Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
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| FORM 990, PART VI, SECTION A, LINE 4 | THE PLAN AMENDMENT NO. 24, EFFECTIVE NOVEMBER 3, 2021, MADE CHANGES TO THE MONTHLY VERIFICATION OF RECURRING CLAIMS REQUIRED, REMOVED THE FEE FOR MISSING INFORMATION, CLARIFIED HIPAA PRIVACY AND SECURITY REQUIREMENTS, AND CHANGED HOW THE DISCLOSURE AND SECURITY OF PROTECTED HEALTH INFORMATION ARE HANDLED. THE PLAN AMENDMENT NO. 25, EFFECTIVE MAY 4, 2022, MADE CHANGES TO THE PREMIUM REIMBURSEMENT PLAN AND ADDED A NEW SUBSECTION ABOUT THE DOCUMENTATION VERIFICATION OF REIMBURSEMENT (SUBSECTION 3.5 (C)). THE AMENDMENT ALSO REVISED THE LANGUAGE IN SUBSECTION 3.5 (B) AND RENUMBERED FORMER SUBSECTION 3.5 (C) AS SUBSECTION 3.5 (D). |
| FORM 990, PART VI, SECTION A, LINE 7A | THE TRUST AGREEMENT PROVIDES FOR NINE TRUSTEES, SIX OF WHOM ARE SELECTED BY THE MEMBERS OF THE PARTICIPATING LABOR ORGANIZATIONS AND THREE OF WHOM ARE APPOINTED BY THE BOARD OF DIRECTORS OF THE PARTICIPATING LABOR ORGANIZATIONS. IN THE EVENT OF EARLY TERMINATION OF APPOINTMENT, RESIGNATION, OR A DEATH OF A TRUSTEE, THE BOARD OF DIRECTORS OF THE LABOR ORGANIZATION THAT CHOSE THE TRUSTEE SHALL APPOINT A SUCCESSOR TRUSTEE FOR THE REMAINDER OF THAT TERM. ELECTIONS AND APPOINTMENTS SHALL BE CONDUCTED ACCORDING TO THE PROCEDURES PROVIDED FOR IN THE BY-LAWS OF THE LABOR ORGANIZATIONS FOR THEIR ELECTIONS OF THEIR BOARD OF DIRECTORS AND THEIR APPOINTEES. THE APPOINTMENT OF A TRUSTEE MAY BE TERMINATED, AT ANY TIME, BY THE ENTITY WHICH ORIGINALLY MADE THE APPOINTMENT, ACCORDING TO SUCH ENTITY'S INTERNAL RULES, PROCEDURES, OR PRACTICES. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE TRUST AGREEMENT RESERVES LIMITED AUTHORITY FOR THE PLAN SPONSOR TO MAKE DECISIONS REGARDING CHANGES TO THE COMPOSITION OF THE BOARD OF TRUSTEES AND TO RECEIVE NOTICE OR APPROVE OF MERGERS, TERMINATIONS AND TRUST AGREEMENT AMENDMENTS. |
| FORM 990, PART VI, SECTION A, LINE 8B | THE TRUST HAS NO SEPARATE COMMITTEES. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CHAIRMAN OF THE BOARD OF TRUSTEES READS THE FORM 990 FOR COMPLETENESS AND ACCURACY, AND COMPARES THE AMOUNTS TO THE AUDITED FINANCIAL STATEMENTS FOR CONSISTENCY, BEFORE SIGNING AND FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OF TRUSTEES MEET REGULARLY TO REVIEW AND MONITOR TRUST ACTIVITIES. ALL BOARD MEMBERS ARE COVERED BY THE CONFLICT OF INTEREST POLICY. BOARD MEMBERS SHALL SUBMIT A SIGNED CONFLICT OF INTEREST DISCLOSURE FORM TO THE BOARD, AND SHALL HAVE THE DUTY TO DISCLOSE ANY CONFLICT OF INTEREST AS SOON AS IT IS DISCOVERED. WHEN A MEMBER DECIDES HE OR SHE HAS A CONFLICT OF INTEREST, THE MEMBER SHALL LEAVE THE MEETING DURING THE DISCUSSIONS AND VOTING ON THE ISSUE. THERE HAVE BEEN NO INCIDENCES OF ANY CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE TRUST HAS NO EMPLOYEES AND HAS PAID NO COMPENSATION TO ITS TRUSTEES OR OFFICERS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE TRUST'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. THE TRUST'S SUMMARY ANNUAL REPORT IS PROVIDED TO PARTICIPANTS ON AN ANNUAL BASIS. |
| FORM 990 PART VI, SECTION B, LINE 13: | THE TRUST'S WHISTLEBLOWER POLICY IS INCLUDED IN THE ARTICLE VI, SECTION 19 OF THE TRUST AGREEMENT. |
