2017-11-15T12:35:49-06:00 2016-12-31 231980475 KREISCHER MILLER 100 WITMER ROAD SUITE 350 HORSHAM PA 190442369 990 2016-01-01 222471827 AWW CO INC & ITS DESIGNATED SUB AFFIL GROUP INSURANCE TRUST AMER 8563465895 1025 LAUREL OAK ROAD VOORHEES NJ 08043 MARK MORTON VP, COMPENSATION AND BENEFITS 8563465895 2017-11-14 1 CHRISTOPHER M PEKULA P00734965 2154414600 64.55.30.226 2017-11-14 15:31:12 ES P 6C9B1A35775087DBDB8A6D25ECA509C7F6C27838 93B9C5084192534B8098865106E3535C59CB5260 2016 2021-01-29 14:40:06Z MARK MORTON 1025 LAUREL OAK ROAD VOORHEES NJ 08043 102116123 0 X N/A X 1983 PA SEE SCHEDULE O 5 5 0 5 3378 0 0 0 85898665 94206951 3780 3378 1177709 7905794 87080154 102116123 0 0 94309758 98281866 967036 808682 0 0 0 11491281 3398449 106768075 102488997 -19687921 -372874 487091 708180 5476325 6070288 -4989234 -5362108 X THE TRUST IS A VOLUNTARY EMPLOYEE'S BENEFICIARY ASSOCIATION (THE "VEBA") ESTABLISHED BY AMERICAN WATER WORKS COMPANY INC. (THE COMPANY). THE COMPANY AND PARTICIPANTS FUND THE VEBA SOLELY TO PROVIDE GROUP INSURANCE, EMPLOYEE ASSISTANCE AND LONG-TERM DISABILITY BENEFITS TO THE COMPANY'S EMPLOYEES. THE GROUP INSURANCE PLAN, (MEDICAL, DENTAL, PRESCRIPTION, VISION, GROUP LIFE INSURANCE, SHORT TERM DISABILITY AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS) AND THE EMPLOYEE ASSISTANCE PLAN ARE PROVIDED TO ALL FULL-TIME PERMANENT EMPLOYEES AND, AS PERMITTED UNDER THE PLAN, TO DEPENDENTS. THE LONG-TERM DISABILITY PLAN PROVIDES ITS BENEFITS TO THE COMPANY'S NON-BARGAINING UNIT EMPLOYEES. 0 0 102413268 102112745 THE TRUST IS A VOLUNTARY EMPLOYEE'S BENEFICIARY ASSOCIATION (THE "VEBA") ESTABLISHED BY AMERICAN WATER WORKS COMPANY INC. (THE COMPANY). THE COMPANY AND PARTICIPANTS FUND THE VEBA SOLELY TO PROVIDE GROUP INSURANCE, EMPLOYEE ASSISTANCE AND LONG-TERM DISABILITY BENEFITS TO THE COMPANY'S EMPLOYEES. THE GROUP INSURANCE PLAN, (MEDICAL, DENTAL, PRESCRIPTION, VISION, GROUP LIFE INSURANCE, SHORT TERM DISABILITY AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS) AND THE EMPLOYEE ASSISTANCE PLAN ARE PROVIDED TO ALL FULL-TIME PERMANENT EMPLOYEES AND, AS PERMITTED UNDER THE PLAN, TO DEPENDENTS. THE LONG-TERM DISABILITY PLAN PROVIDES ITS BENEFITS TO THE COMPANY'S NON-BARGAINING UNIT EMPLOYEES. 102413268 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 1 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X AMERICAN WATER WORKS CO INC 8563465895 1025 LAUREL OAK ROAD VOORHEES NJ 08043 MICHAEL HOFFMAN BENEFIT COMMITTEE 2.00 X 0 0 0 JENN GAMBOL CO-CHAIR 8.00 X 0 0 0 BRUCE HAUK BENEFIT COMMITTEE 2.00 X 0 0 0 DAVID CHOATE BENEFIT COMMITTEE 2.00 X 0 0 0 MARK MORTON CO-CHAIR 8.00 X 0 0 0 WELLS FARGO BANK NA TRUSTEE 1.00 20.00 X 