2021-11-15T17:13:44-06:00 2020-12-31 990 2020-01-01 911285759 Carrix Inc Benefits Trust % T BICKNELL CARR 2066543632 1131 SW Klickitat Wy Seattle WA 98134 John Aldaya CFO 2066543536 2021-11-12 John Aldaya 999009999 2020 2022-09-23 18:48:47Z John Aldaya 1131 SW Klickitat Wy Seattle WA 98134 27200728 false X N/A X 1982 OR PROVIDES MEDICAL, DENTAL, PHARMACUETICAL AND VISION BENEFITS TO ELIGIBLE MEMBERS AND MAY COVER THEIR DEPENDENTS 3 0 0 0 0 0 23700609 27156010 153534 44718 0 0 23854143 27200728 0 0 20848583 20253902 0 0 0 0 0 1022750 1796600 21871333 22050502 1982810 5150226 13203068 18601613 2620403 2868722 10582665 15732891 X PROVIDES HEALTHCARE BENEIFTS TO ELIGIBLE MEMBERS AND MAY COVER THEIR DEPENDENTS false false 22050502 27200728 PROVIDES MEDCIAL, DENTAL, PHARMACUETICAL AND VISION BENEFITS TO ELIGIBLE MEMBERS AND MAY ALSO COVER THEIR DEPENDENTS. THIS PLAN ALSO COVERS HEALTH BENEFITS FOR CERTAIN RETIRED, DISABLED & TERMINATED EMPLOYEES. 22050502 false false false false false false false false false false false false true 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 false false false true 0 0 0 false false false false false false false false X 3 0 true false false false false false false true true false false true true false false false false false X T BICKNELL 2066543656 1131 SW KLICKITAT WY Seattle WA 98134 X Jon Hemingway Truste 0.0 0.05 X 0 0 0 Fredrick D Smith Trustee 0.0 0.0 X 0 0 0 John Aldaya CFO 0.0 0.1 X X 0 0 0 Knud Stubkjaer CEO 0.0 0.0 X 0 0 0 0 0 0 0 false false false Premera Blue Cross PO BOX 91060 SEATTLE WA 98111 CLAIMS ADMINISTRATOR 900583 Mercer Consulting 1301 Fifth Avenue SEATTLE WA 98101 Plan Consultant 102205 Delta Dental 9706 Fourth Avenue NE SEATTLE WA 98115 Dental Claims Admini 110366 3 0 EMPLOYER CONTRIBUTIONS 900099 26425747 26425747 EMPLOYEE CONTRIBUTIONS 900099 730263 730263 27156010 44718 44718 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27200728 27200728 0 0 0 20253902 20253902 0 0 0 0 0 0 102205 102205 0 17558 17558 0 0 0 1035547 1035547 0 0 0 0 0 0 0 0 0 0 0 641290 641290 22050502 21930739 119763 2238685 7389891 8737878 8782597 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2226505 2429125 13203068 18601613 2620403 2868722 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2620403 2868722 X 0 0 0 0 10582665 15732891 10582665 15732891 13203068 18601613 5150226 X false true X true false EMPLOYER CONTRIBUTION REC 1952553 CLAIMS RECOVERY REC 463244 PARTICIPANT CONTRIBUTION REC 13328 2429125 27200728 27200728 27200728 21906945 21906945 143557 143557 22050502 PART V11, Line 4b Other additional claims for Tax Purposes - $143,557 PART VI, SECTION B, LINE 11b FORM 990 is prepared by the plan sponsor, Carrix, Inc. As part of the preparation process, the Form 990 instructions are reviewed. As part of the review process, the plan sponsor conducts a review of the entire Form 990 to ensure that it is complete and accurate. The plan sponsor will consult with a professional advisor if necessary. The Trustees are provided a copy of the completed Form 990 for their information and review. PART VI, SECTION C, LINE 19 The filing organization is a VEBA, exempt under section 501(c)(9), and issues audited Financials each year. Neither the Financial Statements nor the governing documents are made available to the general public by the plan sponsor. However, the audited Financial Statements are attached to the Form 5500, and the financial information is reported on both the Form 990 and the Form 5500. The Form 5500 is open for public inspection. The financial information is also reported to each participant of the VEBA annually via the Summary Annual Report. Any member of the VEBA plan can also request and receive a full copy of the audited financial statements along with copies of the Form 990 and the Form 5500 directly from the plan sponsor. The plan sponsor has adopted a conflict of interest policy that spells out the situations to avoid and the procedure for disclosing conflicts or potential conflicts of interest to a Manager, the Legal Department and Human Resources. The organization also has an Employee Guide that includes all Business Principals & Values, Business Practices, Employment Practices & Policies, Information and Technology Policies and Employee Benefits and is available to all employees on both the Employee Community Portal and the Employee Self Service Portal located in the HCM system. This Guide meets the requirements of the Federal Employee Retirement Income Security Act of 1974 (ERISA). The Employee Benefits section covers various topics such as membership eligibility, what medical, dental & vision benefits are and are not covered by the plan, information about plan administration that includes appeal rights and the procedures for making an appeal. The VEBA uses a third party claims administrator and professional advisors to ensure that its benefits and procedures are properly administered on behalf of all members.