2023-05-15T15:27:42-05:00 2022-06-30 450250958 EIDE BAILLY LLP 10681 FOOTHILL BLVD STE 300 RANCHO CUCAMONGA CA 917303831 990 2021-07-01 926027877 PUBLIC EDUCATION HEALTH TRUST PUBL 9072747526 2550 DENALI 1614 ANCHORAGE AK 99503 RHONDA PROWELL-KITTER CHIEF FINANCIAL OFFICER 9072747526 2023-05-15 1 RHONDA PROWELL-KITTER 999009999 CATHERINE L GRAY CPA P01294460 9094664410 2023-05-15 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z RHONDA PROWELL-KITTER 2550 DENALI 1614 ANCHORAGE AK 99503 179489604 0 X HTTPS://PEHTAK.COM/ X 1996 AK TO PROVIDE COMPREHENSIVE MEDICAL, DENTAL, VISION, AND PRESCRIPTION DRUG BENEFITS. 7 7 3 7 2812825 0 0 0 137658612 131087381 1632049 2812825 4227861 5006041 143518522 138906247 0 0 129174770 126507236 508658 522099 0 0 0 5899108 5912778 135582536 132942113 7935986 5964134 55144732 52102114 17703611 17710202 37441121 34391912 TO PROVIDE COMPREHENSIVE MEDICAL, DENTAL, VISION, AND PRESCRIPTION DRUG BENEFITS. 0 0 TO PROVIDE COMPREHENSIVE MEDICAL, DENTAL, VISION, AND PRESCRIPTION BENEFITS TO APPROXIMATELY 13,000 PLAN PARTICIPANTS. 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 7 0 1 3 1 1 1 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 1 0 0 X RHONDA PROWELL-KITTER 9072747526 2550 DENALI 1614 ANCHORAGE AK 99503 X TOM KLAAMEYER TRUSTEE 1.00 X 0 0 0 JESSICA COOK TRUSTEE 1.00 X 0 0 0 KATHLEEN BELL TRUSTEE 1.00 X 0 0 0 LAURA MULGREW TRUSTEE 1.00 X 0 0 0 TIM WALTERS TRUSTEE 1.00 X 0 0 0 JOSH ANDREWS TRUSTEE 1.00 X 0 0 0 BRIDGET WEISS TRUSTEE 1.00 X 0 0 0 RHONDA PROWELL-KITTER CFO/PLAN ADMINISTRATOR 60.00 X 196605 0 80315 196605 0 80315 1 0 1 0 EBMS PO BOX 21367 BILLINGS MT 59104 TPA FEES 1999843 EBMS PO BOX 21367 BILLINGS MT 59104 UTILIZATION REVIEW 876294 HUMANA 500 WEST MAIN STREET LOUISVILLE KY 40202 WELLNESS ADMIN FEE 511569 AON HEWITT 199 FREMONT STREET SUITE 1500 SAN FRANCISCO CA 94105 CONSULTING/ACTUARY 265308 UBS 3000 A STREET ANCHORAGE AK 99503 INVESTMENT ADVISOR 264194 5 EMPLOYER CONTRIBUTIONS 131087381 131087381 131087381 1074050 1074050 42322132 40583357 1738775 1738775 1738775 MISCELLANEOUS 5006041 5006041 5006041 138906247 136093422 2812825 0 126507236 230749 291350 24844 24400 264194 76869 25377 49256 7033 2158 30220 FEES PAID TO THIRD PART 3882444 STOP-LOSS INSURANCE PRE 732846 CORE SERVICE FEES 265308 ACA TRANSITIONAL REINSU 263370 264459 132942113 107000 16345 9398222 11131597 352246 353947 66398 41077 30454 25321 43469885 35819909 1786925 4754995 55144732 52102114 17703611 17710202 17703611 17710202 X 0 0 0 0 37441121 34391912 37441121 34391912 55144732 52102114 5964134 -9544132 530789 0 X X 0 1 X 1 0 66398 41077 25321 25321 PRESCRIPTION REBATES 4754995 4754995 OTHER 91457 INCURRED BUT NOT REPORTED 16635000 UNEARNED REVENUE 983745 17710202 X 129097921 -9544132 -9544132 138642053 264194 264194 138906247 132528919 0 132528919 264194 149000 413194 132942113 PART X, LINE 2: THE PLAN HAS ADOPTED GUIDANCE, ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD, ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE PLAN BELIEVES THAT THE PLAN HAS NOT TAKEN UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS AS A TAX LIABILITY. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN NET BENEFIT OBLIGATIONS 149,000. X X 0 0 0 RHONDA PROWELL-KITTER CFO/PLAN ADMINISTRATOR 196605 0 0 0 0 0 46171 0 34144 0 276920 0 0 0 FORM 990, PART VI, SECTION A, LINE 8B THE PLAN DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE TRUSTEES DESIGNATE THE ADMINISTRATOR TO REVIEW THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C POLICY IS REVIEWED ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15A REVIEW OF INDUSTRY DATA. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. FORM 990 PART VII SECTION A COLUMN E AND F CERTAIN TRUSTEES OF THE TRUST, FOR WHICH THERE IS NO APPLICABLE REPORTING EXEMPTION, ARE EMPLOYEES OF CONTRIBUTING EMPLOYER THAT ARE CONSIDERED RELATED ORGANIZATIONS UNDER THE DEFINITIONS IN SCHEDULE R. THE TRUST IS UNABLE TO REPORT COMPENSATION AND BENEFITS PAID TO THE TRUSTEES BY RELATED ORGANIZATIONS AS IT WAS UNABLE TO OBTAIN THE INFORMATION AFTER MAKING REASONABLE EFFORTS. THE TRUST REQUESTED THE COMPENSATION INFORMATION FROM THE TRUSTEE(S) BY PROVIDING A QUESTIONNAIRE REQUESTING THE REQUIRED INFORMATION ALONG WITH INSTRUCTIONS TO EXPLAIN THE INFORMATION NEEDED. THE QUESTIONNAIRES FOR THE TRUSTEES WERE NOT RECEIVED BACK PRIOR TO FILING THE TAX RETURN. FORM 990. PART XI, LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSEEING THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND FOR SELECTING THE INDEPENDENT AUDITOR. ALASKA GATEWAY SCHOOL DISTRICT AK GOVERNMENT ANCHORAGE EDUCATION ASSOCIATION AK GOVERNMENT BRISTOL BAY BOROUGH SCHOOL DISTRICT AK GOVERNMENT CHATHAM SCHOOL DISTRICT AK GOVERNMENT CLASSIFIED EMPLOYEES ASSOCATION AK GOVERNMENT COPPER RIVER SCHOOL DISTRICT AK GOVERNMENT CORDOVA SCHOOL DISTRICT AK GOVERNMENT CRAIG CITY SCHOOL DISTRICT AK GOVERNMENT DELTA GREELY SCHOOL DISTRICT AK GOVERNMENT DENALI BOROUGH SCHOOL DISTRICT AK GOVERNMENT HAINES SCHOOL DISTRICT AK GOVERNMENT HOONAH SCHOOL DISTRICT AK GOVERNMENT HYDABURG CITY SCHOOL AK GOVERNMENT JUNEAU EDUCATION ASSOCIATION AK GOVERNMENT KAKE SCHOOL DISTRICT AK GOVERNMENT KASHUNAMIUT SCHOOL DISTRICT AK GOVERNMENT KLAWOCK SCHOOL DISTRICT AK GOVERNMENT MAT-SU BOROUGH SCHOOL DISTRICT AK GOVERNMENT NEA-ALASKA AK GOVERNMENT NENANA CITY SCHOOL DISTRICT AK GOVERNMENT PETERSBURG SCHOOL DISTRICT AK GOVERNMENT PRIBILOF SCHOOL DISTRICT AK GOVERNMENT SOUTHEAST ISLAND SCHOOL DISTRICT AK GOVERNMENT TANANA SCHOOL DISTRICT AK GOVERNMENT WRANGELL SCHOOL DISTRICT AK GOVERNMENT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PARTS II, III, AND IV - IDENTIFICATION OF RELATED TAX ORGANIZATIONS IN A MULTIEMPLOYER PLAN, A CONTRIBUTING EMPLOYER IS CONSIDERED A RELATED ORGANIZATION BECAUSE THEY ARE OBLIGATED TO CONTRIBUTE TO THE PLAN PURSUANT TO THE TERMS IN THE COLLECTIVE BARGAINING OR PARTICIPATION AGREEMENT.