Liabilities / Assets
20th percentile
Higher debt load relative to assets than 20% of similar nonprofits.
990 • Fiscal year 2017 • EIN 22-3203500
Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.
Liabilities / Assets
20th percentile
Higher debt load relative to assets than 20% of similar nonprofits.
Liabilities / Revenue
39th percentile
Higher debt load relative to revenue than 39% of similar nonprofits.
Net Margin
72nd percentile
Higher net margin than 72% of similar nonprofits.
Top Officer Pay
40th percentile
Higher top officer pay than 40% of similar nonprofits.
Top officer pay equals 0.0% of source-year revenue.
Asset Growth
62nd percentile
Faster asset growth than 62% of similar nonprofits.
Revenue Growth
9th percentile
Faster revenue growth than 9% of similar nonprofits.
Assets
Up$39,978,046
Up $3,860,888 (+11%) from 2016
Net Assets
Up$39,939,692
Up $3,875,084 (+11%) from 2016
Liabilities
Down$38,354
Down $14,196 (-27%) from 2016
Revenue
Down$2,446,134
Down $387,515 (-14%) from 2016
Expenses
Up$2,108,070
Up $183,514 (+9.5%) from 2016
Net Income
Down$338,064
Down $571,029 (-63%) from 2016
PROVIDE MEDICAL BENEFITS
| Line | Beginning | End | Change |
|---|---|---|---|
| Assets | |||
| Rtn Earn Endowment Incm Other Fnds | $36,064,608 | $39,939,692 | ▲ $3,875,084 |
| Investments in Publicly Traded Securities | $33,350,480 | $37,349,665 | ▲ $3,999,185 |
| Savings and Temporary Cash Investments | $2,714,239 | $2,589,401 | ▼ $124,838 |
| Pd in Cap Srpls Land Bldg Eqp Fund | $0 | $0 | → $0 |
| Cap Stk Tr Prin Current Funds | $0 | $0 | → $0 |
| Total Assets | $36,117,158 | $39,978,046 | ▲ $3,860,888 |
| Other Assets Total | $52,439 | $38,980 | ▼ $13,459 |
| Liabilities | |||
| Accounts Payable and Accrued Expenses | $52,550 | $38,354 | ▼ $14,196 |
| Total Liabilities | $52,550 | $38,354 | ▼ $14,196 |
| Net Assets / Fund Balance | |||
| Total Net Assets Fund Balance | $36,064,608 | $39,939,692 | ▲ $3,875,084 |
| Total Liabilities and Net Assets / Fund Balance | $36,117,158 | $39,978,046 | ▲ $3,860,888 |
| Name | Title |
|---|---|
| Brett Radulovich | Agent of Pln Administrator |
| Carl Levander | Agent of Pln Administrator |
| Joseph W Mulpas | Agent of Pln Administrator |
| Richard L Bond | Agent of Pln Administrator |
| Shawn Anderson | Agent of Pln Administrator |
| Teresa M Smith | Agent of Pln Administrator |
| Line Item | Amount |
|---|---|
| Other Expenses | $97,936 |
| Grants and Similar Amounts Paid | $0 |
| Professional Fundraising Fees | $0 |
| Salaries, Compensation, and Employee Benefits | $0 |
| Total Fundraising Expense | $0 |
| Line Item | Program | Management | Fundraising | Total |
|---|---|---|---|---|
| Benefits to Members | - | - | - | $2,010,134 |
| Fees for Services Legal | - | - | - | $55,474 |
| Fees for Services Accounting | - | - | - | $26,294 |
| Fees for Service Investment Mgmnt Fees | - | - | - | $16,168 |
| Total Functional Expenses | $0 | $0 | $0 | $2,108,070 |
| Line Item | Amount |
|---|---|
| Professional Fundraising Fees | $0 |
“The completed form 990 is provided to certain agents of the plan administrator and the sponsor of the fund. They review the form and discuss any matters about which they are uncertain. Upon fully understanding the completed form 990, the form is approved and submitted electronically to the irs.”
