2016-11-14T13:49:13-06:00 2015-12-31 721396621 CARR RIGGS & INGRAM LLC 3011 ARMORY DRIVE SUITE 190 NASHVILLE TN 37204 990 2015-01-01 466653802 NN RETIREES BENEFIT TRUST NNRE 6156783138 PO BOX 292877 NASHVILLE TN 37229 GARY DONAHEE VEBA COMMITTEE CHAIR 6156783138 2016-11-14 1 GARY K SHARP P01362704 6156651811 2016-11-14 2015 2017-02-10 21:41:12Z GARY DONAHEE PO BOX 292877 NASHVILLE TN 37229 10612931 0 X NNRBT.ORG X 2013 NJ THE TRUST (VEBA) PROVIDES REIMBURSEMENT OF ELIGIBLE MEDICAL EXPENSES. 5 5 0 0 594335 469171 0 0 0 0 477156 594335 0 0 477156 594335 0 0 10227862 8833808 40000 30000 0 0 0 534621 551923 10802483 9415731 -10325327 -8821396 51030688 42312554 274856 352756 50755832 41959798 THE TRUST SPONSORS AND MAINTAINS A HEALTH REIMBURSEMENT ARRANGEMENT (HRA) PLAN THAT MEETS THE REQUIREMENTS OF IRS NOTICE 2002-45 AND WHICH PROVIDES FOR THE REIMBURSEMENT OF ELIGIBLE MEDICAL EXPENSES FOR PARTICIPANTS OF THE HRA PLAN IN ACCORDANCE OF THE HRA PLAN DOCUMENTS. 0 0 9415731 THE TRUST SPONSORS A HEALTH REIMBURSEMENT ARRANGEMENT (HRA) PLAN WHICH IS INTENDED TO MEET THE REQUIREMENTS SET FORTH IN IRS NOTICE 2002-45. THE HRA PLAN PROVIDES FOR THE REIMBURSEMENT OF ELIGIBLE MEDICAL EXPENSES SUBMITTED BY PARTICIPANTS IN THE HRA PLAN WHO ARE ELIGIBLE FORMER RETIREES OF NORTEL NETWORKS INC. ("NORTEL") THAT PARTICIPATED IN THE NORTEL SPONSORED RETIREE HEALTH AND WELFARE BENEFIT PLANS PRIOR TO THE TERMINATION OF SUCH PLANS BY NORTEL IN CONNECTION WITH ITS BANKRUPTCY FILING. THE REIMBURSEMENTS RECEIVED FROM THE HRA PLAN HELP OFFSET THE BENEFITS THAT RETIREES LOST AS A RESULT OF THE TERMINATION OF THE NORTEL RETIREE HEALTH AND WELFARE BENEFITS PLANS. 9415731 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 6 0 1 0 1 1 0 0 0 0 0 X 5 5 0 1 0 0 1 1 0 1 1 0 0 1 0 0 1 0 0 0 X INTEGRATIVE ACCOUNTING SOLUTIONS PLLC 2706834333 2315 MAYFAIR DR STE 28 OWENSBORO KY 42301 GARY R DONAHEE CHAIRMAN, COMMITTEE MEMBER 5.00 X X 6000 0 0 SUSAN KANE SECRETARY, COMMITTEE MEMBE 5.00 X X 6000 0 0 MICHAEL RESSNER TREASURER, COMMITTEE MEMBE 5.00 X X 6000 0 0 JOHN ZALOKAR COMMITTEE MEMBER 5.00 X 6000 0 0 MARK HAUPT COMMITTEE MEMBER 5.00 X 6000 0 0 30000 0 0 0 0 0 0 WAGEWORKS INC 1100 PARK PLACE 4TH FLOOR SAN MATEO CA 94403 BENEFIT PAYOR 137414 WELLS FARGO INST RETIREMENT & TRUST 12 E 49TH ST MAC J0109-261 NEW YORK NY 10017 INVESTMENT MGT. 120756 2 595843 595843 10017088 10018596 -1508 -1508 -1508 594335 0 594335 0 8833808 30000 33671 47428 115146 137447 5697 32981 FEDERAL INCOME TAX - 99 169622 EXCISE TAX - PCORI FEE 9609 TELEPHONE 134 WEBSITE EXPENSE 96 92 9415731 1317972 3258617 3466 0 106083 73102 49240719 38694480 362448 286355 51030688 42312554 162856 167256 112000 185500 274856 352756 X 0 0 0 0 50755832 41959798 50755832 41959798 51030688 42312554 -8821396 25362 0 X X 0 1 X 1 0 0 185500 185500 X 619697 25362 25362 594335 0 594335 9415731 0 9415731 0 9415731 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATE OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF DECEMBER 31, 2015 AND 2014, THERE ARE NO UNCERTAIN POSITIONS TAKEN, OR EXPECTED TO BE TAKEN, THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. FORM 990, PART VI, SECTION A, LINE 3 THE TRUST HAS DELEGATED CONTROL OVER THE CLAIMS PAYMENT PROCESS TO AN OUTSIDE THIRD-PARTY PROCESSOR PURSUANT TO A WRITTEN CONTRACT. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS WHO ARE BENEFICIARIES OF THE VEBA (TRUST) AND RECEIVE REIMBURSEMENT OF ELIGIBLE MEDICAL EXPENSES IN ACCORDANCE WITH THE HRA PLAN DOCUMENT. FORM 990, PART VI, SECTION A, LINE 7A THE VEBA COMMITTEE HAS THE AUTHORITY TO APPOINT AND REMOVE, EMPLOY AND DISCHARGE, AND PRESCRIBE THE DUTIES AND FIX THE COMPENSATION, IF ANY, OF ALL OFFICERS, AGENTS AND THIRD PARTY SERVICE PROVIDERS OF THE TRUST. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS DISTRIBUTED TO EACH MEMBER OF THE VEBA COMMITTEE. THE COMMITTEE MEETS TO DISCUSS AND APPROVE THE FORM 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DOES NOT HAVE PROCESSES FOR REVIEWING AND APPROVING THE COMPENSATION OF THE CEO, EXECUTIVE DIRECTOR, TOP MANAGEMENT OFFICAL OR OTHER OFFICERS OR KEY EMPLOYEES BECAUSE THE ORGANIZATION DOES NOT HAVE PERSONS SERVING IN SUCH POSITIONS. ACCORDINGLY SUCH PROCESSES WOULD NOT BE APPLICABLE TO THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE TRUST AGREEMENT, HRA PLAN DOCUMENTS AND OTHER GOVERNING DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. BENEFICIARIES OF THE TRUST (AND PARTICIPANTS IN THE HRA PLAN) MAY REQUEST COPIES OF HRA PLAN DOCUMENTS AND THE FORM 5500, AND WILL BE PROVIDED WITH A SUMMARY ANNUAL REPORT (SAR) FOR THE HRA PLAN PER ERISA REQUIREMENTS. FORM 990, PART XII, LINE 2(C): THE ENTIRE VEBA COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND IS INVOLVED IN THE SELECTION OF THE AUDITOR AND THE REVIEW OF THE FINANCIAL STATEMENTS AND AUDITOR'S REPORT ISSUED BY THE INDEPENDENT AUDITOR.