California Institute of Technology Retiree Medical Plan Jpl Veba Tr

FORM 990, PART I, LINE 1 AND PART III, LINES 1 AND 4A:

“THE CALTECH RETIREE MEDICAL PLAN FOR JPL EMPLOYEES VEBA TRUST ("TRUST") WAS ESTABLISHED TO HOLD IN TRUST CONTRIBUTIONS TO THE CALTECH RETIREE HEALTH AND LIFE benefits PROGRAM FOR JPL EMPLOYEES ("PLAN") AND TO FACILITATE THE PLAN'S INVESTMENT AND BENEFITS PAYMENT ACTIVITY. THE PLAN, AMENDED AND RESTATED AS OF JANUARY 1, 2015, IS SPONSORED BY THE CALIFORNIA INSTITUTE OF TECHNOLOGY (THE "INSTITUTE"CALTECH"). THE PLAN PROVIDES POST-RETIREMENT MEDICAL, DENTAL, VISION AND LIFE INSURANCE BENEFITS TO ELIGIBLE RETIREES AND THEIR SPOUSES AND DEPENDENTS OF CALTECH'S JET PROPULSION LABORATORY ("JPL"), A FEDERALLY FUNDED RESEARCH AND DEVELOPMENT CENTER MANAGED BY CALTECH FOR THE NATIONAL AERONAUTICS AND SPACE ADMINISTRATION ("NASA"). FORM 990, PART VI, SECTION A, LINE 1A AND PART VII, SECTION A, LINE 1: THE SOLE TRUSTEE OF THE TRUST IS STATE STREET BANK. THE TRUST HAS NO OTHER TRUSTEES AND HAS NO BOARD MEMBERS, OFFICERS, OR EMPLOYEES. FORM 990, PART VI, SECTION A, LINES 3 AND 7B: UNDER THE TRUST AGREEMENT, CALTECH IS THE ADMINISTRATOR OF THE TRUST. AS A RESULT, CALTECH'S OFFICERS, EMPLOYEES, AND CONTRACTORS OVERSEE THE DAY-TO-DAY OPERATIONS OF THE TRUST. CALTECH'S SERVICES AS ADMINISTRATOR ARE PROVIDED AT NO CHARGE TO THE TRUST. FORM 990, PART VI, SECTION B, LINE 11B: THE INSTITUTE PREPARES FORM 990 WITH THE ASSISTANCE OF A PAID PREPARER. A FINAL DRAFT OF FORM 990 IS PROVIDED TO THE OVERSIGHT COMMITTEE AND CALTECH'S VP & CFO PRIOR TO FILING WITH THE IRS. AN AUTHORIZED SIGNATORY OF THE TRUST AND ITS PAID PREPARER, RESPECTIVELY, SIGN THE FINAL FORM 990. FORM 990, PART VI, SECTION B, LINES 12-14: THE TRUST IS ADMINISTERED BY CALTECH EMPLOYEES AND CERTAIN CONTRACTORS SELECTED BY CALTECH TO PERFORM VARIOUS ADMINISTRATIVE SERVICES FOR THE TRUST. ALTHOUGH THE TRUST DOES NOT HAVE CONFLICT OF INTEREST, WHISTLEBLOWER, AND DOCUMENT RETENTION AND DESTRUCTION POLICIES, CALTECH EMPLOYEES THAT ADMINISTER THE TRUST AND MEMBERS OF THE OVERSIGHT COMMITTEE ARE REQUIRED TO ABIDE BY CALTECH'S RESPECTIVE POLICIES IN THESE AREAS. FORM 990, PART VI, SECTION C, LINE 19: THE TRUST'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AND CALTECH'S CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, SCHEDULE R, PART II, LINE 1: CALIFORNIA INSTITUTE OF TECHNOLOGY IS THE SPONSOR OF THE PLAN AND THE ADMINISTRATOR OF THE TRUST. FORM 990, SCHEDULE R, PART V, LINE 1C: CALTECH MAKES CONTRIBUTIONS TO THE TRUST ACCORDING TO A FUNDING ARRANGEMENT WITH NASA THAT IS STIPULATED IN THE CONTRACT BETWEEN CALTECH AND NASA FOR THE MANAGEMENT OF JPL. FORM 990, SCHEDULE R, PART V, LINE 1M: CALTECH EMPLOYEES PERFORM ADMINISTRATIVE SERVICES FOR THE TRUST. SUCH SERVICES ARE PART OF THE NORMAL COURSE OF SUCH EMPLOYEES' DUTIES IN ADMINISTERING CALTECH'S BENEFIT PLANS, AND CALTECH RECEIVES NO REIMBURSEMENT FOR SUCH SERVICE TO THE TRUST. THEREFORE, THE AFOREMENTIONED SERVICES ARE NOT RECORDED AS CONTRIBUTIONS TO THE TRUST. FORM 990, SCHEDULE R, PART V, LINE 1Q: CALTECH CONTRIBUTES TO THE TRUST TO FUND EXTERNAL ADMINISTRATIVE COSTS, SUCH AS RECORDKEEPING, INVESTMENT MANAGEMENT AND AUDIT EXPENSES.”