“The company conducts, at least annually, a survey of officers and selected employees regarding relationships with vendors, etc. As determined by the vice-president, audit and ethics officer. The purpose of this survey is to disclose any direct or indirect interest or a position held in the entity that might present a conflict of interest, financial or otherwise.”
“The governing documents, conflict of interest policy and financial statements are available upon request at the office of the plan sponsor.”
“Transfer of assets between trusts -41,359.”
“The activity of the trust is audited at the plan level and not at the trust level. The audit of the plan is prepared in accordance with generally accepted accounting principles and may include more than one trust which participates in the plan.”
“Gaap requires plan management to evaluate tax positions taken by the plan and recognize a tax liability (or asset) if the plan has taken an uncertain position that more likely than not would not be sustained upon examination by the internal revenue service. The plan is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress.”
This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.
| Path | # | Value |
|---|---|---|
| IRS990/AccountantCompileOrReviewInd | 0 | 0 |
| IRS990/AccountsPayableAccrExpnssGrp/BOYAmt | 0 | 52550 |
| IRS990/AccountsPayableAccrExpnssGrp/EOYAmt | 0 | 38354 |
| IRS990/ActivitiesConductedPrtshpInd | 0 | 0 |
| IRS990/ActivityOrMissionDesc | 0 | PROVIDE MEDICAL BENEFITS |
| IRS990/AnnualDisclosureCoveredPrsnInd | 0 | 1 |
| IRS990/AuditCommitteeInd | 0 | 1 |
| IRS990/BackupWthldComplianceInd | 0 | 1 |
| IRS990/BenefitsToMembersGrp/TotalAmt | 0 | 2010134 |
| IRS990/BooksInCareOfDetail/PersonNm | 0 | TODD LANICH |
| IRS990/BooksInCareOfDetail/PhoneNum | 0 | 6144604623 |
| IRS990/BooksInCareOfDetail/USAddress/AddressLine1Txt | 0 | 290 W NATIONWIDE BLVD |
| IRS990/BooksInCareOfDetail/USAddress/CityNm | 0 | COLUMBUS |
| IRS990/BooksInCareOfDetail/USAddress/StateAbbreviationCd | 0 | OH |
| IRS990/BooksInCareOfDetail/USAddress/ZIPCd | 0 | 43215 |
| IRS990/BusinessRlnWithFamMemInd | 0 | 0 |
| IRS990/BusinessRlnWithOfficerEntInd | 0 | 0 |
| IRS990/BusinessRlnWithOrgMemInd | 0 | 0 |
| IRS990/CapStkTrPrinCurrentFundsGrp/BOYAmt | 0 | 0 |
| IRS990/CapStkTrPrinCurrentFundsGrp/EOYAmt | 0 | 0 |
| IRS990/ChangeToOrgDocumentsInd | 0 | 0 |
| IRS990/CntrctRcvdGreaterThan100KCnt | 0 | 0 |
| IRS990/CollectionsOfArtInd | 0 | 0 |
| IRS990/CompensationFromOtherSrcsInd | 0 | 0 |
| IRS990/CompensationProcessCEOInd | 0 | 0 |
| IRS990/CompensationProcessOtherInd | 0 | 0 |
| IRS990/ConflictOfInterestPolicyInd | 0 | 1 |
| IRS990/ConservationEasementsInd | 0 | 0 |
| IRS990/ConsolidatedAuditFinclStmtInd | 0 | 1 |
| IRS990/CreditCounselingInd | 0 | 0 |
| IRS990/CYBenefitsPaidToMembersAmt | 0 | 2010134 |
| IRS990/CYContributionsGrantsAmt | 0 | 0 |
| IRS990/CYGrantsAndSimilarPaidAmt | 0 | 0 |
| IRS990/CYInvestmentIncomeAmt | 0 | 2192062 |
| IRS990/CYOtherExpensesAmt | 0 | 97936 |
| IRS990/CYOtherRevenueAmt | 0 | 0 |
| IRS990/CYProgramServiceRevenueAmt | 0 | 254072 |
| IRS990/CYRevenuesLessExpensesAmt | 0 | 338064 |
| IRS990/CYSalariesCompEmpBnftPaidAmt | 0 | 0 |
| IRS990/CYTotalExpensesAmt | 0 | 2108070 |
| IRS990/CYTotalFundraisingExpenseAmt | 0 | 0 |