113751 0 0 113751 0 0 0 0 0 0 HORIZON BCBS NJ PO BOX 310 NEWARK NJ 071010310 ADMINISTER MEDICAL CARE 2394407 AMERICAN WATER WORKS CO INC 1025 LAUREL OAK ROAD VOORHEES NJ 08043 HEALTH & WELLNESS PROGRAM 694931 AETNA INC PO BOX 70966 CHICAGO IL 606730944 ADMIN DENTAL & DISABILITY 214260 OPERATING ENGINEERS TRUST PO BOX 3708 HONOLULU HI 96811 FUND MANAGEMENT 166640 CAREBRIDGE CORP 40 LLOYD AVE SUITE 207 MALVERN PA 19355 EMPLOYEE ASSISTANCE 135314 5 COMPANY CONTRIBUTIONS 900099 81167871 81167871 MEMBER CONTRIBUTIONS 900099 13039080 13039080 94206951 3378 3378 REFUNDS 900099 7905794 7905794 7905794 102116123 102112745 3378 0 98281866 98281866 113751 113751 694931 694931 3060853 3060853 6750 6750 -44772 -44772 REINSURANCE FEE 375618 375618 102488997 102413268 75729 0 23335 183 463756 707997 487091 708180 5476325 6070288 5476325 6070288 X -4989234 -5362108 0 0 0 0 -4989234 -5362108 487091 708180 -372874 0 X X 1 X 1 X 1 0 0 MEDICAL CLAIMS INCURRED BUT NOT REPORTED 6070288 6070288 FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANZIATION MISSION: THE TRUST IS A VOLUNTARY EMPLOYEE'S BENEFICIARY ASSOCIATION (THE "VEBA") ESTABLISHED BY AMERICAN WATER WORKS COMPANY INC. (THE COMPANY). THE COMPANY AND PARTICIPANTS FUND THE VEBA SOLELY TO PROVIDE GROUP INSURANCE, EMPLOYEE ASSISTANCE AND LONG-TERM DISABILITY BENEFITS TO THE COMPANY'S EMPLOYEES. THE GROUP INSURANCE PLAN, (MEDICAL, DENTAL, PRESCRIPTION, VISION, GROUP LIFE INSURANCE, SHORT TERM DISABILITY AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS) AND THE EMPLOYEE ASSISTANCE PLAN ARE PROVIDED TO ALL FULL-TIME PERMANENT EMPLOYEES AND, AS PERMITTED UNDER THE PLAN, TO DEPENDENTS. THE LONG-TERM DISABILITY PLAN PROVIDES ITS BENEFITS TO THE COMPANY'S NON-BARGAINING UNIT EMPLOYEES. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS OF AMERICAN WATER WORKS COMPANY, INC. APPOINTS THE MEMBERS OF THE RETIREMENT/BENEFITS COMMITTEE. THE COMMITTEE MEMBERS SERVE ON A VOLUNTARY BASIS AS THE INDIVIDUAL TRUSTEES OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE BENEFITS COMMITTEE. FORM 990, PART VI, SECTION B, LINE 12C AMERICAN WATER WORKS CO, INC MAINTAINS A CODE OF ETHICS THAT GOVERNS THE ACTIONS OF THE BENEFITS COMMITTEE MEMBERS. THE CODE REQUIRES THAT CONFLICTS OF INTEREST BE AVOIDED, REQUIRES ANNUAL CERTIFICATION OF COMPLIANCE AND INCLUDES A "NO RETALIATION" POLICY REGARDING REPORTS OF VIOLATIONS. FORM 990, PART VI, SECTION C, LINE 19 EMPLOYEES RECEIVE A SUMMARY PLAN DOCUMENT (SPD) WHEN HIRED. A SUMMARY ANNUAL REPORT (SAR) IS DISTRIBUTED ANNUALLY. THE CODE OF ETHICS ON THE COMPANY'S INTERNET AND INTRANET SITES, HARD COPIES ARE AVAILABLE THROUGH THE HR DEPARTMENT. ALL OTHER DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 1 THE ACCOUNTING METHOD IS MODIFIED CASH. AN ANNUAL AUDIT IS CONDUCTED BY AN INDEPENDENT AUDITOR FOR AMERICAN WATER WORKS COMPANY, INC AND ITS DESIGNATED SUBS. AND AFFIL GROUP INSURANCE PLAN (PLAN). THE PLAN INCLUDES THIS VEBA AS WELL AS OTHER VEBAS REPORTED ON SCHEDULE R. FORM 990, PART XII, LINE 2C NO CHANGE FROM THE PRIOR YEAR. FORM 990, PART VI, LINE 9 JAMES SHERIDAN, 330 FELLOWSHIP ROAD, MOUNT LAUREL, NJ 08054 FORM 990, PART VII THIS VEBA TRUST PAYS THE INSTITUTIONAL TRUSTEE AND OTHER INDEPENDENT CONTRACTORS BY THE SERVICE RENDERED. AWWC LIFE INSURANCE TRUST PO BOX 5627 CHERRY HILL NJ 08034 043207700 LIFE INSURANCE MA N/A T 0 AWW POST RETIREMENT MED TRUST BARGAINING PO BOX 5627 CHERRY HILL NJ 08034 043207704 MED BENEFIT MA N/A T 0 AWW CO INC & POST RETIREMENT MEDICAL TRUSTNON BARGAINING PO BOX 5627 CHERRY HILL NJ 08034 043207706 MED BENEFIT MA N/A T 0 AMERICAN LAKE WATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 061396121 WATER UTILITY IL N/A C 0 THAMES WATER NORTH AMERICA INC PO BOX 5627 CHERRY HILL NJ 08034 061548192 DEVELOPMENT SERVICES DE N/A C 0 NEW YORK AMERICAN WATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 111516966 WATER UTILITY NY N/A C 0 MT EBO SEWAGE WORKS INC PO BOX 5627 CHERRY HILL NJ 08034 133223856 WATER UTILITY NY N/A C 0 LAUREL OAK PROPERTIES CORPORATION PO BOX 5627 CHERRY HILL NJ 08034 201022964 LEASING DE N/A C 0 NEW JERSEY AMERICAN WATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 221546642 WATER UTILITY NJ N/A C 0 ENVIRONMENTAL DISPOSAL CORPORATION PO BOX 5627 CHERRY HILL NJ 08034 222391983 WATER UTILITY NJ N/A C 0 E TOWN PROPERTIES INC PO BOX 5627 CHERRY HILL NJ 08034 222817018 MANAGE REAL ESTATE DE N/A C 0 AMERICAN WATER ENTERPRISES PO BOX 5627 CHERRY HILL NJ 08034 223169459 HOLDING COMPANY DE N/A C 0 AAET INC PO BOX 5627 CHERRY HILL NJ 08034 223259128 WATER/WASTEWATER MGM DE N/A C 0 EDISON EATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 223519296 WATER UTILITY NJ N/A C 0 LIBERTY WATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 223596293 WATER PURIFICATION DE N/A C 0 AMERICAN WATER CAPITAL CORP PO BOX 5627 CHERRY HILL NJ 08034 223732448 FINANCE COMPANY DE N/A C 0 AMERICAN WATER WORKS SERVICE COMPANY PO BOX 5627 CHERRY HILL NJ 08034 231340234 SHARED SERVICES DE N/A C 0 PENNSYLVANIA AMERICAN WATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 251008096 WATER UTILITY PA N/A C 0 AMERICAN WATER RESOURCES HOLDINGS INC PO BOX 5627 CHERRY HILL NJ 08034 275107201 HOLDING COMPANY DE N/A C 0 AMERICAN WATER RESOURCES OF TEXAS INC PO BOX 5627 CHERRY HILL NJ 08034 275107457 MANAGEMENT SERVICES DE N/A C 0 INDIANA AMERICAN WATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 350936102 WATER UTILITY IN N/A C 0 MICHIGAN AMERICAN WATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 381657784 WATER UTILITY MI N/A C 0 IOWA AMERICAN WATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 420735216 WATER UTILITY DE N/A C 0 ENVIRONMENTAL MANAGEMENT CORPORATION PO BOX 5627 CHERRY HILL NJ 08034 431205270 WATER WASTE MANAGEMENT MO N/A C 0 MISSOURI AMERICAN WATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 440578460 WATER UTILITY MO N/A C 0 AW TECHNOLOGIES INCORPORATED PO BOX 5627 CHERRY HILL NJ 08034 453808303 WATER-USIGN EMERGING TECH DE N/A C 0 AMERICAN WATER RESOURCES OF FLORIDA PO BOX 5627 CHERRY HILL NJ 08034 455262240 MANAGEMENT SERVICES DE N/A C 0 AWI INC PO BOX 5627 CHERRY HILL NJ 08034 474426070 FINANCIAL SERVICES CO DE N/A C 0 AMERICAN WATER WORKS COMPANY 131 WOODCREST ROAD CHERRY HILL NJ 08003 510063696 HOLDING COMPANY DE N/A C 0 CALIFORNIA AMERICAN WATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 510104148 WATER UTILITY CA N/A C 0 ILLINOIS AMERICAN WATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 510105894 WATER UTILITY IL N/A C 0 MARYLAND AMERICAN WATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 520265025 WATER UTILITY MD N/A C 0 VIRGINIA AMERICAN WATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 540119650 WATER UTILITY VA N/A C 0 WEST VIRGINIA AMERICAN WATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 550307487 WATER UTILITY WV N/A C 0 NYWSC POST RETIREMENT HEALTHCARE ASSOC 1025 LAUREL OAK RD VOORHEES NJ 08043 550823550 MED BENEFIT NY N/A T 0 KENTUCKY AMERICAN WATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 610485002 WATER UTILITY KY N/A C 0 TENNESSEE-AMERICAN WATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 620529095 WATER UTILITY TN N/A C 0 BLUEFIELD VALLEY WATER WORKS COMPANY PO BOX 5627 CHERRY HILL NJ 08034 666022466 WATER UTILITY VA N/A C 0 AMERICAN WATER ENTERPRISES HOLDING INC PO BOX 5627 CHERRY HILL NJ 08034 760605357 HOLDING COMPANY DE N/A C 0 AMERICAN WATER ENGINEERING INC PO BOX 5627 CHERRY HILL NJ 08034 760654501 WATER UTILITY NJ N/A C 0 SWC ACQUISITION COMPANY PO BOX 5627 CHERRY HILL NJ 08034 813366842 HOLDING COMPANY NJ N/A C 0 AMERICAN WATER SERVICES CDM INC PO BOX 5627 CHERRY HILL NJ 08034 911745331 WATER SUPPLY WA N/A C 0 AMERICAN WATER OPERATIONS AND MAINTENACE INC PO BOX 5627 CHERRY HILL NJ 08034 980165919 UTILITY OPERATION & MAINT TX N/A C 0 AMERICAN WATER (USA) INC PO BOX 5627 CHERRY HILL NJ 08034 980165920 HOLDING COMPANY DE N/A C 0 HAWAII AMERICAN WATER COMPANY PO BOX 5627 CHERRY HILL NJ 08034 990108667 WATER UTILITY NE N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0