2019-11-14T13:44:55-06:00 2018-12-31 450250958 Eide Bailly LLP 401 N 31st St Ste 1120 PO Box 7112 Billings MT 591037112 990 2018-01-01 364061730 First Interstate BancSystem Inc Health Benefits Trust FIRS 4062555300 PO Box 30918 Billings MT 591160918 Rachel Turitto Committee Member 4062555300 2019-11-13 1 John W Jacobsen P00003952 4068962400 2019-11-13 216.147.181.47 2019-11-13 15:21:15 MS P 65D3B8E672A899EA41EAC8ED9B98B8E70A5F160D 65D3B8E672A899EA41EAC8ED9B98B8E70A5F160D 2018 2020-03-31 21:24:44Z Rachel Turitto 401 N 31st Street Billings MT 59101 48847568 0 X N/A X 1994 MT Provide health benefits to participating employees. 6 0 0 0 0 0 0 0 18695854 21458010 87266 97914 0 0 18783120 21555924 0 0 16262512 21211394 9474 15332 0 0 0 2176628 2786439 18448614 24013165 334506 -2457241 6289190 4017924 23863 411600 6265327 3606324 None. 0 0 Payments for the benefit of participants in the health plan for hospital, medical, dental, and vision costs. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 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 1 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 X 6 0 1 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X Rachel Turitto 4062555210 401 N 31st Street Billings MT 59101 Kevin Riley Committee Member 1.00 40.00 X X 0 0 0 Marcy D Mutch Committee Member 1.00 40.00 X X 0 0 0 Mike Cherwin Chief Human Resource Officer 1.00 40.00 X X 0 0 0 Phil Gaglia Committee Member 1.00 40.00 X X 0 0 0 Jodi Delahunt Hubbell Committee Member 1.00 40.00 X X 0 0 0 Rachel Turitto Committee Member 1.00 40.00 X X 0 0 0 First Interstate Wealth Management Trustee 1.00 X 15332 0 0 15332 0 0 0 0 0 0 Allegiance Benefit Plan Management Inc 2806 S Garfield St Missoula MT 59801 Administrative Services 712510 Health 360 800 Main Street Dubuque IA 52004 Health & Wellness Promotion 210230 Navitus Health Solutions 361 Integrity Dr Madison WI 53717 Health & Wellness Promotion 113103 Payne West Insurance 3289 Gabel Rd Billings MT 59102 Administrative Services 111250 4 Employer Contributions 525100 14063524 14063524 Employee Contributions 525100 6515012 6515012 Other Contributions 525100 879474 879474 21458010 109067 109067 27280491 27291644 -11153 -11153 -11153 21555924 21555924 0 0 21211394 15332 912176 539904 Stop Loss Insurance Pre 1334359 24013165 119657 300635 2551700 101705 5886850 1346567 6289190 4017924 23863 411600 23863 411600 X 6265327 3606324 0 0 0 0 6265327 3606324 6289190 4017924 -2457241 -201762 0 X 0 1 X 0 0 0 X 21354162 -201762 -201762 21555924 0 21555924 24013165 0 24013165 0 24013165 Part X, Line 2: The trust established to hold the Plan's assets is intended to qualify pursuant to Section 501(c)(9) of the Internal Revenue Code, and accordingly, the Plan's net investment income is exempt from income taxes. The Plan has obtained an exemption letter dated July 30, 1999 from the Internal Revenue Service, and the Employer believes that the Plan, as amended, continues to qualify and to operate in accordance with the applicable requirements of the Internal Revenue Code. Therefore, no provision for income taxes has been inclued in the Plan's financial statements. Accounting principles generally accepted in the United States of America require plan management to evaluate tax positions taken by the Plan and recognize a tax liability (or asset) if the Plan has taken an uncertain tax position that more likely than not would not be sustained upon examination by the Internal Revenue Service. The Plan is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. Form 990, Part VI, Section A, line 1 First Interstate BancSystem, Inc's Benefits Committee has been delegated all management and fiduciary authority for the benefit plans of First Interstate BancSystem, Inc. There are 6 members of the Benefits Committee that oversee the health plan and they all have equal voting powers on matters. Form 990, Part VI, Section A, line 2 Mike Cherwin, Kevin Riley, Marcy Mutch, Phil Gaglia, Jodi Delahunt Hubbell, and Rachel Turitto - business relationship. Form 990, Part VI, Section B, line 11b A copy of the Form 990 is provided to members of the Benefit Committee via email. Form 990, Part VI, Section C, line 19 The organization does not make the governing documents, conflict of interest policy or financial statements available to the public. Form 990, Part V, Line 1a and 1c and Part VII, Column D, Individual 1 The organization compensated First Interstate Wealth Management for services rendered as Trustee. A third party, Allegiance, files 1099's on behalf of First Interstate BancSystem Inc. Health Benefits Plan and Trust when required. Form 990, Part V, Line 3A and 3B, Filing of Form 990-T The organization is electing to set aside investment income for the purpose of payments for health benefits to its members. The set aside election has been made by filing Schedule G of Form 990-T, in addition to completing a Schedule in Support of Income Set Aside as attached to the 990-T. First Interstate BancSystem Inc PO Box 30918 Billings MT 59116 810331430 Bank MT N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0