| IRS990/CYTotalProfFndrsngExpnsAmt | 0 | 0 |
| IRS990/CYTotalRevenueAmt | 0 | 2446134 |
| IRS990/DecisionsSubjectToApprovaInd | 0 | 0 |
| IRS990/DeductibleArtContributionInd | 0 | 0 |
| IRS990/DeductibleNonCashContriInd | 0 | 0 |
| IRS990/DelegationOfMgmtDutiesInd | 0 | 0 |
| IRS990/Desc | 0 | TO PROVIDE MEDICAL BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. |
| IRS990/DescribedInSection501c3Ind | 0 | 0 |
| IRS990/DisregardedEntityInd | 0 | 0 |
| IRS990/DocumentRetentionPolicyInd | 0 | 1 |
| IRS990/DonorAdvisedFundInd | 0 | 0 |
| IRS990/ElectionOfBoardMembersInd | 0 | 0 |
| IRS990/EmployeeCnt | 0 | 0 |
| IRS990/FamilyOrBusinessRlnInd | 0 | 0 |
| IRS990/FederalGrantAuditRequiredInd | 0 | 0 |
| IRS990/FeesForServicesAccountingGrp/TotalAmt | 0 | 26294 |
| IRS990/FeesForServicesLegalGrp/TotalAmt | 0 | 55474 |
| IRS990/FeesForSrvcInvstMgmntFeesGrp/TotalAmt | 0 | 16168 |
| IRS990/ForeignActivitiesInd | 0 | 0 |
| IRS990/ForeignFinancialAccountInd | 0 | 0 |
| IRS990/ForeignOfficeInd | 0 | 0 |
| IRS990/Form8282PropertyDisposedOfInd | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 0 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 1 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 2 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 3 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 4 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 5 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 0 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 1 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 2 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 3 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 4 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 5 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 5 | X |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 5 | 0 |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 0 | CARL LEVANDER |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 1 | RICHARD L BOND |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 2 | BRETT RADULOVICH |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 3 | SHAWN ANDERSON |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 4 | JOSEPH W MULPAS |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 5 | TERESA M SMITH |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 5 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 5 | 0 |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 0 | AGENT OF PLN ADMINISTRATOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 1 | AGENT OF PLN ADMINISTRATOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 2 | AGENT OF PLN ADMINISTRATOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 3 | AGENT OF PLN ADMINISTRATOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 4 | AGENT OF PLN ADMINISTRATOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 5 | AGENT OF PLN ADMINISTRATOR |
| IRS990/Form990ProvidedToGvrnBodyInd | 0 | 0 |
| IRS990/FormationYr | 0 | 1992 |
| IRS990/FormerOfcrEmployeesListedInd | 0 | 0 |
| IRS990/FSAuditedBasisGrp/ConsolidatedBasisFinclStmtInd | 0 | X |
| IRS990/FSAuditedInd | 0 | 1 |
| IRS990/FundraisingActivitiesInd | 0 | 0 |
| IRS990/GainOrLossGrp/SecuritiesAmt | 0 | 1527336 |
