STRATEGY STUDIO / PUBLIC DATA EXPLORER

SCHOOL DISTRICT 1 HEALTH & WELFARE TRUST FUND: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
SCHOOL DISTRICT 1 HEALTH & WELFARE TRUST FUND (EIN 93-6090239)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-10-10
IRS object ID
201842839349301304
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-10-10T12:05:39-07:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN931015766PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BJORKLUND & MONTPLAISIR CPA'SBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line19020 SW WASHINGTON SQ RD SUITE 46AddressLine1Txt
CityPORTLANDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97223ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN936090239EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SCHOOL DISTRICT NO 1 HEALTH ANDBusinessNameLine1Txt
Business Name Line2WELFARE TRUST FUNDBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlSCHOBusinessNameControlTxt
Phone2063294900PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1700 NE MULTNOMAH ST SUITE 350AddressLine1Txt
CityPORTLANDCityNm
State AbbreviationORStateAbbreviationCd
ZIP972324197ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTERRI BURTONPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone2063294900PhoneNum
Signature2018-10-02SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRICHARD A LAYNEPreparerPersonNm
PTINP00359754PTIN
Phone5036436400PhoneNum
Preparation2018-10-10PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address74.203.59.35IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-10-10IPDt
IP Tm14:05:39IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDB4B1E074543423735CD570429D626CC3B6B6E83AtSubmissionCreationDeviceId
At Submission Filing Device IdDB4B1E074543423735CD570429D626CC3B6B6E83AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2018-06-14 16:35:46ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTERRI BURTONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1700 NE MULTNOMAH ST SUITE 350AddressLine1Txt
CityPORTLANDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97232ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$85,792,740GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressSDTRUST.COMWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1972FormationYr
Legal Domicile StateORLegalDomicileStateCd
Activity Or MissionTO PROVIDE HEALTH AND LIFE INSURANCE BENFITS TO PARTICIPANTS, AS DEFINED IN VARIOUS COLLECTIVE BARGAINING AGREEMNETS, AND THEIR ELIGIBLE SPOUSES AND DEPENDENTS IN ACCORDANCE WITH THE TERMS OF THE BENEFIT PLANS OFFERED.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$12,271,185PYProgramServiceRevenueAmt
CY Program Service Revenue$84,543,864CYProgramServiceRevenueAmt
PY Investment Income-$100,783PYInvestmentIncomeAmt
CY Investment Income$600,467CYInvestmentIncomeAmt
CY Other Revenue$2,366CYOtherRevenueAmt
PY Total Revenue$12,170,402PYTotalRevenueAmt
CY Total Revenue$85,146,697CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$12,138,487PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$82,805,190CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$326,948PYOtherExpensesAmt
CY Other Expenses$1,859,103CYOtherExpensesAmt
PY Total Expenses$12,465,435PYTotalExpensesAmt
CY Total Expenses$84,664,293CYTotalExpensesAmt
PY Revenues Less Expenses-$295,033PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$482,404CYRevenuesLessExpensesAmt
Total Assets BOY$40,837,197TotalAssetsBOYAmt
Total Assets EOY$43,395,935TotalAssetsEOYAmt
Total Liabilities BOY$29,353,525TotalLiabilitiesBOYAmt
Total Liabilities EOY$31,049,057TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$11,483,672NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$12,346,878NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE HEALTH AND LIFE INSURANCE BENFITS TO PARTICIPANTS, AS DEFINED IN VARIOUS COLLECTIVE BARGAINING AGREEMNETS, AND THEIR ELIGIBLE SPOUSES AND DEPENDENTS IN ACCORDANCE WITH THE TERMS OF THE BENEFIT PLANS OFFERED.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
DescTO PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
DescTO PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS.Desc
FieldValueIRS element (for citing)
Described In Section501c3falseDescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document113IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Own WebsiteYes (X)OwnWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTHWEST ADMINISTRATOS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2067263239PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12323 EASTLAKE AVENUE EAddressLine1Txt
CitySEATTLECityNm
State AbbreviationWAStateAbbreviationCd
ZIP981023305ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
LEONARD ANDERSON
TRUSTEE1.00Yes (X)$0$0$0
PAUL ANTHONY
TRUSTEE1.00Yes (X)$0$0$0
BELINDA REAGAN
TRUSTEE1.00Yes (X)$0$0$0
TERRI BURTON
TRUSTEE1.00Yes (X)$0$0$0
SUZANNE COHEN
CHAIR PERSON1.00Yes (X)$0$0$0Yes (X)
MARTY PAVLIK
TRUSTEE1.00Yes (X)$0$0$0
JOHN BERKEY
TRUSTEE1.00Yes (X)$0$0$0
MICHELLE BATTEN
TRUSTEE1.00Yes (X)$0$0$0
