2022-11-10T16:39:21-06:00 2021-12-31 952302617 SINGERLEWAK LLP 10960 WILSHIRE BOULEVARD 7TH FLOOR LOS ANGELES CA 900243783 990 2021-01-01 616357929 CALIFORNIA CHARTER SCHOOLS EMPLOYEE WELFARE BENEFIT TRUST CALI 9164671400 80 IRON POINT CIR 200 FOLSOM CA 95630 WALTER WALLACE CHAIRMAN 9164671400 2022-11-09 1 WALTER WALLACE 999009999 LIOR TEMKIN P00748170 3104773924 2022-11-09 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z CHARTERLIFE WALTER WALLACE 80 IRON POINT CIR 200 FOLSOM CA 95630 19167610 0 X N/A X 2008 CA THE PLAN IS A TRUST FUND ESTABLISHED FOR THE SOLE PURPOSE OF SUPPORTING AND MAINTAINING A WELFARE BENEFIT PLAN PROGRAM, ESTABLISHED BY THE SPONSOR, CALIFORNIA CHARTER SCHOOLS, A CALIFORNIA NONPROFIT BENEFIT CORPORATION, FOR THE BENEFIT OF THEIR MEMBER CHARTER SCHOOLS' EMPLOYEES AND THEIR DEPENDENTS. 5 5 4 5 0 0 0 0 23784059 19111001 4204 1511 65471 55098 23853734 19167610 0 0 21975420 18205176 447902 451629 0 0 0 989990 946988 23413312 19603793 440422 -436183 5644901 4751972 651419 194673 4993482 4557299 X THE PLAN IS A TRUST FUND ESTABLISHED FOR THE SOLE PURPOSE OF SUPPORTING AND MAINTAINING A WELFARE BENEFIT PLAN PROGRAM, ESTABLISHED BY THE SPONSOR, CALIFORNIA CHARTER SCHOOLS, A CALIFORNIA NONPROFIT BENEFIT CORPORATION, FOR THE BENEFIT OF THEIR MEMBER CHARTER SCHOOLS' EMPLOYEES AND THEIR DEPENDENTS. 0 0 SUPPORTING AND MAINTAINING A WELFARE BENEFIT PLAN PROGRAM, ESTABLISHED BY THE SPONSOR, CALIFORNIA CHARTER SCHOOLS, A CALIFORNIA NONPROFIT BENEFIT CORPORATION, FOR THE BENEFIT OF THEIR MEMBER CHARTER SCHOOLS' EMPLOYEES AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 6 0 1 4 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X X BRMS 9164671400 80 IRON POINT CIRCLE SUITE 200 FOLSOM CA 95630 TED FUJIMOTO TRUSTEE 1.00 X 0 0 0 CYNTHIA GOMEZ TRUSTEE 1.00 X 0 0 0 MARSHALL MAYOTTE TRUSTEE 1.00 X 0 0 0 JODI RETZLOFF TRUSTEE 1.00 X 0 0 0 WALTER WALLACE TRUSTEE, CHAIRMAN 1.00 X X 0 0 0 MISTI COLE CEO 40.00 X 152220 0 15281 152220 0 15281 1 0 1 0 DICKERSON EMPLOYEE BENEFITS 1918 RIVERSIDE DRIVE LOS ANGELES CA 90039 COMMISSIONS 387920 BENEFIT & RISK MANAGEMENT 80 IRON POINT CIRCLE FOLSOM CA 95630 ADMINISTRATIVE SERVICES 208814 PAYCHEX 911 PANARAMA TRAIL ROCHESTER NY 14625 PAYROLL SERVICES 110534 3 EMPLOYEE/EMPLOYER CONTRIBUTIONS 900099 19111001 19111001 19111001 1511 1511 PREMIUM CREDITS 900099 55098 55098 55098 19167610 19111001 0 56609 18205176 167500 214780 1309 41984 26056 2024 19180 382022 4649 11835 46542 7095 OTHER OPERATING EXPENSE 268456 ADMINISTRATIVE EXPENSES 205185 19603793 5627120 4748992 10686 2980 7095 5644901 4751972 63769 67549 587650 127124 651419 194673 X 0 0 0 0 4993482 4557299 4993482 4557299 5644901 4751972 -436183 0 X 0 1 X 1 0 0 UNBILLED PREMIUMS 127124 127124 X 19167610 0 19167610 0 19167610 19603794 0 19603794 0 19603794 PART X, LINE 2: THE FINANCIAL ACCOUNTING STANDARDS BOARD ISSUED NEW GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE PLAN ADOPTED THIS NEW GUIDANCE FOR THE YEAR ENDED DECEMBER 31, 2021. MANAGEMENT EVALUATED THE PLAN'S TAX POSITIONS AND CONCLUDED THAT THE PLAN HAD MAINTAINED ITS TAX EXEMPT STATUS AND HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. WITH FEW EXCEPTIONS, THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE, OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE 2021. 0 0 0 MISTI COLE CEO 152220 0 0 0 0 0 10050 0 5231 0 167501 0 0 0 FORM 990, PART VI, SECTION A, LINE 4 DURING THE TAX YEAR 2021, THE PLAN AMENDED THEIR BYLAWS IN ORDER TO CHANGE SOME OF THE FUND COVERAGES TO SELF-FUNDED COVERAGES FOR HEALTH, DENTAL AND VISION BEGINNING 1/1/2022. FORM 990, PART VI, SECTION B, LINE 11B THE INFORMATIONAL RETURN IS PREPARED BY OUTSIDE ACCOUNTANTS AND IS REVIEWED BY THE ATTORNEY OF THE TRUST. ONCE APPROVED BY THE ATTORNEY, THE RETURN IS PRESENTED TO THE BOARD FOR FINAL APPROVAL AND FILING. FORM 990, PART VI, SECTION B, LINE 12C THE TRUSTEES ANNUALLY CONFIRM IN WRITING THAT THEY HAVE BEEN PROVIDED WITH A COPY OF THE CONFLICT POLICY, REVIEWED IT, UNDERSTAND IT AND WILL COMPLY WITH IT IN THE FUTURE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.