2024-10-29T13:34:06-05:00 2023-12-31 910189318 MOSS ADAMS LLP 635 CAMPBELL TECHNOLOGY PARKWAY CAMPBELL CA 950085071 990 2023-01-01 336026701 FUJITSU GROUP HEALTH BENEFIT PLAN TRUST C/O US BANK TTEE FUJI 6196996627 950 17TH ST DENVER CO 80202 COREY REAVIS FOR US BANK NA TRUSTEE 6196996627 2024-10-27 1 1 PAMELA ALEXANDERSON P01218925 4085587500 2024-10-27 2023 2024-10-15 13:58:12Z COREY REAVIS FOR US BANK 950 17TH ST DENVER CO 80202 31180817 0 X N/A X 1985 CA TO PROVIDE MEDICAL, DENTAL, VISION, AND SHORT TERM DISABILITY BENEFITS TO ITS MEMBERS. 1 1 0 0 178 0 0 0 28650060 31180639 285 178 0 0 28650345 31180817 0 0 28878516 29357542 14424 11218 0 0 0 1900014 1917655 30792954 31286415 -2142609 -105598 3228355 3122757 0 0 3228355 3122757 THE PLAN PROVIDES MEDICAL, DENTAL, AND VISION BENEFITS AS WELL AS SHORT TERM DISABILITY BENEFITS TO SUBSIDIARIES AND AFFILIATES OF THE PLAN SPONSOR WHO ELECT TO PARTICIPATE IN THE PLAN. 0 0 31286414 31180639 THE PRIMARY EXEMPT ACCOMPLISHMENT FOR THE PLAN DURING THE YEAR WAS THE PAYMENT OF MEDICAL, DENTAL, VISION, AND SHORT TERM DISABILITY BENEFITS FOR ITS MEMBERS. 31286414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 X 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 1 0 0 0 X US BANK 6196996627 950 17TH ST DENVER CO 80202 US BANK TRUSTEE 0.10 X 11218 0 0 11218 0 0 0 0 0 0 ANTHEM BLUE CROSS LIFE AND HEALTH INS C 409 S GLENDALE AVE GLENDALE CA 91205 CONTRACT ADMIN 1233766 EMPYREAN BENEFIT SOLUTIONS INC 3010 BRIARPARK DRIVE SUITE 8000 HOUSTON TX 77042 CONTRACT ADMIN 242115 2 PLAN CONTRIBUTIONS 900099 31180639 31180639 31180639 178 178 31180817 31180639 178 0 29357542 11218 68295 78335 1771025 31286415 3228355 3122757 3228355 3122757 0 0 X 0 0 0 0 3228355 3122757 3228355 3122757 3228355 3122757 -105598 0 X 0 1 X 1 0 0 X 30228378 0 30228378 952439 952439 31180817 30657415 0 30657415 629000 629000 31286415 PART X, LINE 2: THE TRUST HAS OBTAINED A FAVORABLE TAX EXEMPTION LETTER DATED MARCH 16, 1988, FROM THE INTERNAL REVENUE SERVICE (IRS) STATING THAT THE TRUST IS TAX-EXEMPT UNDER SECTION 501(A) OF THE CODE AS A VOLUNTARY EMPLOYEE BENEFICIARY ASSOCIATION. THE PLAN BELIEVES THAT THE TRUST, AS AMENDED ON JULY 29, 1991, CONTINUES TO OPERATE IN CONFORMITY WITH THE CODE AND ERISA. AS A RESULT OF THE PLAN'S FUNDING POLICY, FROM TIME TO TIME IT MAY BE SUBJECT TO INCOME TAXES. NO FEDERAL OR CALIFORNIA UNRELATED BUSINESS INCOME TAXES WERE INCURRED FOR THE YEARS ENDED DECEMBER 31, 2023 AND 2022. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE 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 IRS. NO UNCRTAIN POSITIONS HAVE BEEN IDENTIFIED THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS AS OF DECEMBER 31, 2023 AND 2022. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO IRS AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 4B - OTHER ADJUSTMENTS: ACCRUAL TO CASH ADJUSTMENT 952,439. PART XII, LINE 4B - OTHER ADJUSTMENTS: ACCRUAL TO CASH ADJUSTMENT 629,000. FORM 990, PART VI, SECTION B, LINE 11B PAID CPA FIRM PREPARES THE 990 AND PROVIDES TO THE TRUSTEE FOR REVIEW FOR ACCURACY AND REASONABLENESS. THE RETURN THEN GOES TO THE VEBA COMMITTEE FOR REVIEW AND IF APPROVED, THE RETURN IS FILED. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST FUJITSU TECH & BUSINESS OF AME SEE ATTCHD FOR LIST OF AFFIL E ARQUES AVE SUNNYVALE CA 94081 464314843 TECHNOLOGY & BUSINESS SUPPORT CA N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 SCH. R LN IV IDENTIFICATION OF RELATED ORG TAXABLE AS A CORP OR TRUST (CONT FCL COMPONENTS AMERICA INC. FDK FUJITSU GENERAL AMERICA INC FUJITSU LIMITED FUJITSU NETWORK COMMUNICATIONS, INC FUJITSU NORTH AMERICA, INC. FUJITSU OPTICAL COMPONENTS AMERICA INC FUJITSU RESEARCH OF AMERICA, INC GLOBERANGER CORPORATION SHINKO ELECTRIC AMERICA, INC TRANSTRON AMERICA INC