| IRS990/GamingActivitiesInd | 0 | 0 |
| IRS990/GoverningBodyVotingMembersCnt | 0 | 6 |
| IRS990/GrantsToIndividualsInd | 0 | 0 |
| IRS990/GrantsToOrganizationsInd | 0 | 0 |
| IRS990/GrantToRelatedPersonInd | 0 | 0 |
| IRS990/GrossAmountSalesAssetsGrp/SecuritiesAmt | 0 | 4794964 |
| IRS990/GrossReceiptsAmt | 0 | 5713762 |
| IRS990/GroupReturnForAffiliatesInd | 0 | 0 |
| IRS990/IncludeFIN48FootnoteInd | 0 | 1 |
| IRS990/IndependentAuditFinclStmtInd | 0 | 0 |
| IRS990/IndependentVotingMemberCnt | 0 | 6 |
| IRS990/IndivRcvdGreaterThan100KCnt | 0 | 0 |
| IRS990/IndoorTanningServicesInd | 0 | 0 |
| IRS990/InfoInScheduleOPartVIInd | 0 | X |
| IRS990/InfoInScheduleOPartXIIInd | 0 | X |
| IRS990/InfoInScheduleOPartXIInd | 0 | X |
| IRS990/InvestmentIncomeGrp/ExclusionAmt | 0 | 664726 |
| IRS990/InvestmentIncomeGrp/TotalRevenueColumnAmt | 0 | 664726 |
| IRS990/InvestmentInJointVentureInd | 0 | 0 |
| IRS990/InvestmentsPubTradedSecGrp/BOYAmt | 0 | 33350480 |
| IRS990/InvestmentsPubTradedSecGrp/EOYAmt | 0 | 37349665 |
| IRS990/IRPDocumentCnt | 0 | 3 |
| IRS990/IRPDocumentW2GCnt | 0 | 0 |
| IRS990/LegalDomicileStateCd | 0 | IL |
| IRS990/LessCostOthBasisSalesExpnssGrp/SecuritiesAmt | 0 | 3267628 |
| IRS990/LoanOutstandingInd | 0 | 0 |
| IRS990/LocalChaptersInd | 0 | 0 |
| IRS990/MaterialDiversionOrMisuseInd | 0 | 0 |
| IRS990/MembersOrStockholdersInd | 0 | 0 |
| IRS990/MethodOfAccountingAccrualInd | 0 | X |
| IRS990/MinutesOfCommitteesInd | 0 | 1 |
| IRS990/MinutesOfGoverningBodyInd | 0 | 1 |
| IRS990/MissionDesc | 0 | PROVIDE MEDICAL BENEFITS |
| IRS990/MoreThan5000KToIndividualsInd | 0 | 0 |
| IRS990/MoreThan5000KToOrgInd | 0 | 0 |
| IRS990/NetAssetsOrFundBalancesBOYAmt | 0 | 36064608 |
| IRS990/NetAssetsOrFundBalancesEOYAmt | 0 | 39939692 |
| IRS990/NetGainOrLossInvestmentsGrp/ExclusionAmt | 0 | 1527336 |
| IRS990/NetGainOrLossInvestmentsGrp/TotalRevenueColumnAmt | 0 | 1527336 |
| IRS990/NetUnrelatedBusTxblIncmAmt | 0 | 0 |
| IRS990/NetUnrlzdGainsLossesInvstAmt | 0 | 3578379 |
| IRS990/NoListedPersonsCompensatedInd | 0 | X |
| IRS990/NondeductibleContributionsInd | 0 | 0 |
| IRS990/OfficerMailingAddressInd | 0 | 0 |
| IRS990/OperateHospitalInd | 0 | 0 |
| IRS990/Organization501cInd | 0 | X |
| IRS990/OrgDoesNotFollowSFAS117Ind | 0 | X |
| IRS990/OtherAssetsTotalGrp/BOYAmt | 0 | 52439 |
| IRS990/OtherAssetsTotalGrp/EOYAmt | 0 | 38980 |
| IRS990/OtherChangesInNetAssetsAmt | 0 | -41359 |
| IRS990/PartialLiquidationInd | 0 | 0 |
| IRS990/PdInCapSrplsLandBldgEqpFundGrp/BOYAmt | 0 | 0 |
| IRS990/PdInCapSrplsLandBldgEqpFundGrp/EOYAmt | 0 | 0 |
| IRS990/PoliticalCampaignActyInd | 0 | 0 |
| IRS990/PrincipalOfficerNm | 0 | SHAWN ANDERSON |
| IRS990/ProfessionalFundraisingInd | 0 | 0 |
| IRS990/ProgramServiceRevenueGrp/BusinessCd | 0 | 900099 |
| IRS990/ProgramServiceRevenueGrp/Desc | 0 | EMPLOYER CONTRIBUTIONS |
| IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt | 0 | 254072 |
| IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt | 0 | 254072 |
| IRS990/ProhibitedTaxShelterTransInd | 0 | 0 |
| IRS990/PYBenefitsPaidToMembersAmt | 0 | 1830426 |
| IRS990/PYContributionsGrantsAmt | 0 | 0 |
| IRS990/PYGrantsAndSimilarPaidAmt | 0 | 0 |
| IRS990/PYInvestmentIncomeAmt | 0 | 2764233 |
| IRS990/PYOtherExpensesAmt | 0 | 94130 |
