SHELL MEDICAL PLAN: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
SHELL MEDICAL PLAN (EIN 74-2200128)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-13
IRS object ID
202213179349300746
Schema version
2021v4.1
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)
Return2022-11-13T13:00:31-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN134008324PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PRICEWATERHOUSECOOPERS LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1301 GRANT STREET 45TH FLOORAddressLine1Txt
CityPITTSBURGHCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15219ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN742200128EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SHELL MEDICAL PLANBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSHELBusinessNameControlTxt
Phone6025620883PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 53456 S4101-22GAddressLine1Txt
CityPHOENIXCityNm
State AbbreviationAZStateAbbreviationCd
ZIP85072ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
Person-PersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone6025620883PhoneNum
Signature2022-11-09SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLAURA B STROBELPreparerPersonNm
PTINP01271955PTIN
Phone4123556000PhoneNum
Preparation2022-11-09PreparationDt
Self EmployedYes (X)SelfEmployedInd

Additional Filer Information AdditionalFilerInformation

FieldValueIRS element (for citing)
Trusted CustomerTrustedCustomerGrp
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd
Principal OfficerPRINCIPAL FINANCIAL GROUPPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 10316AddressLine1Txt
CityDES MOINESCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50306ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$509,542,348GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation2002FormationYr
Legal Domicile StateTXLegalDomicileStateCd
Activity Or MissionPROVIDE CERTAIN HEALTH WELLNESS ACCIDENT, LIFE, DISABILITY, AND OTHER WELFARE BENEFITS FOR ELIGIBLE EMPLOYEES AND THEIR DEPENDENTSActivityOrMissionDesc
Voting Members Governing Body1VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$535,559,655PYProgramServiceRevenueAmt
CY Program Service Revenue$509,515,363CYProgramServiceRevenueAmt
PY Investment Income$347,133PYInvestmentIncomeAmt
CY Investment Income$26,953CYInvestmentIncomeAmt
CY Other Revenue$32CYOtherRevenueAmt
PY Total Revenue$535,906,788PYTotalRevenueAmt
CY Total Revenue$509,542,348CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$483,931,869PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$507,648,362CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$56,600CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$18,946,803PYOtherExpensesAmt
CY Other Expenses$17,058,412CYOtherExpensesAmt
PY Total Expenses$502,878,672PYTotalExpensesAmt
CY Total Expenses$524,763,374CYTotalExpensesAmt
PY Revenues Less Expenses$33,028,116PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$15,221,026CYRevenuesLessExpensesAmt
Total Assets BOY$75,038,733TotalAssetsBOYAmt
Total Assets EOY$59,819,611TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$75,038,733NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$59,819,611NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE CERTAIN HEALTH WELLNESS ACCIDENT, LIFE, DISABILITY, AND OTHER WELFARE BENEFITS FOR ELIGIBLE EMPLOYEES AND THEIR DEPENDENTSMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
DescPROVIDE CERTAIN HEALTH WELLNESS ACCIDENT, LIFE, DISABILITY, AND OTHER WELFARE BENEFITS FOR ELIGIBLE EMPLOYEES AND THEIR DEPENDENTSDesc
Described In Section501c3falseDescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
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
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Excs Tax Sect4951 Or4952 Or4953falseExcsTaxSect4951Or4952Or4953Ind
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members1GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
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 CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonPRINCIPAL FINANCIAL GROUPPersonNm
Phone6025620883PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 10316AddressLine1Txt
