2025-11-14T12:45:26-06:00 2024-12-31 870343246 Squire & Company PC 215 S State Street Suite 1100 Salt Lake City UT 84111 990 2024-01-01 942667827 Harmons Employee Welfare Benefit Plan Trust HARM 8019578464 3540 South 4000 West West Valley City UT 84120 Nicole Lengel CFO 8019698261 2025-11-14 1 1 Gregory O Hyde CPA P00641196 8015330409 2025-11-14 2024 2025-03-06 01:10:19Z Justin Mangone 3540 South 4000 West West Valley City UT 84120 13950927 0 X harmonsgrocery.com X 1979 UT Provide medical, dental, disability and life benefits to the employees of Harmon City, Inc. 2 1 0 0 0 0 0 0 13436330 13928119 20842 22808 0 0 13457172 13950927 0 0 12427691 11003408 12500 12500 0 0 0 883701 1117122 13323892 12133030 133280 1817897 1593262 3508597 1451321 1548759 141941 1959838 X Provide medical, dental, disability and life benefits to the employees of Harmon City, Inc. 0 0 12133030 Provide medical, dental, disability and life benefits to the employees of Harmon City, Inc. Provide medical, dental, disability and life benefits to the employees of Harmon City, Inc. 12133030 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 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 2 1 0 0 0 0 0 0 0 1 1 1 0 1 0 0 1 0 0 0 X Harmon City Inc 8019578464 3540 S 400 W West Valley City UT 84120 Principal Group Trustee 0.10 X 12500 0 0 Justin Mangone Controller 1.00 X 0 0 0 Nicole Lengel CFO 1.00 X 0 0 0 12500 0 0 0 0 0 0 Selecthealth 5381 S Green Street Salt Lake City UT 84123 Admin fees 582473 Payer Matrix 1400 N Providence Rd Suite 5000 Media PA 19063 Admin fees 238965 U of U Health Plan 6056 Fashion Square Drive Suite 31 Murray UT 84107 Admin fees 212028 3 Employer contributions 9665710 9665710 Employee contributions 4227855 4227855 COBRA contributions 34554 34554 13928119 22808 22808 13950927 22808 0 13928119 11003408 12500 Claims processing fees 1117122 12133030 408079 677237 1185183 2831360 1593262 3508597 1451321 1548759 1451321 1548759 X 141941 1959838 141941 1959838 1593262 3508597 1817897 0 X 0 1 X 1 0 0 13950927 0 13950927 0 13950927 12133030 0 12133030 0 12133030 Form 990, Part VI Line 9 - Officers Who Cannot Be Reached Principal Group 2150 S 1300 E Suite 300 Salt Lake City, UT 84106 Form 990, Part VI, Section B, line 11b The CFO reviews the Form 990 and ties it to the trial balance. It is then presented to the governing body for approval. Form 990, Part VI, Section C, line 19 No documents available to the public.