Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| PART I, LINE 1 AND PART III, LINES 1 AND 4A: | THE TRUST FUND IS A MULTI-EMPLOYER HEALTH PLAN PROVIDING MEDICAL, DENTAL, SUPPLEMENTAL DISABILITY, VISION, VACATION AND PRESCRIPTION DRUG BENEFITS TO ACTIVE EMPLOYEES, RETIREES AND THEIR DEPENDENTS. A DEATH BENEFIT AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFIT IS ALSO OFFERED TO ACTIVE EMPLOYEES AND RETIREES. |
| PART VI, LINE 11B: | THE FORM 990 IS REVIEWED BY THE BOARD OF TRUSTEES AND ADMINISTRATOR OF THE TRUST FUND PRIOR TO BEING FILED. |
| PART VI, LINE 12C: | THE POLICY IS PROVIDED TO EACH TRUSTEE AFTER A NEW TRUSTEE IS APPOINTED AND IS REQUESTED THAT HE OR SHE REPORT ANY REAL OR POTENTIAL CONFLICTS OF INTEREST TO THE TRUST FUND'S LEGAL COUNSEL. THE POLICY IS REVIEWED ANNUALLY BY THE BOARD OF TRUSTEES. |
| PART VI, LINE 15A: | COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. |
| PART VI, LINE 19: | ALL GOVERNING DOCUMENTS, THE TRUST FUND'S CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AT THE TRUST FUND'S PLACE OF BUSINESS. |
| PART VII, SECTION A: | ANY TRUSTEES' COMPENSATION AND/OR BENEFITS FROM RELATED TAX-EXEMPT ORGANIZATIONS IS AVAILABLE ON THOSE ORGANIZATIONS' FORM 990. |
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