| IRS990/PYOtherRevenueAmt | 0 | 0 |
| IRS990/PYProgramServiceRevenueAmt | 0 | 69416 |
| IRS990/PYRevenuesLessExpensesAmt | 0 | 909093 |
| IRS990/PYSalariesCompEmpBnftPaidAmt | 0 | 0 |
| IRS990/PYTotalExpensesAmt | 0 | 1924556 |
| IRS990/PYTotalProfFndrsngExpnsAmt | 0 | 0 |
| IRS990/PYTotalRevenueAmt | 0 | 2833649 |
| IRS990/QuidProQuoContributionsInd | 0 | 0 |
| IRS990/ReconcilationRevenueExpnssAmt | 0 | 338064 |
| IRS990/RegularMonitoringEnfrcInd | 0 | 1 |
| IRS990/RelatedEntityInd | 0 | 1 |
| IRS990/RelatedOrganizationCtrlEntInd | 0 | 0 |
| IRS990/ReportInvestmentsOtherSecInd | 0 | 0 |
| IRS990/ReportLandBuildingEquipmentInd | 0 | 0 |
| IRS990/ReportOtherAssetsInd | 0 | 0 |
| IRS990/ReportOtherLiabilitiesInd | 0 | 0 |
| IRS990/ReportProgramRelatedInvstInd | 0 | 0 |
| IRS990/RtnEarnEndowmentIncmOthFndsGrp/BOYAmt | 0 | 36064608 |
| IRS990/RtnEarnEndowmentIncmOthFndsGrp/EOYAmt | 0 | 39939692 |
| IRS990/SavingsAndTempCashInvstGrp/BOYAmt | 0 | 2714239 |
| IRS990/SavingsAndTempCashInvstGrp/EOYAmt | 0 | 2589401 |
| IRS990/ScheduleBRequiredInd | 0 | 0 |
| IRS990ScheduleD/FootnoteTextInd | 0 | X |
| IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt | 0 | GAAP REQUIRES PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. |
| IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | PART X, LINE 2: |
| IRS990ScheduleD/TotalBookValueLandBuildingsAmt | 0 | 0 |
| IRS990/ScheduleJRequiredInd | 0 | 0 |
| IRS990/ScheduleORequiredInd | 0 | 1 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 0 | THE COMPLETED FORM 990 IS PROVIDED TO CERTAIN AGENTS OF THE PLAN ADMINISTRATOR AND THE SPONSOR OF THE FUND. THEY REVIEW THE FORM AND DISCUSS ANY MATTERS ABOUT WHICH THEY ARE UNCERTAIN. UPON FULLY UNDERSTANDING THE COMPLETED FORM 990, THE FORM IS APPROVED AND SUBMITTED ELECTRONICALLY TO THE IRS. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 1 | THE COMPANY CONDUCTS, AT LEAST ANNUALLY, A SURVEY OF OFFICERS AND SELECTED EMPLOYEES REGARDING RELATIONSHIPS WITH VENDORS, ETC. AS DETERMINED BY THE VICE-PRESIDENT, AUDIT AND ETHICS OFFICER. THE PURPOSE OF THIS SURVEY IS TO DISCLOSE ANY DIRECT OR INDIRECT INTEREST OR A POSITION HELD IN THE ENTITY THAT MIGHT PRESENT A CONFLICT OF INTEREST, FINANCIAL OR OTHERWISE. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 2 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE OFFICE OF THE PLAN SPONSOR. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 3 | TRANSFER OF ASSETS BETWEEN TRUSTS -41,359. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 4 | THE ACTIVITY OF THE TRUST IS AUDITED AT THE PLAN LEVEL AND NOT AT THE TRUST LEVEL. THE AUDIT OF THE PLAN IS PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES AND MAY INCLUDE MORE THAN ONE TRUST WHICH PARTICIPATES IN THE PLAN. |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | FORM 990, PART VI, SECTION B, LINE 11B |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 1 | FORM 990, PART VI, SECTION B, LINE 12C |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 2 | FORM 990, PART VI, SECTION C, LINE 19 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 3 | FORM 990, PART XI, LINE 9: |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 4 | PAGE 12, PART XII - FINANCIAL STATEMENTS: |
| IRS990ScheduleR/AssetExchangeInd | 0 | 0 |
