The Ht Hackney Co Veba

“Statement regarding overall governing body and management functions: the taxpayer is a voluntary employee benefit association (the "trust") whose sole purpose is to receive contributions and make disbursements pursuant to the h.t. Hackney company flexible benefits plan (the "plan"). The plan is a welfare benefit plan subject to erisa that provides health care benefits for all eligible employees of the h.t. Hackney company (the "sponsor") and is funded in part by employee contributions and in part from the general assets of sponsor whose payments also flow through the trust. United healthcare administers the plan. Employee premiums are deducted from employee earnings each payday and a check or ach for total employee premiums and employer contributions is then forwarded to the regions bank trust department from benefits administrator for crediting to the trust's account. Employer's contribution is calculated monthly, based on the target amount that is determined annually, and forwarded to the trust department, as well. Regions bank's trust department invests the funds in money market instruments. Claim invoices are received from united healthcare weekly and a request for funds transfer to the plan's checking account is submitted to the trust department by the benefits administrator for payment of claims. The trust department provides monthly statements to the plan administrator. Part vi contains several questions that are either inapplicable to the trust or that are answered differently from other types of tax-exempt organizations, specifically: no. 3 - the plan administrator has delegated the management and investment of its assets to the trust department of regions bank. No. 8 - all actions taken by the trust are well documented by plan administrator and an outside agency but there are no meetings and document actions with respect to the trust. No. 11 - the form 990 is reviewed by the benefits administrator and the cfo or sponsor. No. 12 - the trust does not have a written conflict of interest policy. United healthcare follows the benefits plan documents and there are no potential conflicts of interest. Any appeals are reviewed by united healthcare regardless of who it is. No. 14 - the sponsor does not have an established document retention and destruction policy. No. 15 - this is not applicable. The trust does not have employees and does not compensate directly or indirectly any employees of employer. No. 19 - the plan and the sponsor provide information to plan participants as required by erisa and the department of labor. The trust has not made governing documents or financial statements available to the public and the trust does not maintain a conflict of interest policy.”

“Included in discussion above.”

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“Included in discussion above.”

“Regions bank - 151 major reynolds place, knoxville, tn 37919.”