2021-11-12T11:25:58-06:00 2020-12-31 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2020-01-01 476685299 KAISER FOUNDATION HEALTH PLAN INC RETIREE HEALTH AND WELFARE PLAN % STATE STREET BANK KAIS 5102716611 C/O STATE STREET BANK PO BOX 5100 BOSTON MA 022060001 THOMAS MEIER SR VP & TREASURER 5102716611 2021-11-12 THOMAS MEIER 999009999 JOANNE KRUEGER P01235586 2673303000 2021-11-09 2 2020 2022-09-23 18:48:47Z STATE STREET BANK PO BOX 5100 BOSTON MA 02206 528055920 false X N/A X 2014 CA SEE SCHEDULE O. 1 1 0 0 0 0 0 28500000 0 166943970 528055920 0 0 195443970 528055920 0 0 0 0 197707 103464 0 0 0 38775794 16453401 38973501 16556865 156470469 511499055 5347159223 5679273121 143717113 1938646 5203442110 5677334475 X SEE SCHEDULE O. false false 0 0 0 THE PLAN PROVIDES FUNDING FOR THE PAYMENT OF BENEFITS TO ELIGIBLE PERSONS. 0 false false false false false false false false false false false false false false true false false false false false false false false false false false false false false false false false false false false false false false false true false false true 0 0 0 false false false false false false false X 1 1 false false false false false false false false false false false true false false false false false false CA X STATE STREET BANK 6176543003 PO BOX 5100 BOSTON MA 02206 STATE STREET BANK TRUST COMP TRUSTEE 1.0 0.0 X 103464 0 0 103464 0 0 1 false false false AETOS ALTERNATIVES MANAGEMENT LLC 2180 SAND HILL ROAD 410 MENLO PARK CA 94025 INVESTMENT MGMT 970565 1 0 0 38506806 38506806 0 0 0 0 0 489549114 489549114 489549114 0 0 0 0 0 0 0 0 0 0 528055920 38506806 0 0 0 0 103464 0 0 0 0 0 84082 0 26900 0 0 2198782 0 0 0 0 0 0 0 0 0 0 0 0 0 BENEFIT ADMIN EXPENSES 6791637 ACCRUED EXPENSES 6015284 FOREIGN INCOME TAX 1152317 OTHER EXPENSES 184399 16556865 151067391 4148018 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5184160782 5672482909 0 0 0 0 0 0 11931050 2642194 5347159223 5679273121 143717113 1938646 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143717113 1938646 X 5203442110 5677334475 0 0 0 0 5203442110 5677334475 5347159223 5679273121 511499055 -37606690 X false false 662239423 -37606690 171790193 134183503 528055920 528055920 188347058 171790193 171790193 16556865 16556865 SCHEDULE D, PART XI, LINE 2D TRANSFERS IN PER THE BOOKS AND NOT OTHERWISE REPORTED ON THE TAX RETURN $171,790,193 SCHEDULE D, PART XII, LINE 2D TRANSFERS OUT PER THE BOOKS AND NOT OTHERWISE REPORTED ON THE TAX RETURN $171,790,193 FORM 990, PART I, LINE 1 & PART III, LINE 1 THE KAISER FOUNDATION HEALTH PLAN INC. RETIREE HEALTH AND WELFARE PLAN HAS BEEN ESTABLISHED BY THE PLAN SPONSOR FOR THE EXCLUSIVE PURPOSES OF PROVIDING BENEFITS UNDER THE KAISER FOUNDATION HEALTH PLAN, INC. RETIREE HEALTH AND WELFARE PLAN INCLUDING, BUT NOT LIMITED TO (1) PAYING INSURANCE PREMIUMS FOR THE INSURED BENEFIT OPTIONS UNDER THE KAISER FOUNDATION HEALTH PLAN INC, INSURED WELFARE BENEFIT PLAN FOR RETIREES; (2) PAYING CLAIMS AND FUNDING THE PREMIUM SUBSIDY UNDER THE KAISER FOUNDATION HEALTH PLAN, INC. RETIREE MEDICAL PREMIUM SUBSIDY HEALTH REIMBURSEMENT ARRANGEMENT PLAN; (3) PAYING CLAIMS AND BENEFITS UNDER THE KAISER FOUNDATION HELATH PLAN, INC. SELF FUNDED HEALTH PLAN FOR RETIREES, AND (4) PAYING ADMINISTRATIVE EXPENSES FOR THE VEBA AND THE PLAN. FORM 990, PART VI, LINES 1A & 1B & PART VII THE PLAN SPONSOR IS THE KAISER FOUNDATION HEALTH PLAN, INC. THE TRUST IS ADMINISTERED BY THE PLAN SPONSOR IN ACCORDANCE WITH THE TERMS OF THE TRUST AGREEMENT. AS SUCH, THE VEBA DOES NOT HAVE A GOVERNING BODY THAT EXERCISES DISCRETION. FORM 990, PART VI, LINE 8 & LINES 12-15 THESE QUESTIONS ARE NOT APPLICABLE TO THIS TRUST. ADDITIONALLY, THE TRUST DOES NOT HAVE ANY EMPLOYEES, THEREFORE NO PROCESSES RELATED TO EMPLOYEE COMPENSATION ARE IN PLACE. FORM 990, PART VI, SECTION B, LINE 11B A COMPLETE ELECTRONIC COPY OF THE ORGANIZATION'S FORM 990 WAS PROVIDED TO THE TRUSTEE FOR REVIEW PRIOR TO THE FILING WITH THE IRS. KAISER FOUNDATION HEALTH PLAN INC ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 941340523 HEALTH CARE CA 501(C)(3) 10 NA false false false false false false false false false false false false false false false false false false false false