CityDES MOINESCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50306ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per WeekAverageHoursPerWeekRtInstitutional TrusteeInstitutionalTrusteeInd
MARVIN E ODUM
PRESIDENTYes (X)$0$0$0
JULIAN DALZELL
SENIOR VPYes (X)$0$0$0
WILLIAM C LOWREY
SENIOR VPYes (X)$0$0$0
T T COLES
VPYes (X)$0$0$0
CYNTHIA A DEERE
VP FINANCEYes (X)$0$0$0
B P MALNAK
VP GOV/T AFFAIRSYes (X)$0$0$0
RICHARD MENNITI
TREASURERYes (X)$0$0$0
A M NOLTE
CONTROLLERYes (X)$0$0$0
LYNN S BOROGEMIER
ASST. SECRETARYYes (X)$0$0$0
JOHN M ESQUIVEL
ASST. SECRETARYYes (X)$0$0$0
HECTOR PINEDA
ASST. SECRETARYYes (X)$0$0$0
STEPHANIE J PAUL
ASST. SECRETARYYes (X)$0$0$0
CANDIDA WOLFRAM
ASST. SECRETARYYes (X)$0$0$0
TABATHA R BAKER
ASST. SECRETARYYes (X)$0$0$0
PRINCIPAL FINANCIAL GROUP
TRUSTEE$56,600$0$01.0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$56,600TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescEMPLOYER CONTRIBUTIONSDesc
Business525100BusinessCd
Total Revenue Column$509,515,363TotalRevenueColumnAmt
Related Or Exempt Func Income$509,515,363RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$509,515,363TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$26,953TotalRevenueColumnAmt
Exclusion$26,953ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Business900099BusinessCd
Total Revenue Column$32TotalRevenueColumnAmt
Exclusion$32ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$32OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$509,542,348TotalRevenueColumnAmt
Related Or Exempt Func Income$509,515,363RelatedOrExemptFuncIncomeAmt
Exclusion$26,985ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$507,648,362TotalAmt
Program Services$507,648,362ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$56,600TotalAmt
Management And General$56,600ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$188,538TotalAmt
Management And General$188,538ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescADMINISTRATIVE EXPENSESDesc
Total$16,869,874TotalAmt
Management And General$16,869,874ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$524,763,374TotalAmt
Program Services$507,648,362ProgramServicesAmt
Management And General$17,115,012ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
EOY$2,107EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$75,038,733BOYAmt
EOY$59,817,504EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$75,038,733BOYAmt
EOY$59,819,611EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$75,038,733BOYAmt
EOY$59,819,611EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$75,038,733BOYAmt
EOY$59,819,611EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$75,038,733BOYAmt
EOY$59,819,611EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$15,221,026ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$1,904OtherChangesInNetAssetsAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
Acct Compile Or Review BasisAcctCompileOrReviewBasisGrp
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part IV, Line 12bTHE ORGANIZATION WAS INCLUDED IN CONSOLIDATED INDEPENDENT AUDITED FINANCIAL STATEMENTS BUT DID NOT OBTAIN SEPARATE INDEPENDENT AUDITED FINANCIAL STATEMENTS FOR THE YEAR. THE ORGNIZATION OPTS OUT OF COMPLETING SCHEDULE D, PARTS XI AND XII.
FORM 990, PAGE 6, PART VI, LINE 11-DESCRIPTION OF PROCESS FOR REVIEWTHE SOLE TRUSTEE RECEIVES AND REVIEWS THE FORM 990
EXPLANATION FOR FORM 990, PAGE 6, PART VI, LINE 12cTHE ORGANIZATION COMPLIES WITH THE SAME POLICY AND ENFORCEMENT AS ITS TRUSTEE
FORM 990, PAGE 6, PART VI, LINE 19NO DOCUMENTS AVAILABLE TO THE PUBLIC
EXPLANATION FOR FORM 990, PART XI, LINE 9MUTUAL FUND TIMING ADJ

Schedule R IRS990ScheduleR

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SHELL OIL COMPANYBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1909 FANNIN STREETAddressLine1Txt
CityHOUSTONCityNm
State AbbreviationTXStateAbbreviationCd
ZIP77010ZIPCd
FieldValueIRS element (for citing)
Primary ActivitiesOIL AND GASPrimaryActivitiesTxt
Legal Domicile StateTXLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeC corpEntityTypeTxt
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

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