2020-06-03T13:03:32-05:00 2019-12-31 550621482 GRAY GRIFFITH & MAYS AC 707 VIRGINIA STREETEASTSUITE 400 CHARLESTON WV 253012711 990 2019-01-01 200367488 SPECIAL METALS CORPORATION SALARIED RETIREES WELFARE PLAN SPEC 3045250331 3150 US ROUTE 60 ONA WV 25545 ROY SMITH PRESIDENT OF THE BOARD 3045250331 2020-05-28 1 J RYAN LINDSAY P01835061 3043459400 64.127.29.130 2020-05-28 10:30:56 ED P 9817086D0D4943BBAEE1DD1F650EF854B2A0276C 9817086D0D4943BBAEE1DD1F650EF854B2A0276C 2019 2020-09-23 17:36:50Z ROY SMITH 160 WILLOUGHBY AVENUE HUNTINGTON WV 25705 5919568 0 X N/A X 2003 WV VOLUNTARY EMPLOYEE BENEFIT ASSOCIATION.TO PROVIDE HEALTH INSURANCE BENEFITS TO RETIREES AND THEIR DEPENDENTS AND TO PROVIDE LIFE INSURANCE 12 12 0 0 0 0 0 0 3449924 3470907 68029 155603 0 0 3517953 3626510 0 0 2946403 2726407 0 0 0 0 0 395724 400158 3342127 3126565 175826 499945 5198462 5989865 394398 333108 4804064 5656757 VOLUNTARY EMPLOYEE BENEFIT ASSOCIATION.TO PROVIDE HEALTH INSURANCE BENEFITS TO RETIREES AND THEIR DEPENDENTS AND TO PROVIDE LIFE INSURANCE. 0 0 2726407 3470907 VOLUNTARY EMPLOYEE BENEFIT ASSOCIATION.TO PROVIDE HEALTH INSURANCE BENEFITS TO RETIREES AND THEIR DEPENDENTS AND TO PROVIDE LIFE INSURANCE. 2726407 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 WV X AMERICAN BENEFIT CORPORATION 3045250331 3150 US ROUTE 60 ONA WV 25545 X LARRY MUSICK TRUSTEE 5.00 X 0 0 0 CAROLINE THOMAS TREASURER 5.00 X X 0 0 0 DAN WOLFE TRUSTEE 5.00 X 0 0 0 MARY RANSBOTTOM TRUSTEE 5.00 X 0 0 0 THOMAS LEMKE TRUSTEE 5.00 X 0 0 0 JAMES CRUM SECRETARY 5.00 X X 0 0 0 RON HAEBERLE VICE CHAIRMAN 5.00 X X 0 0 0 RUTH STOUT TRUSTEE 5.00 X 0 0 0 DARRELL SMITH TRUSTEE 5.00 X 0 0 0 GARY SIMPSON TRUSTEE 5.00 X 0 0 0 ROGER CHAPMAN TRUSTEE 5.00 X 0 0 0 ROY SMITH CHAIRMAN OF THE BOARD 5.00 X X 0 0 0 0 0 0 0 0 0 0 0 EMPLOYER CONTRIBUTIONS 525100 1910747 1910747 PARTICIPANT CONTRIBUTIONS 525100 830170 830170 PRESCRIPTION DRUG REBATES 525100 400854 400854 MEDICARE PART D SUBSIDIES 525100 318539 318539 MEDICARE PART D SUSIDY PY RECOVER 525100 10597 10597 3470907 131459 131459 2317202 2293058 24144 24144 24144 3626510 3470907 0 155603 X 2726407 1534 10938 42466 341572 2577 1071 3126565 3091 1000 2826868 3300978 49717 138598 23359 2295427 2549289 5198462 5989865 67425 73466 85858 85222 241115 174420 394398 333108 X 4804064 5656757 4804064 5656757 5198462 5989865 499945 352748 0 X X 0 0 0 0 ESTIMATED CLAIMS LIABILITY 174420 174420 3979258 352748 352748 3626510 0 3626510 3148692 0 3148692 -22127 -22127 3126565 PART XII, LINE 4B - OTHER ADJUSTMENTS: TO RECORD THE CHANGE IN BENEFITS INCURRED BUT NOT REPORTED LIABILITY -22,127. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE BOARD OF TRUSTEES' CHAIRMAN AND SECRETARY BEFORE THEY SIGN AND FILE THE FORM 990 FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCING COMPLIANCE WITH CONFLICT OF INTEREST POLICY - TRUSTEES ATTEND MEETING ON FIDUCIARY RESPONSIBILITIES. THE BOARD OF TRUSTEES FUNCTIONS AS A WHOLE; NO INDIVIDUAL TRUSTEE CAN ACT ALONE FORM 990, PART VI, SECTION C, LINE 19 THE PLAN MAKES AVAILABLE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST FORM 990, PART IX, LINE 11G SELF FUNDED ADMINISTRATIVE EXPENSES 267,952. CONTRACT ADMINISTRATION FEES 73,620. PART XII, LINE 2C THE PLAN HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.