| Return Reference | Explanation |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4D | PROVIDING MEDICAL AND DENTAL BENEFITS FOR PARTICIPANTS AND THEIR DEPENDENTS, AND LIFE COVERAGE FOR PARTICIPANTS. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE PLAN ADMINISTRATOR REVIEWS THE FORM 990 PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 19 | UPON REQUEST |
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| Software Version: |