Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part VI, Section A, Line 6 | THE ORGANIZATION'S MEMBERS CONSIST OF THE PARTICIPATING BANKS IN FLORIDA WHO HAVE CONSOLIDATED UNDER ONE ENTITY TO PROVIDE HEALTH BENEFITS TO THEIR EMPLOYEES AND ELIGIBLE DEPENDENTS. |
| Form 990, Part VI, Section B, Line 11b | THE VP OF ACCOUNTING HAS BEEN DELEGATED THE AUTHORITY TO REVIEW AND FILE THE FORM 990 AND SUBSEQUENT TO THE FILING, IT IS DISTRIBUTED TO THE BOARD OF TRUSTEES. |
| Form 990, Part VI, Section C, Line 19 | Governing documents, conflict of interest policies,financial statements and Form 990 are made available upon request. |
| Form 990, Part XI, Line 9 | CHANGE IN NON-ADMITTED ASSETS = $16354 |
| Form 990, Part XI, Line 9 | PAID IN SURPLUS = $1603760 |
| Software ID: | 22015553 |
| Software Version: | 2022v5.0 |