2020-07-15T15:29:21-05:00 2019-06-30 450250958 EIDE BAILLY LLP 3130 CROW CANYON PL STE 300 SAN RAMON CA 945831386 990 2018-07-01 926027877 PUBLIC EDUCATION HEALTH TRUST PUBL 9072747526 4003 IOWA DRIVE ANCHORAGE AK 99517 RHONDA PROWELL-KITTER CHIEF FINANCIAL OFFICER 9072747526 2020-07-15 1 THERESA MONTGOMERY P00232100 9254804000 2020-07-15 50.220.115.34 2020-07-15 15:28:38 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 327E456370A643C83A1BB4325D39191A230D016A 2018 2020-11-19 02:30:22Z RHONDA PROWELL-KITTER 4003 IOWA DRIVE ANCHORAGE AK 99517 142224857 0 X N/A X 1996 AK TO PROVIDE COMPREHENSIVE MEDICAL, DENTAL, VISION, AND PRESCRIPTION DRUG BENEFITS. 7 7 3 0 0 0 0 0 130310673 138049872 914817 1248457 976041 2926528 132201531 142224857 0 0 126082372 127829365 440148 454658 0 0 0 6035739 6313207 132558259 134597230 -356728 7627627 26157439 39404207 15437899 21007473 10719540 18396734 TO PROVIDE COMPREHENSIVE MEDICAL, DENTAL, VISION, AND PRESCRIPTION DRUG BENEFITS. 0 0 TO PROVIDE COMPREHENSIVE MEDICAL, DENTAL, VISION, AND PRESCRIPTION DRUG BENEFITS. 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 0 0 3 1 0 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 4003 IOWA DRIVE ANCHORAGE AK 99517 TIM PARKER TRUSTEE 5.00 X 0 0 0 JESSICA COOK TRUSTEE 5.00 X 0 0 0 KATHLEEN BELL TRUSTEE 5.00 X 0 0 0 STEPHEN BYERS TRUSTEE 5.00 X 0 0 0 TIM WALTERS TRUSTEE 5.00 X 0 0 0 JOSH ANDREWS TRUSTEE 5.00 X 0 0 0 PRUDENCE MCKENNEY TRUSTEE 5.00 X 0 0 0 RHONDA PROWELL-KITTER CHIEF FINANCIAL OFFICER 40.00 X 176270 0 47288 176270 0 47288 1 0 1 0 EBMS PO BOX 21367 BILLINGS MT 59104 TPA FEES 2424029 EBMS PO BOX 21367 BILLINGS MT 59104 UTILIZATION REVIEW 1114252 HUMANA 500 WEST MAIN STREET LOUISVILLE KY 40202 HEALTH ADMIN FEES 483378 AON HEWITT 199 FREMONT STREET SUITE 1500 SAN FRANCISCO CA 94105 CORE SERVICE FEES 255000 EBMS PO BOX 21367 BILLINGS MT 59104 BROKER FEES 194107 5 EMPLOYER CONTRIBUTIONS 900099 138049872 138049872 138049872 760529 760529 487928 0 487928 487928 487928 MISCELLANEOUS 900099 2926528 2926528 2926528 142224857 141736929 0 487928 127829365 223558 185028 31213 14859 69705 27150 130074 38842 36156 14511 11569 6689 27094 FEES PAID TO THIRD PART 4483321 STOP-LOSS INSURANCE PRE 514849 ACA TRANSITIONAL REINSU 335273 CORE SERVICE FEES 255000 362974 134597230 42915 65293 5753146 17558943 340807 339249 67898 48590 25994 19308 19984009 20964075 10568 457339 26157439 39404207 15437899 21007473 15437899 21007473 X 0 0 0 0 10719540 18396734 10719540 18396734 26157439 39404207 7627627 49567 0 X X 0 1 X 1 0 67898 48590 19308 19308 OTHER 58704 INCURRED BUT NOT REPORTED 19952000 UNEARNED REVENUE 996769 21007473 X 142144350 49567 49567 142094783 130074 130074 142224857 129583156 0 129583156 130074 4884000 5014074 134597230 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 4,884,000. X X 0 0 0 RHONDA PROWELL-KITTER CHIEF FINANCIAL OFFICER 176270 0 0 0 0 0 41494 0 5794 0 223558 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 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. VARIOUS - SEE SUPPLEMENTAL INFORMATION 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. THE ADMINISTRATIVE OFFICE ONLY MAINTAINS THE DATA NECESSARY TO FULFILL THE OBLIGATION TO CONTRIBUTE, IT DOES NOT MAINTAIN SPECIFIC BUSINESS DATA REGARDING THE EMPLOYERS, SUCH AS ENTITY TYPE OR TAX INFORMATION.