2022-05-12T16:58:42-05:00 2021-06-30 450250958 EIDE BAILLY LLP 10681 FOOTHILL BLVD STE 300 RANCHO CUCAMONGA CA 917303831 990 2020-07-01 926027877 PUBLIC EDUCATION HEALTH TRUST PUBL 9072747526 2550 DENALI NO 1614 ANCHORAGE AK 99503 RHONDA PROWELL-KITTER CHIEF FINANCIAL OFFICER 9072747526 2022-05-12 1 RHONDA PROWELL-KITTER 999009999 CATHERINE L GRAY CPA P01294460 9094664410 2022-05-12 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z RHONDA PROWELL-KITTER 2550 DENALI NO 1614 ANCHORAGE AK 99503 143518522 0 X HTTPS://PEHTAK.COM/ X 1996 AK TO PROVIDE COMPREHENSIVE MEDICAL, DENTAL, VISION, AND PRESCRIPTION DRUG BENEFITS. 7 7 3 7 1632049 0 0 0 137477341 137658612 1541677 1632049 4875738 4227861 143894756 143518522 0 0 129364383 129174770 482507 508658 0 0 0 6329533 5899108 136176423 135582536 7718333 7935986 43987390 55144732 18661221 17703611 25326169 37441121 TO PROVIDE COMPREHENSIVE MEDICAL, DENTAL, VISION, AND PRESCRIPTION DRUG BENEFITS. 0 0 TO PROVIDE COMPREHENSIVE MEDICAL, DENTAL, VISION, AND PRESCRIPTION BENEFITS TO APPROXIMATELY 16,000 PLAN PARTICIPANTS. 0 0 0 0 0 0 0 0 0 1 0 0 0 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 9 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 NO 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 CHAIR 1.00 X X 0 0 0 JOSH ANDREWS SECRETARY 1.00 X X 0 0 0 BRIDGET WEISS TRUSTEE 1.00 X 0 0 0 RHONDA PROWELL-KITTER CHIEF FINANCIAL OFFICER 60.00 X 194250 0 79024 194250 0 79024 1 0 1 0 EBMS PO BOX 21367 BILLINGS MT 59104 TPA FEES 1579374 EBMS PO BOX 21367 BILLINGS MT 59104 UTILIZATION REVIEW 918930 HUMANA 500 WEST MAIN STREET LOUISVILLE KY 40202 WELLNESS ADMIN FEE 580860 AON HEWITT 199 FREMONT STREET SUITE 1500 SAN FRANCISCO CA 94105 CONSULTING/ACTUARY 265308 UBS 3000 A STREET ANCHORAGE AK 99503 BROKER FEES 236860 6 EMPLOYER CONTRIBUTIONS 900099 137658612 137658612 137658612 900332 900332 731717 0 731717 731717 731717 MISCELLANEOUS 900099 4227861 4227861 4227861 143518522 141886473 1632049 0 129174770 273274 129752 33589 49410 22633 81949 21080 236860 115765 61934 37492 5841 30061 FEES PAID TO THIRD PART 3609583 STOP-LOSS INSURANCE PRE 675053 ACA TRANSITIONAL REINSU 475100 CORE SERVICE FEES 265308 283082 135582536 29839 107000 13232048 9398222 346851 352246 66398 35944 12965 30454 29435416 43469885 930271 1786925 43987390 55144732 18661221 17703611 18661221 17703611 X 0 0 0 0 25326169 37441121 25326169 37441121 43987390 55144732 7935986 5642871 -1463905 0 X X 0 1 X 1 0 66398 35944 30454 30454 OTHER 273670 INCURRED BUT NOT REPORTED 16486000 UNEARNED REVENUE 943941 17703611 X 148924533 5642871 5642871 143281662 236860 236860 143518522 137254676 0 137254676 236860 -1909000 -1672140 135582536 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 -1,909,000. X X 0 0 0 RHONDA PROWELL-KITTER CHIEF FINANCIAL OFFICER 194250 0 0 0 0 0 45630 0 33394 0 273274 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.