2022-11-03T11:42:08-04:00 2021-12-31 581094351 MCNAIR MCLEMORE MIDDLEBROOKS & CO LLC POST OFFICE BOX ONE MACON GA 312020001 990 2021-01-01 357042070 SAS VEBA SASV 213 THIRD STREET MACON GA 31201 LORRAINE TAYLOR TRUSTEE 2022-11-03 true LORRAINE TAYLOR 999009999 J RANDOLPH NICHOLS P00347246 4787466277 2022-11-03 2021 2022-09-23 18:48:47Z LORRAINE TAYLOR 213 THIRD STREET MACON GA 31201 26850962 false X X 2014 GA PROVIDE WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR ELIGIBLE DEPENDENTS FOR THOSE EMPLOYEES OF COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES COVERED BY THE TRUST. 0 0 0 0 0 24519037 25399343 0 989484 1451619 25508521 26850962 0 0 0 0 0 27011640 29273221 27011640 29273221 -1503119 -2422259 3424212 992706 5162682 3865716 -1738470 -2873010 X PROVIDE WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR ELIGIBLE DEPENDENTS FOR THOSE EMPLOYEES OF COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES COVERED BY THE TRUST. false false VEBA REVENUES CONSIST OF CONTRIBUTIONS FROM COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES AND EMPLOYEES. ALL REVENUES ARE TO BE USED FOR PROVIDING WELFARE BENEFITS FOR ELIGIBLE EMPLOYEES AND THEIR ELIGIBLE DEPENDENTS. VEBA REVENUES CONSIST OF CONTRIBUTIONS FROM COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES AND EMPLOYEES. ALL REVENUES ARE TO BE USED FOR PROVIDING WELFARE BENEFITS FOR ELIGIBLE EMPLOYEES AND THEIR ELIGIBLE DEPENDENTS. false false 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 true false false false false false false false false false false false false false false true 0 0 0 false false false false false false false false X 0 0 false false false false false false false true true false false true true true true true true false false false GA X SAS VEBA 4786212100 213 THIRD STREET MACON GA 31201 RONNIE ROLLINS TRUSTEE 0.00 40.00 X 0 823442 26000 LORRAINE TAYLOR TRUSTEE 0.00 40.00 X 0 735759 26000 KATHRYN DENNIS TRUSTEE 0.00 4.00 X 0 24000 0 1583201 52000 false true false BENEFIT ADMINISTRATIVE SYSTEMS LLC 17475 JOVANNA DRIVE SUITE 18 HOMEWOOD IL 60430 INSURANCE SRVCS 28343624 VOYA 7632 SW DURHAM ROAD SUITE 115 TIGARD OR 97224 INSURANCE SRVCS 1169936 THE BENEFIT COMPANY LLC SIX CONCOURSE PARKWAY SUITE 2750 ATLANTA GA 30328 INSURANCE SRVCS 255000 3 CONTRIBUTIONS 524298 25399343 25399343 25399343 OTHER 524298 1451619 1451619 1451619 26850962 26850962 26197 28000 26690253 CONTRACT SERVICES 2527389 BANK CHARGES 885 POSTAGE 497 29273221 0 0 0 2103289 2370 1320352 990336 571 3424212 992706 5162682 3865716 5162682 3865716 X -1738470 -2873010 -1738470 -2873010 3424212 992706 X -2422259 1287719 X false true X true false false false RONNIE ROLLINS TRUSTEE 823442 26000 849442 LORRAINE TAYLOR TRUSTEE 735759 26000 761759 SCHEDULE J, PART III COMPENSATION FOR TRUSTEES PAID FROM A RELATED ORGANIZATION IS DETERMINED BASED ON THE FOLLOWING METHODS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, REVIEW OF FORM 990S OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PAGE 2, PART III, LINE 4D VEBA REVENUES CONSIST OF CONTRIBUTIONS FROM COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES AND EMPLOYEES. ALL REVENUES ARE TO BE USED FOR PROVIDING WELFARE BENEFITS FOR ELIGIBLE EMPLOYEES AND THEIR ELIGIBLE DEPENDENTS. FORM 990, PAGE 6, PART VI, LINE 11B FORM 990 IS REVIEWED BY SAS VEBA'S TRUSTEES WITH ALL SUPPORTING DOCUMENTATION MADE AVAILABLE TO THEM. FORM 990, PAGE 6, PART VI, LINE 12C THE TRUSTEES, AS EMPLOYEES OF COMMUNITY HEALTH SYSTEMS, INC. (CHSI), ARE SUBJECT TO CHSI'S CONFLICT OF INTEREST POLICY. CHSI REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THEIR CONFLICT OF INTEREST POLICY AS PROVIDED FOR IN THEIR POLICY. FORM 990, PAGE 6, PART VI, LINE 19 COMMUNITY HEALTH SYSTEMS, INC. MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AS PART OF ITS FORM 990. THE VEBA TRUST ALSO MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AS PART OF ITS FORM 990. BOTH 990'S ARE AVAILABLE UPON REQUEST AS REFLECTED IN PART VI SECTION C LINE 18. FORM 990, PART XI, LINE 9 BENEFIT OBLIGATION - IBNR 1,287,719