1) EMPLOYMENT OR SERVICE WITH THE CORPORATION, (2) PREVIOUS ENROLLMENT IN A PLAN SPONSORED BY THE CORPORATION, OR (3) SECTION 409 OF THE INDIAN HEALTHCARE IMPROVEMENT ACT (IHCIA), AS INCORPORATED AND AMENDED BY SUBSECTION 10221 OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA); ALLOWING INDIAN TRIBES OR TRIBAL ORGANIZATIONS OR URBAN INDIAN ORGANIZATIONS AND THEIR EMPLOYEES TO PURCHASE COVERAGE UNDER THE FEDERAL EMPLOYEES HEALTH BENEFIT PROGRAM OR ANY OTHER SUCCESSOR PROGRAM AS SUCH TERMS ARE DEFINED THEREIN. PERSONS ADMITED AS SPECIAL MEMBERS IN THE CORPORATION SHALL HAVE ALL THE RIGHTS ACCORDED ASSOCIATE MEMBERS AND MAY ENROLL IN A PLAN SPONSORED BY THE CORPORATION IF PERMITIED UNDER APPLICABLE LAW. |
| FORM 990, PART VI, SECTION A, LINE 7A: | Regular Members shall have the right to vote in the election of directors, Except as otherwise expressly stated in the Bylaws or in the Articles of Incorporation. Members, including Regular Members, shall not have the right to vote on any other matter affecting the Corporation, including but not limited to merger, consolidation and dissolution. |
| FORM 990, PART VI, SECTION B, LINE 11B: | THE FORM 990 IS REVIEWED BY BOTH THE CONTROLLER AND EXECUTIVE DIRECTOR BEFORE IT IS FORWARDED TO THE TREASURER FOR FINAL REVIEW AND SIGNATURE. |
| FORM 990, PART VI, SECTION B, LINE 12C: | OFFICERS, DIRECTORS OR TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANNUALLY ANY INTERESTS THAT COULD GIVE RISE TO CONFLICTS OF INTEREST; INCLUDING, BUT NOT LIMITED TO EMPLOYMENT AND ANY WOR PERFORMED FOR ANOTHER ORGANIZATION PAID OR UNPAID. |
| FORM 990, PART VI, SECTION B, LINE 15A: | THE BOARD SETS THE COMPENSATION OF THE EXECUTIVE DIRECTOR BASED UPON OUTSIDE RECOMMENDATIONS AND STATISTICAL DATA. THE EXECUTIVE DIRECTOR'S COMPENSATION WAS LAST REVIEWED IN JANUARY 2019. |
| FORM 990, PART VI, SECTION C, LINE 19: | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABE UPON REQUEST TO THE PUBLIC. The organization's bylaws are available on its website for anyone to view, with the latest update as of October 1, 2012. |
| FORM 990, PART XI, LINE 9: | OTHER CHANGES TO NET ASSETS OR FUND BALANCE OF ($19,778,208) CONSISTS OF THE FOLLOWING: INCREMENTAL EFFECT OF FASB ASC TOPIC 715 - POST RETIREMENT BENEFITS OF ($50,802), RETURN OF EXCESS RESERVES ($34,727,073), SPECIAL RESERVE OF $14,999,667. |
| FORM 990, PART VII, SECTION A, COLUMN F: | ESTIMATED AMOUNT OF OTHER COMPENSATION THE INCREASE IN THE TOTAL PRESENT VALUE OF THE BENEFIT INCREASE COMES PRIMARILY FROM THE INCREASE IN ACCRUALS DURING THE YEAR. ADDITIONALLY, THE DISCOUNT RATE USED AT THE END OF 2018 WAS 4.25%, WHILE THE DISCOUNT RATE USED AT THE END OF 2019 WAS 3.50%. THE DECREASE IN THE DICOUNT RATE INCREASED THE LIABILITIES BY CLOSE TO $700,000. THESE ARE ACTUARY CALCULATIONS AND THESE AMOUNTS DO NOT RESPRESENT A CASH OUTLAY. |
| FORM 990, PART XII, LINE 1: | BASIS OF PRESENTATION THIS TAX RETURN COMBINES TWO PLANS OF THE ENTITY. THE FINANCIAL STATEMENTS OF THE BENEFIT PLAN ARE IN ACCORDANCE WITH GAAP. THE FINANCIAL STATEMENTS OF THE HEALTH PLAN ARE PREPARED PURSUANT TO THE U.S. OFFICE OF PERSONNEL MANAGEMENT'S (OPM) PRESCRIBED ACCOUNTING PRACTICES FOR FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM ("FEHBP") CARRIERS AND IS NOT INTENDED TO BE A COMPLETE PRESENTATION IN ACCORDANCE WITH GAAP. IN ACCORDANCE WITH OPM'S PRESCRIBED ACCOUNTING PRACTICES, EXPENSES ARE ONLY RECOGNIZED AND PAID BY THE HEALTH PLAN IF ALLOWED UNDER THE U.S. GOVERNMENT'S COST ACCOUNTING STANDARDS AND OTHER LIMITATIONS IMPOSED BY THE CONTRACT WITH OPM. IN THIS REGARD, SOME EXPENSES NOT ALLOWED BY THE HEALTH PLAN ARE CHARGED AS MISCELLANEOUS EXPENSES OF THE BENEFIT PLAN. |
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
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