2023-11-13T14:02:05-06:00 2022-12-31 PwC US Tax LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2022-01-01 476685299 KAISER FOUNDATION HEALTH PLAN INC RETIREE HEALTH AND WELFARE PLAN % STATE STREET BANK KAIS 5102716611 C/O STATE STREET BANK PO BOX 5100 BOSTON MA 022060001 THOMAS MEIER SR VP & TREASURER 5102716611 2023-11-09 THOMAS MEIER 999009999 JOANNE KRUEGER P01235586 2673303000 2023-11-09 2 2022 2023-04-26 12:10:37Z STATE STREET BANK PO BOX 5100 BOSTON MA 02206 30093272 false X N/A X 2014 CA SEE SCHEDULE O. 1 1 0 0 0 0 0 0 0 0 206309367 30093272 0 0 206309367 30093272 0 0 0 0 510646 114748 0 0 0 21907820 21661598 22418466 21776346 183890901 8316926 6263155647 4935690823 2247775 1963704 6260907872 4933727119 X SEE SCHEDULE O. false false 0 0 0 THE PLAN PROVIDES FUNDING FOR THE PAYMENT OF BENEFITS TO ELIGIBLE PERSONS. 0 false false false false false false false false false false false false false false true false false false false false false false false false false false false false false false false false false false false false false false false true false false true 0 0 0 false false false false false false false X 1 1 false false false false false false false false false false false true false false false false false false CA X STATE STREET BANK 6176543003 PO BOX 5100 BOSTON MA 02206 STATE STREET BANK TRUST COMP TRUSTEE 1.0 0.0 X 114748 0 0 114748 0 0 1 false false false 0 0 0 677948 677948 0 0 0 0 0 29415324 29415324 29415324 0 0 0 0 0 0 0 0 0 0 30093272 677948 0 0 0 0 114748 0 0 0 0 0 113655 0 27000 0 0 8910057 0 0 0 0 0 0 0 0 0 0 0 0 0 BENEFIT ADMIN EXPENSES 6829789 ACCRUED EXPENSES 5750032 FOREIGN INCOME TAX -354 OTHER EXPENSES 31419 21776346 0 0 0 23429885 34405342 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6237108165 4900167203 0 0 0 0 0 0 2617597 1118278 6263155647 4935690823 2247775 1963704 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2247775 1963704 X 6260907872 4933727119 0 0 0 0 6260907872 4933727119 6263155647 4935690823 8316926 -1335497679 X false true X false -1110978572 -1335497679 194425835 -1141071844 30093272 30093272 216202181 194425835 194425835 21776346 21776346 SCHEDULE D, PART XI, LINE 2D TRANSFERS IN PER THE BOOKS AND NOT OTHERWISE REPORTED ON THE TAX RETURN $194,425,835 SCHEDULE D, PART XII, LINE 2D TRANSFERS OUT PER THE BOOKS AND NOT OTHERWISE REPORTED ON THE TAX RETURN $194,425,835 FORM 990, PART I, LINE 1 & PART III, LINE 1 THE KAISER FOUNDATION HEALTH PLAN INC. RETIREE HEALTH AND WELFARE PLAN HAS BEEN ESTABLISHED BY THE PLAN SPONSOR FOR THE EXCLUSIVE PURPOSES OF PROVIDING BENEFITS UNDER THE KAISER FOUNDATION HEALTH PLAN, INC. RETIREE HEALTH AND WELFARE PLAN INCLUDING, BUT NOT LIMITED TO (1) PAYING INSURANCE PREMIUMS FOR THE INSURED BENEFIT OPTIONS UNDER THE KAISER FOUNDATION HEALTH PLAN INC, INSURED WELFARE BENEFIT PLAN FOR RETIREES; (2) PAYING CLAIMS AND FUNDING THE PREMIUM SUBSIDY UNDER THE KAISER FOUNDATION HEALTH PLAN, INC. RETIREE MEDICAL PREMIUM SUBSIDY HEALTH REIMBURSEMENT ARRANGEMENT PLAN; (3) PAYING CLAIMS AND BENEFITS UNDER THE KAISER FOUNDATION HEALTH PLAN, INC. SELF FUNDED HEALTH PLAN FOR RETIREES, AND (4) PAYING ADMINISTRATIVE EXPENSES FOR THE VEBA AND THE PLAN. FORM 990, PART VI, LINES 1A & 1B & PART VII THE PLAN SPONSOR IS THE KAISER FOUNDATION HEALTH PLAN, INC. THE TRUST IS ADMINISTERED BY THE PLAN SPONSOR IN ACCORDANCE WITH THE TERMS OF THE TRUST AGREEMENT. AS SUCH, THE VEBA DOES NOT HAVE A GOVERNING BODY THAT EXERCISES DISCRETION. FORM 990, PART VI, LINE 8 & LINES 12-15 THE PLAN SPONSOR IS THE KAISER FOUNDATION HEALTH PLAN, INC. THE TRUST IS ADMINISTERED BY THE PLAN SPONSOR IN ACCORDANCE WITH THE TERMS OF THE TRUST AGREEMENT. AS SUCH, THE VEBA DOES NOT HAVE A GOVERNING BODY THAT EXERCISES DISCRETION. FORM 990, PART VI, SECTION B, LINE 11B A COMPLETE ELECTRONIC COPY OF THE ORGANIZATION'S FORM 990 WAS PROVIDED TO THE TRUSTEE FOR REVIEW PRIOR TO THE FILING WITH THE IRS. KAISER FOUNDATION HEALTH PLAN INC ONE KAISER PLAZA - 26TH FLOOR OAKLAND CA 94612 941340523 HEALTH CARE CA 501(C)(3) 10 NA false false false false false false false false false false false false false false false false false false false false