| IRS990ScheduleR/AssetPurchaseFromOtherOrgInd | 0 | 0 |
| IRS990ScheduleR/AssetSaleToOtherOrgInd | 0 | 0 |
| IRS990ScheduleR/DivRelatedOrganizationInd | 0 | 0 |
| IRS990ScheduleR/GiftGrntCapContriFromOthOrgInd | 0 | 0 |
| IRS990ScheduleR/GiftGrntOrCapContriToOthOrgInd | 0 | 0 |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/ControlledOrganizationInd | 0 | 0 |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/DirectControllingNACd | 0 | N/A |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/EIN | 0 | 352108964 |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/EntityTypeTxt | 0 | C |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/LegalDomicileStateCd | 0 | DE |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/PrimaryActivitiesTxt | 0 | CONTRIBUTING EMPLOYER/SPONSOR |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/RelatedOrganizationName/BusinessNameLine1Txt | 0 | NISOURCE INC |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/AddressLine1Txt | 0 | 801 E 86TH AVE |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/CityNm | 0 | MERRILLVILLE |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/StateAbbreviationCd | 0 | IN |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/ZIPCd | 0 | 46410 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd | 0 | 0 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd | 1 | 0 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd | 2 | 0 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd | 3 | 0 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt | 0 | NISOURCE NON-UNION POST-65 RETIREE MEDICAL BENEFITS VEBA TRUST |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt | 1 | NISOURCE NON-UNION LIFE AND MEDICAL BENEFITS VEBA TRUST |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt | 2 | NISOURCE UNION LIFE AND MEDICAL BENEFITS VEBA TRUST |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt | 3 | NORTHERN INDIANA PUBLIC CO HEALTH & MEDICAL BEN TRST |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN | 0 | 223203498 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN | 1 | 206907686 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN | 2 | 510344224 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN | 3 | 351883904 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt | 0 | 501(C)9 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt | 1 | 501(C)9 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt | 2 | 501(C)9 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt | 3 | 501(C)9 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd | 0 | IN |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd | 1 | IN |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd | 2 | IN |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd | 3 | IN |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt | 0 | PROVIDE MEDICAL BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt | 1 | PROVIDE LIFE & MEDICAL BENEFITS TO ELIGIBLE PARTICIPANTS & DEPENDENTS |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt | 2 | PROVIDE LIFE & MEDICAL BENEFITS TO ELIGIBLE PARTICIPANTS & DEPENDENTS |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt | 3 | PROVIDE MEDICAL BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt | 0 | 801 EAST 86TH AVE |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt | 1 | 801 EAST 86TH AVE |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt | 2 | 801 EAST 86TH AVE |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt | 3 | 801 EAST 86TH AVE |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm | 0 | MERRILLVILLE |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm | 1 | MERRILLVILLE |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm | 2 | MERRILLVILLE |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm | 3 | MERRILLVILLE |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd | 0 | IN |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd | 1 | IN |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd | 2 | IN |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd | 3 | IN |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd | 0 | 46410 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd | 1 | 46410 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd | 2 | 46410 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd | 3 | 46410 |
| IRS990ScheduleR/LoansOrGuaranteesFromOthOrgInd | 0 | 0 |
| IRS990ScheduleR/LoansOrGuaranteesToOtherOrgInd | 0 | 0 |
| IRS990ScheduleR/PaidEmployeesSharingInd | 0 | 0 |
| IRS990ScheduleR/PerformOfServicesByOtherOrgInd | 0 | 0 |
| IRS990ScheduleR/PerformOfServicesForOthOrgInd | 0 | 0 |
| IRS990ScheduleR/ReceiptOfIntAnntsRntsRyltsInd | 0 | 0 |
| IRS990ScheduleR/ReimbursementPaidByOtherOrgInd | 0 | 0 |
| IRS990ScheduleR/ReimbursementPaidToOtherOrgInd | 0 | 0 |
| IRS990ScheduleR/RentalOfFacilitiesToOthOrgInd | 0 | 0 |
| IRS990ScheduleR/RentalOfFcltsFromOthOrgInd | 0 | 0 |
| IRS990ScheduleR/SharingOfFacilitiesInd | 0 | 0 |
| IRS990ScheduleR/TransferFromOtherOrgInd | 0 | 1 |
| IRS990ScheduleR/TransferToOtherOrgInd | 0 | 1 |
| IRS990/SchoolOperatingInd | 0 | 0 |
| IRS990/SignificantChangeInd | 0 | 0 |
| IRS990/SignificantNewProgramSrvcInd | 0 | 0 |
| IRS990/SubjectToProxyTaxInd | 0 | 0 |
| IRS990/TaxablePartyNotificationInd | 0 | 0 |
| IRS990/TaxExemptBondsInd | 0 | 0 |
| IRS990/TempOrPermanentEndowmentsInd | 0 | 0 |
| IRS990/TerminateOperationsInd | 0 | 0 |
| IRS990/TotalAssetsBOYAmt | 0 | 36117158 |
| IRS990/TotalAssetsEOYAmt | 0 | 39978046 |
| IRS990/TotalAssetsGrp/BOYAmt | 0 | 36117158 |
| IRS990/TotalAssetsGrp/EOYAmt | 0 | 39978046 |
| IRS990/TotalCompGreaterThan150KInd | 0 | 0 |
| IRS990/TotalEmployeeCnt | 0 | 0 |
| IRS990/TotalFunctionalExpensesGrp/TotalAmt | 0 | 2108070 |
| IRS990/TotalGrossUBIAmt | 0 | 0 |
| IRS990/TotalLiabilitiesBOYAmt | 0 | 52550 |
| IRS990/TotalLiabilitiesEOYAmt | 0 | 38354 |
| IRS990/TotalLiabilitiesGrp/BOYAmt | 0 | 52550 |
| IRS990/TotalLiabilitiesGrp/EOYAmt | 0 | 38354 |
| IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt | 0 | 36064608 |
| IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt | 0 | 39939692 |
| IRS990/TotalOtherCompensationAmt | 0 | 0 |
| IRS990/TotalProgramServiceRevenueAmt | 0 | 254072 |
| IRS990/TotalReportableCompFromOrgAmt | 0 | 0 |
| IRS990/TotalRevenueGrp/ExclusionAmt | 0 | 2192062 |
| IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt | 0 | 254072 |
| IRS990/TotalRevenueGrp/TotalRevenueColumnAmt | 0 | 2446134 |
| IRS990/TotalRevenueGrp/UnrelatedBusinessRevenueAmt | 0 | 0 |