RUSS PETERSON
TRUSTEE1.00Yes (X)$0$0$0
PAT CHRISTENSEN
TRUSTEE1.00Yes (X)$0$0$0
LARRY WARREN
TRUSTEE1.00Yes (X)$0$0$0
LAIRD CUSACK
TRUSTEE1.00Yes (X)$0$0$0
MEI LEE
TRUSTEE1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
REGENCE BLUECROSS BLUE SHIELD OF OR
PO BOX 1271PORTLANDOR972071271CLAIMS ADMIN.$659,723
NORTHWEST ADMINISTRATORS INC
700 NE MULTNOMAH ST SUITE 350PORTLANDOR97232CONTRACT ADMIN.$434,796
MERCER HUMAN RESOURCE CONSULTING
111 SW COLUMBIA STREETPORTLANDOR97201CONSULTANT$275,754
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYER CONTRIBUTIONS$81,811,242$81,811,242
PARTICIPANT CONTRIBUTIONS$2,732,622$2,732,622
FieldValueIRS element (for citing)
Total Program Service Revenue$84,543,864TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$345,233TotalRevenueColumnAmt
Related Or Exempt Func Income$345,233RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$901,277SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$646,043SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$255,234SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$255,234TotalRevenueColumnAmt
Related Or Exempt Func Income$255,234RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Total Revenue Column$2,366TotalRevenueColumnAmt
Related Or Exempt Func Income$2,366RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,366OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$85,146,697TotalRevenueColumnAmt
Related Or Exempt Func Income$85,146,697RelatedOrExemptFuncIncomeAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$82,805,190TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$434,796TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$52,900TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$26,300TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$437,590TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$39,132TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$151,115TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$30,360TotalAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmt
CLAIMS ADMINISTRATION$678,855
FICA TAX EXPENSE$4,846
PCORI TAX$3,209

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$84,664,293TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$804,619BOYAmt
EOY$1,403,637EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$19,831,561BOYAmt
EOY$20,974,284EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,486,551BOYAmt
EOY$8,032,144EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$261,613BOYAmt
EOY$1,701,566EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$10,452,853BOYAmt
EOY$11,284,304EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$40,837,197BOYAmt
EOY$43,395,935EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$113,405BOYAmt
EOY$86,169EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$3,687,695BOYAmt
EOY$5,127,951EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$25,552,425BOYAmt
EOY$25,834,937EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$29,353,525BOYAmt
EOY$31,049,057EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$11,483,672BOYAmt
EOY$12,346,878EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,483,672BOYAmt
EOY$12,346,878EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$40,837,197BOYAmt
EOY$43,395,935EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$482,404ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$380,802NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
DEFERRED INCOME UNDER RESERVE POLICY$14,241,315
INSURANCE PREMIUMS PAYABLE$5,567,309
CLAIMS PAYABLE$3,106,313
CLAIMS INCURRED BUT NOT REPORTED$2,920,000
FieldValueIRS element (for citing)
Total Liability$25,834,937TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$85,527,499TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$380,802NetUnrealizedGainsInvstAmt
Revenue Not Reported$380,802RevenueNotReportedAmt
Revenue Subtotal$85,146,697RevenueSubtotalAmt
Total Revenue Per Form990$85,146,697TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$84,730,020TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$84,730,020ExpensesSubtotalAmt
Other Expenses Not Included-$65,727OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt-$65,727ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$84,664,293TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PAGE 4, PART XII, LINE 4BFormAndLineReferenceDesc
ExplanationDECREASE IN BENEFIT OBLIGATIONS -65,727ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 2, PART III, LINE 4DTO PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS.
FORM 990, PAGE 6, PART VI, LINE 11BTRUSTEES REVIEW FORM 990 AND ASK QUESTIONS OF THE PREPARER PRIOR TO FILING.
FORM 990, PAGE 6, PART VI, LINE 12CTRUSTEES ARE REQUIRED TO NOTIFY THE TRUST OF ANY CHANGES IN THEIR INTERESTS THAT COULD GIVE RISE TO CONFLICTS.
FORM 990, PAGE 6, PART VI, LINE 15ANO COMPENSATION IS PAID
FORM 990, PAGE 6, PART VI, LINE 15BNO COMPENSATION IS PAID.
FORM 990, PAGE 6, PART VI, LINE 19THE TRUST DOCUMENT, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MAINTAINED IN THE TRUSTS' OFFICE AND ARE AVAILABLE UPON REQUEST.