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      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
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      <FSAuditedInd>true</FSAuditedInd>
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      <AuditCommitteeInd>true</AuditCommitteeInd>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XII, Line 2d</FormAndLineReferenceDesc>
        <ExplanationTxt>ACCRUED HEALTH CLAIMS 12/31/17 INCLUDED IN BENEFIT OBLIGATIONS STATEMENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XII, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>ACCRUED HEALTH CLAIMS 12/31/18 INCLUDED IN BENEFIT OBLIGATIONS STATEMENT</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="IRS990ScheduleO-01" softwareId="18007482">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION UTILIZES THE SERVICES OF I.E. SHAFFER, A THIRD PARTY ADMINISTRATOR, AND FABIAN &amp; BYRN, LLC A CLAIMS ADMINISTRATOR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>A COPY OF THE FORM 990 IS PROVIDED TO EACH TRUSTEE AT A</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>MEETING PRIOR TO THE FILING DATE, WHERE QUESTIONS THAT A</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>TRUSTEE MAY HAVE ARE ADDRESSED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HAS A REGULARLY SCHEDULED QUARTERLY</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>MEETING WHERE IT MONITORS COMPLIANCE WITH THE POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>NO COMPENSATION - EMPLOYEE BENEFIT PLAN.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE DOCUMENTS ARE AVAILABLE TO PARTICIPANTS AND THE PUBLIC</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>COLLECTION FEES - LEGAL 20745. 20745.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>COLLECTION FEES REIMB-102 PENSION/SURETY 13860. 13860.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>PATIENT CENTERED OUTCOME FEE 15913. 15913.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>PAYROLL AUDIT FEES 31647. 31647.</ExplanationTxt>
      </SupplementalInformationDetail>
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  </ReturnData>
</Return>