| IRS990/TotalVolunteersCnt | 0 | 0 |
| IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt | 0 | 36117158 |
| IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt | 0 | 39978046 |
| IRS990/TotReportableCompRltdOrgAmt | 0 | 0 |
| IRS990/TypeOfOrganizationTrustInd | 0 | X |
| IRS990/UnrelatedBusIncmOverLimitInd | 0 | 0 |
| IRS990/UponRequestInd | 0 | X |
| IRS990/USAddress/AddressLine1Txt | 0 | 801 EAST 86TH AVENUE |
| IRS990/USAddress/CityNm | 0 | MERRILLVILLE |
| IRS990/USAddress/StateAbbreviationCd | 0 | IN |
| IRS990/USAddress/ZIPCd | 0 | 46410 |
| IRS990/VotingMembersGoverningBodyCnt | 0 | 6 |
| IRS990/VotingMembersIndependentCnt | 0 | 6 |
| IRS990/WebsiteAddressTxt | 0 | N/A |
| IRS990/WhistleblowerPolicyInd | 0 | 1 |
| ReturnHeader/BuildTS | 0 | 2019-02-21 02:37:17Z |
| ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd | 0 | 1 |
| ReturnHeader/BusinessOfficerGrp/PersonNm | 0 | SHAWN ANDERSON |
| ReturnHeader/BusinessOfficerGrp/PersonTitleTxt | 0 | COMMITTEE MEMBER |
| ReturnHeader/BusinessOfficerGrp/PhoneNum | 0 | 6144605454 |
| ReturnHeader/BusinessOfficerGrp/SignatureDt | 0 | 2018-11-14 |
| ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt | 0 | NISOURCE UNION POST-65 RETIREE MEDICAL |
| ReturnHeader/Filer/BusinessName/BusinessNameLine2Txt | 0 | BENEFITS VEBA TRUST |
| ReturnHeader/Filer/BusinessNameControlTxt | 0 | NISO |
| ReturnHeader/Filer/EIN | 0 | 223203500 |
| ReturnHeader/Filer/PhoneNum | 0 | 2196475990 |
| ReturnHeader/Filer/USAddress/AddressLine1Txt | 0 | 801 EAST 86TH AVENUE |
| ReturnHeader/Filer/USAddress/CityNm | 0 | MERRILLVILLE |
| ReturnHeader/Filer/USAddress/StateAbbreviationCd | 0 | IN |
| ReturnHeader/Filer/USAddress/ZIPCd | 0 | 46410 |
| ReturnHeader/FilingSecurityInformation/AtSubmissionCreationDeviceId | 0 | 44C1FA5AFC11E21FF39A39E920F6BF6F0CAB4C4E |
| ReturnHeader/FilingSecurityInformation/AtSubmissionFilingDeviceId | 0 | DBF743AF1216C3B70D6C9C598EE47CA4DBC4F1E6 |
| ReturnHeader/FilingSecurityInformation/FilingLicenseTypeCd | 0 | P |
| ReturnHeader/FilingSecurityInformation/IPAddress/IPv4AddressTxt | 0 | 12.235.239.120 |
| ReturnHeader/FilingSecurityInformation/IPDt | 0 | 2018-11-14 |
| ReturnHeader/FilingSecurityInformation/IPTimezoneCd | 0 | CS |
| ReturnHeader/FilingSecurityInformation/IPTm | 0 | 10:27:33 |
| ReturnHeader/PreparerFirmGrp/PreparerFirmEIN | 0 | 320043599 |
| ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt | 0 | LEGACY PROFESSIONALS LLP |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt | 0 | 222 INDIANAPOLIS SUITE 103 |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm | 0 | SCHERERVILLE |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd | 0 | IN |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd | 0 | 46375 |
| ReturnHeader/PreparerPersonGrp/PhoneNum | 0 | 3123680500 |
| ReturnHeader/PreparerPersonGrp/PreparerPersonNm | 0 | LOUISE KING |
| ReturnHeader/ReturnTs | 0 | 2018-11-14T10:27:16-06:00 |
| ReturnHeader/ReturnTypeCd | 0 | 990 |
| ReturnHeader/TaxPeriodBeginDt | 0 | 2017-01-01 |
| ReturnHeader/TaxPeriodEndDt | 0 | 2017-12-31 |
| ReturnHeader/TaxYr | 0 | 2017 |
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Displayed year
2017 • Form 990Detailed filing. Detailed filing data is available for this year.