2020-10-30T16:12:49-05:00 2019-12-31 910189318 MOSS ADAMS LLP 2882 PROSPECT PARK DR STE 300 RANCHO CORDOVA CA 95670 990 2019-02-01 320606993 ADVENTIST HEALTH AND RIDEOUT EMPLOYEE HEALTH PLAN TRUST ADVE 9164060000 PO BOX 619135 ROSEVILLE CA 95661 WELLS FARGO INSITUTIONAL TRUSTEE 9164060000 2020-10-20 1 TRACY S PAGLIA P00366884 9165038100 2020-09-20 172.9.161.112 2020-10-20 17:45:21 PD P 2CA4604677747A1B8287DC7DD1B2F222DAF5CAE3 2CA4604677747A1B8287DC7DD1B2F222DAF5CAE3 2019 2021-04-22 16:20:28Z X X RICHARD RAWSON PO BOX 619135 ROSEVILLE CA 95661 41944096 0 X NONE X 2019 CA TO PROVIDES MEDICAL, DENTAL, AND VISION BENEFITS TO ELIGIBLE EMPLOYEES OF RIDEOUT AND THEIR DEPENDENTS. 1 0 0 0 0 0 0 41916410 27686 0 41944096 0 36886324 364 0 0 1975422 38862110 3081986 3081986 0 3081986 NONE 0 0 RIDEOUT MEMORIAL HOSPITAL DBA ADVENTIST HEALTH AND RIDEOUT ("RIDEOUT"), WHICH IS A 501(C)(3) HOSPITAL, ESTABLISHED THE ADVENTIST HEALTH AND RIDEOUT EMPLOYEE WELFARE PLAN (THE "PLAN"). THE PLAN PROVIDES MEDICAL, DENTAL, AND VISION BENEFITS TO ELIGIBLE EMPLOYEES OF RIDEOUT AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X JAY LIPPS VP SYSTEM CONTROLLER 9164061092 PO BOX 619135 ROSEVILLE CA 95661 WELLS FARGO TRUSTEE 1.00 X 364 0 0 364 0 0 0 0 0 0 ADVENTIST HEALTH SYSTEMWEST PO BOX 619135 ROSEVILLE CA 95661 CLAIMS ADMINISTRATION FEES 1844942 0 EMPLOYER AND EMPLOYEE CONTRIBUTIO 900099 41916410 41916410 41916410 27686 27686 41944096 41916410 0 27686 36886324 364 1844942 70985 59495 38862110 0 3081986 0 3081986 0 0 X 0 0 0 0 0 3081986 0 3081986 0 3081986 3081986 0 X 0 1 X 1 0 FORM 990, PART VI, SECTION A, LINE 8A NO MEETINGS WERE HELD DURING THE TAX YEAR. FORM 990, PART VI, SECTION A, LINE 8B THE TRUST HAS NO SEPARATE COMMITTEES. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM WITH INFORMATION PROVIDED BY THE INSTITUTIONAL TRUSTEE. THE FORM 990 IS REVIEWED BY THE TREASURY MANAGER AND THEN BY THE VP SYSTEM CONTROLLER. THE RETURN WILL BE SENT OUT TO WELLS FARGO, THE INSTITUTIONAL TRUSTEE TO REVIEW AND SIGN THE TAX RETURN. FORM 990, PART VI, SECTION C, LINE 19 THE TRUST'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. THE TRUST'S SUMMARY ANNUAL REPORT IS PROVIDED TO PARTICIPANTS ON AN ANNUAL BASIS. FREMONT-RIDEOUT HEALTH GROUP 989 PLUMAS STREET YUBA CITY CA 95991 942917251 ACUTE CARE HOSPITAL CA 501(C)(3) LINE 12B, II STONE POINT HEALTH 0 RIDEOUT MEMORIAL HOSPITAL 989 PLUMAS STREET YUBA CITY CA 95991 941387866 HOSPITAL CA 501(C)(3) LINE 3 FREMONT-RIDEOUT HEALTH GROUP 0 UNITED COM-SERVE 989 PLUMAS STREET YUBA CITY CA 95991 943015356 SKILLED NURSING/ASSISTED LIVING/HOME HEALTH CA 501(C)(3) LINE 12B, II FREMONT-RIDEOUT HEALTH GROUP 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1