2023-11-13T10:46:52-06:00 2022-12-31 340677006 MALONEY NOVOTNY LLC 1111 SUPERIOR AVE SUITE 700 CLEVELAND OH 441142540 990 2022-01-01 811268907 OHIO FARM BUREAU HEALTH BENEFITS PLAN TRUST OHIO 6142492400 280 NORTH HIGH STREET 6TH FLOOR COLUMBUS OH 43218 MICHAEL BAILEY CHAIRPERSON 6142462400 2023-11-10 1 MICHAEL BAILEY 999009999 0 CHRISTOPHER B ANDERSON P00226559 2163630100 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MICHAEL BAILEY 280 NORTH HIGH STREET 6TH FLOOR COLUMBUS OH 43218 15683267 0 X N/A X 2015 OH THE ORGANIZATION IS A MULTIPLE EMPLOYER WELFARE ARRANGEMENT (MEWA) WHICH PROVIDES MEDICAL AND PRESCRIPTION DRUG BENEFITS FOR ITS MEMBERS. 7 7 0 0 13413 1683 0 0 13538971 15669854 386 13413 0 0 13539357 15683267 0 0 11676936 14407324 0 0 0 0 0 1905285 1356261 13582221 15763585 -42864 -80318 6338118 4138686 5629689 3510575 708429 628111 THE ORGANIZATION IS A MULTIPLE EMPLOYER WELFARE ARRANGEMENT (MEWA) WHICH PROVIDES MEDICAL AND PRESCRIPTION DRUG BENEFITS FOR ITS MEMBERS. 0 0 ALL FUNDS ARE SPENT TO ACCOMPLISH THE TRUST'S ONLY PURPOSE WHICH IS DESCRIBED IN LINE 1 ABOVE. 0 0 0 0 0 0 0 0 0 0 0 0 1 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 1 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 X 7 7 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X MICHAEL BAILEY 6142492400 280 NHIGH ST 6TH FL COLUMBUS OH 43218 X BILL PATTERSON TRUSTEE 1.00 X 0 0 0 BILL GRULICH TRUSTEE 1.00 X 0 0 0 CHRIS WEAVER TRUSTEE 1.00 X 0 0 0 GREG DIESTCH TRUSTEE 1.00 X 0 0 0 MIKE BOYERT TRUSTEE 1.00 X 0 0 0 MICHAEL BAILEY CHAIRPERSON 1.00 X 0 0 0 TONI SCHWAB TRUSTEE 1.00 X 0 0 0 DAN RAPP PLAN ADMINISTRATOR 1.00 X 0 0 0 0 0 0 0 0 0 0 COMMUNITY INSURANCE COMPANY 1351 WILLIAM HOWARD TAFT RD CINCINNATI OH 45206 ADMINISTRATIVE SERVICES 1128572 CONSOLIPLEX AGRICULTURE 9555 ROCKSIDE RD 300-C CLEVELAND OH 44125 CONTRACT MANAGEMENT 116421 2 EMPLOYERS' CONTRIB. 525100 15669854 15669854 15669854 13413 13413 15683267 15669854 13413 0 14407324 1270994 43022 1440 3221 REGULATORY FEES 37584 15763585 200000 200000 1530001 1859439 0 3365 4608117 2075882 6338118 4138686 15888 18382 5613801 3492193 5629689 3510575 X 708429 628111 708429 628111 6338118 4138686 -80318 0 X 0 1 X 1 0 0 REINSURANCE RECEIVABLE 2075882 2075882 NET REINSURANCE PAYABLE 3492193 3492193 X 15683267 0 15683267 0 15683267 15763585 0 15763585 0 15763585 PART X, LINE 2: FIN 48/ASC 740 FOOTNOTE - THE TRUST'S MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE TRUST AND HAS CONCLUDED THAT, AS OF DECEMBER 31, 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE TRUST 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 6 MEMBERS OF THE ORGANIZATION - THE MEMBERS OF THE ORGANIZATION ARE THE PARTICIPATING EMPLOYERS IN THE MULTIPLE EMPLOYER WELFARE ARRANGEMENT. FORM 990, PART VI, SECTION A, LINE 7A POWERS OF THE MEMBERS - THE MEMBERS, WHO ARE THE PARTICIPATING EMPLOYERS IN THE PLAN, ELECT THE TRUSTEES IN ACCORDANCE WITH THE ORGANIZATION'S BYLAWS. THE OPERATING COMMITTEE COMPOSED OF TRUSTEES GOVERNS THE PLAN. THE TRUSTEES SERVE THREE-YEAR STAGGERED TERMS. FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF FORM 990 - WITH THE ASSISTANCE OF THE OUTSIDE PUBLIC ACCOUNTING FIRM, FORM 990 IS REVIEWED IN DETAIL BY THE TRUSTEES. AFTER THIS REVIEW, THE CHAIR AND TRUSTEE SIGNS AND SUBMITS THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCEMENT OF CONFLICT POLICY - EACH TRUSTEE AT THE BEGINNING OF EACH YEAR MUST REPORT WHETHER HE/SHE HAS ANY INTEREST IN ANY PARTY DOING BUSINESS WITH THE TRUST. THIS IS DONE ON THE TRUSTEE CODE OF CONDUCT STATEMENT. THE CASH MANAGEMENT SYSTEM DOES NOT ALLOW FOR ACH DISBURSEMENTS TO OFFICERS, DIRECTORS, AND TRUSTEES. THE PROCEDURE FOR CUTTING CHECKS REQUIRES SIGNOFF BY ALL TRUSTEES. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS - ALL DOCUMENTS ARE AVAILABLE UPON REQUEST BY ANY PARTICIPATING BANK OR INDIVIDUAL PLAN PARTICIPANT. NOTICES ARE SENT TO INTERESTED PARTIES WHEN THE ANNUAL REPORTS ARE COMPLETE. 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