| FORM 990 PART VI, SECTION B, LINE 14: | THE TRUST'S DOCUMENT RETENTION AND DESTRUCTION POLICY IS COVERED IN THE ARTICLE VI, SECTION 11 OF THE TRUST AGREEMENT. |
| FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC | MICHAEL WEISS - CITY OF IRVINE #1 CIVIC CENTER PLAZA, IRVINE, CA 92606. BRIAN BROWN - CITY OF IRVINE #1 CIVIC CENTER PLAZA, IRVINE, CA 92606. MATHEW ARAGON - CITY OF IRVINE #1 CIVIC CENTER PLAZA, IRVINE, CA 92606. NINA BERBIGLIA - CITY OF IRVINE #1 CIVIC CENTER PLAZA, IRVINE, CA 92606. DARCY JONES - CITY OF IRVINE #1 CIVIC CENTER PLAZA, IRVINE, CA 92606. JAMES MOORE - CITY OF IRVINE #1 CIVIC CENTER PLAZA, IRVINE, CA 92606. BRIAN SHIPPEE - CITY OF IRVINE #1 CIVIC CENTER PLAZA, IRVINE, CA 92606. MARK SOMERS - CITY OF IRVINE #1 CIVIC CENTER PLAZA, IRVINE, CA 92606. DAVE WILLS - CITY OF IRVINE #1 CIVIC CENTER PLAZA, IRVINE, CA 92606. |
| FORM 990, PART VII, SECTION A, LINE 1A: | THE TRUST DOES NOT HAVE INFORMATION REGARDING THE COMPENSATION RECEIVED BY THE TRUSTEES FROM THE CITY OF IRVINE ("CITY"). THE MEMBERS OF THE BOARD OF TRUSTEES ARE PAID CITY EMPLOYEES. THEY ARE EMPLOYED BY THE CITY AND RECEIVE ALL THEIR COMPENSATION SOLELY CONNECTED TO THEIR DUTIES AS CITY EMPLOYEES. IN THEIR ROLE AS TRUSTEES, THEY ARE FIDUCIARIES AND SUBJECT TO LEGAL PROHIBITIONS AGAINST SELF-DEALING. THEY SERVE ON A VOLUNTEER BASIS AS TRUST FIDUCIARIES; THEY DO NOT RECEIVE ANY ADDITIONAL COMPENSATION FROM THE CITY OR ANY OTHER PARTY FOR THEIR SERVICES ON THE BOARD OF TRUSTEES. FURTHER, THE TRUST HAS A CONFLICT OF INTEREST POLICY, WHICH REQUIRES TRUSTEES TO DISCLOSE ANY FINANCIAL ARRANGEMENTS THAT WOULD CREATE A CONFLICT OF INTEREST. SECTION 7(A) OF THE CONFLICT OF INTEREST POLICY OF THE TRUST, EFFECTIVE JULY 1, 2008 AND AS AMENDED THEREAFTER, STATES THE FOLLOWING: "TRUSTEES SHALL HAVE A DUTY TO DISCLOSE TO THE BOARD ANY CONFLICT OF INTEREST AS SOON AS IT IS DISCOVERED BY THE TRUSTEE. IN PARTICULAR, A TRUSTEE SHALL DISCLOSE A CONFLICT OF INTEREST PRIOR TO ANY BOARD OR COMMITTEE DECISION ON THE MATTER RELATED TO THE CONFLICT OF INTEREST." THE POLICY ALSO REQUIRES DISCLOSURE IN WRITTEN FORM OF "ANY ENTITIES IN WHICH YOU, OR A RELATIVE, PRESENTLY HAVE A DIRECT OR INDIRECT PAYMENT ARRANGEMENT THAT MAY PRESENT A CONFLICT OF INTEREST WITH THE TRUST. NOTE ALSO THAT THE DISCLOSURE OF COMPENSATION REQUESTED ON THE FORM 990 WOULD CAUSE ADDITIONAL ADMINISTRATIVE BURDEN BY REQUIRING THE TRUST TO COLLECT THIS INFORMATION ANNUALLY, SINCE THE TRUSTEES' COMPENSATION AS CITY EMPLOYEES VARIES FROM YEAR TO YEAR, AND FROM TRUSTEE TO TRUSTEE. FINALLY, AND VERY IMPORTANTLY, THE FORM 990 IS PUBLIC INFORMATION. IT IS LIKELY THAT REQUIRING THE DISCLOSURE OF COMPENSATION WILL DISSUADE CITY EMPLOYEES FROM VOLUNTEERING TO SERVE ON THE BOARD. THE TRUST WOULD THEN HAVE TO SPEND TRUST ASSETS TO HIRE A PROFESSIONAL TRUSTEE. PLEASE CONTACT THE TRUST OFFICE IF YOU WOULD LIKE FURTHER INFORMATION, AND/OR WOULD LIKE TO DISCUSS THIS FURTHER. THE TRUSTEES WANT TO BE COOPERATIVE WITH THE IRS, BUT REQUESTING THIS COMPENSATION INFORMATION IS PROBLEMATIC FOR THE REASONS STATED ABOVE. |
| FORM 990, PART XI, LINE 2C: | THE BOARD OF TRUSTEES ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS. THERE IS NO SEPARATE AUDIT COMMITTEE. |
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