Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| PART I, LINE 1 - ORGANIZATION'S MISSION: | TO PROVIDE MEDICAL, DENTAL, PRESCRIPTION, VISION, PERSONAL CARE ACCOUNTS, DISABILITY, LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS, SUBJECT TO CERTAIN ELIGIBILITY REQUIREMENTS. |
| PART VI, LINE 11B: | THE FORM 990 IS REVIEWED BY THE ADMINISTRATIVE OFFICE PRIOR TO FILING; ANY UNUSUAL ITEMS ARE BROUGHT TO THE BOARD OF TRUSTEES ATTENTION. |
| PART VI, LINE 12C: | THE BOARD OF TRUSTEES AND ALL PROFESSIONALS ARE AWARE OF THE CONFLICT OF INTEREST POLICY AND ARE TO CONTACT LEGAL COUNSEL IF ANY POTENTIAL CONFLICTS ARISE. |
| PART VI, LINE 19: | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE AT THE PLAN OFFICE UPON REQUEST. |
| PART VII, SECTION A: | COMPENSATION PAID TO TRUSTEES EMPLOYED BY NOT-FOR-PROFIT ORGANIZATIONS IS PROPERLY REPORTED ON THE EMPLOYER'S ANNUAL TAX FILINGS. |
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