2024-11-07T07:29:27-06:00 2023-12-31 135565207 KPMG LLP 60 SOUTH STREET BOSTON MA 02111 990 2023-01-01 416558543 AMICA RETIREE MEDICAL TRUST AMIC 8006526422 100 AMICA WAY LINCOLN RI 028651156 ERIC SANTOS SR ASSISTANT VICE PRESIDENT 8006526422 2024-10-11 1 0 STEPHANIE LONCZAK P01880207 6179881000 2023 2024-10-15 13:58:12Z EDMUND SHALLCROSS III 100 AMICA WAY LINCOLN RI 028651156 139070117 0 X N/A X 2006 RI THE TRUST PROVIDES PARTICIPANTS WITH SICK AND ACCIDENT BENEFITS (WITHIN THE MEANING OF TREAS. REG. SEC. 1.501(C)(9)-(3)(C)). THE TRUST IS FOR THE BENEFIT OF PARTICIPANTS AND ELIGIBLE DEPENDENTS WHO MEET THE ELIGIBILITY CRITERIA UNDER THE AMICA MUTUAL INS. CO. RETIREE MEDICAL PLAN. 5 0 0 0 9245635 9444584 0 0 0 0 29169650 11223955 709804 902669 29879454 12126624 0 0 10000000 12900000 0 0 0 0 0 9753044 1939533 19753044 14839533 10126410 -2712909 332476437 355834959 10038200 12947537 322438237 342887422 X SEE SCHEDULE OTHE TRUST PROVIDES PARTICIPANTS WITH SICK AND ACCIDENT BENEFITS (WITHIN THE MEANING OF TREAS. REG. SEC. 1.501(C)(9)-(3)(C)). THE TRUST IS FOR THE BENEFIT OF PARTICIPANTS AND ELIGIBLE DEPENDENTS WHO MEET THE ELIGIBILITY CRITERIA UNDER THE AMICA MUTUAL INS. CO. RETIREE MEDICAL PLAN. 0 0 THE TRUST PROVIDES PARTICIPANTS WITH SICK AND ACCIDENT BENEFITS (WITHIN THE MEANING OF TREAS. REG. SEC. 1.501(C)(9)-(3)(C)). THE TRUST IS FOR THE BENEFIT OF PARTICIPANTS AND ELIGIBLE DEPENDENTS WHO MEET THE ELIGIBILTY CRITERIA UNDER THE AMICA MUTUAL INS. CO. RETIREE MEDICAL PLAN. 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 X 5 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 0 0 0 X MICHAEL L BAKER JR 8006526422 100 AMICA WAY LINCOLN RI 028651156 X EDMUND SHALLCROSS III CHAIRMAN 0.25 37.25 X X 0 0 0 SUZANNE CASEY SECRETARY (THRU 09/2023) 0.25 37.25 X X 0 0 0 JENNIFER MORRISON SECRETARY (AS OF 09/2023) 0.25 37.25 X X 0 0 0 SUSAN CHUNG TRUSTEE 0.25 37.25 X 0 0 0 JAMES LORING TRUSTEE 0.25 37.25 X 0 0 0 SAMUEL PALMISANO TRUSTEE 0.25 37.25 X 0 0 0 0 0 0 0 0 0 0 0 7844564 6026134 1818430 1062559 1062559 129192935 67390 126267861 675632 2925074 -608242 2316832 2316832 PARTNERSHIP BUSINESS INCOME 524126 902669 902669 902669 12126624 0 9245635 2880989 12900000 38200 20633 FEDERAL INCOME TAX PAID 1475408 STATE INCOME TAX PAID 405292 14839533 5456 8190 21029159 8500492 203191240 235528794 105187126 103845591 3063456 7951892 332476437 355834959 0 0 9337 10038200 12938200 10038200 12947537 X 276100000 276100000 0 0 46338237 66787422 322438237 342887422 332476437 355834959 -2712909 23162094 0 X 0 1 X 1 0 0 MISC. LT INVESTED ASSETS 101141901 F COMMERCIAL MORTGAGE 2703690 F 103845591 BENEFITS PAYABLE 12900000 ACCRUED OTHER EXPENSES 38200 12938200 X PART X, LINE 2: U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRES PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE TRUST AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE TRUST HAS TAKEN AN UNCERTAIN POSITION THAT MORE-LIKELY-THAN-NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN SPONSOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2023, 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 PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. AMICA MUTUAL INSURANCE COMPANY SUBSTANTIAL CONTRIBUTOR 12900000 REIMBURSEMENT OF EXPENSES 0 FORM 990, PART VI, SECTION A, LINE 2 ALL OFFICERS AND TRUSTEES OF THE TRUST HAVE A BUSINESS RELATIONSHIP WITH ONE ANOTHER. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS A MEMBER, AMICA MUTUAL INSURANCE COMPANY, WHICH HAS THE POWER TO ELECT MEMBERS OF THE GOVERNING BODY AS WELL AS APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BODY, INCLUDING DECISIONS MADE RELATED TO THE MANAGEMENT OF TRUST ASSETS, FUNDING CONTRIBUTIONS RECEIVED BY THE TRUST, AND PAYMENT MADE OUT OF THE TRUST IN SATISFACTION OF BENEFITS PAYABLE. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS A MEMBER, AMICA MUTUAL INSURANCE COMPANY, WHICH HAS THE POWER TO ELECT MEMBERS OF THE GOVERNING BODY AS WELL AS APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BODY, INCLUDING DECISIONS MADE RELATED TO THE MANAGEMENT OF TRUST ASSETS, FUNDING CONTRIBUTIONS RECEIVED BY THE TRUST, AND PAYMENT MADE OUT OF THE TRUST IN SATISFACTION OF BENEFITS PAYABLE. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION HAS A MEMBER, AMICA MUTUAL INSURANCE COMPANY, WHICH HAS THE POWER TO ELECT MEMBERS OF THE GOVERNING BODY AS WELL AS APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BODY, INCLUDING DECISIONS MADE RELATED TO THE MANAGEMENT OF TRUST ASSETS, FUNDING CONTRIBUTIONS RECEIVED BY THE TRUST, AND PAYMENT MADE OUT OF THE TRUST IN SATISFACTION OF BENEFITS PAYABLE. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DID NOT HAVE ANY COMMITTEES TO DOCUMENT MEETINGS WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B NO REVIEW WAS OR WILL BE CONDUCTED. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART VII, COLUMN E, F: THE ORGANIZATION UTILIZES THE VOLUNTEER EXCEPTION AND NEED NOT REPORT VOLUNTEER OFFICER, DIRECTOR, OR TRUSTEE COMPENSATION. AMICA MUTUAL INSURANCE COMPANY 100 AMICA WAY LINCOLN RI 02865 050348344 INSURANCE RI N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0