| Return Reference | Explanation |
|---|---|
| FORM 990, PART V, LINE 2A AND 2B: | THE PLAN CONTRACTS PERSONNEL FROM A RELATED ORGANIZATION UNDER A COST SHARING AGREEMENT. THESE INDIVIDUALS ARE EMPLOYEES OF THE RELATED ORGANIZATION AND ARE REPORTED ON THE PAYROLL REPORT OF THAT RELATED ORGANIZATION. THUS, NO FORM W-3 OR PAYROLL TAX RETURNS ARE FILED IN THE PLAN'S NAME. THESE FORMS WERE APPROPRIATELY FILED IN THE NAME OF THE RELATED ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE PLAN MANAGER REVIEWS THE 990 AND SHARES A COPY OF THE 990 WITH THE GOVERNING COMMITTEE AS APPROPRIATE DUE TO THE MAKE UP OF THE GOVERNING COMMITTEE CONSISTING OF INSURANCE REPRESENTATIVES. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL MEMBERS OF THE GOVERNING COMMITTEE ARE REQUIRED ANNUALLY TO SUBMIT A COMPLETED CONFLICT OF INTEREST POLICY TO THE PLAN. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE PLAN MANAGER IS AN EMPLOYEE OF A RELATED ORGANIZATION AND IS CONTRACTED BY THE PLAN. AN EXECUTIVE COMMITTEE OF THAT RELATED ORGANIZATION, COMPOSED OF INDEPENDENT GOVERNING COMMITTEE MEMBERS, MEET ON AN ANNUAL BASIS TO DETERMINE THE SALARY ADJUSTMENT FOR THE PLAN MANAGER. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE PLAN DETERMINES WHETHER OR NOT TO MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER 6,054. CONTRACTED SERVICES 155,524. |
| FORM 990, PART XIII, LINE 1: | THE PLAN USES THE STATUTORY BASIS OF ACCOUTING IN ACCORDANCE WITH THE FINANCIAL REPORTING PROVISIONS PRESCRIBED OR PERMITTED BY THE COMMONWEALTH OF KENTUCKY DEPARTMENT OF INSURANCE. |
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