2024-02-06T10:44:53-06:00 2023-06-30 455297192 RYAN GUNSAULS & O'DONNELL LLC 5590 E YALE AVE SUITE 201 DENVER CO 80222 990 2022-07-01 760761485 THE COLORADO BOARDS OF EDUCATION SELF-FUNDED TRUST INC COLO 3033022716 4950 S YOSEMITE ST F2 351 GREENWOOD VILLAGE CO 80111 EDWIN PITTAWAY PLAN MANAGER 3033022716 2024-02-02 1 EDWIN PITTAWAY 999009999 0 KATHERINE T MOELLER CPA P01270619 3037585558 2024-02-02 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z COLO PUBLIC EDUCATN HEALTH PLAN EDWIN PITTAWAY 4950 S YOSEMITE ST F2 351 GREENWOOD VILLAGE CO 80111 28255560 0 X WWW.CASB.ORG X 2004 CO TO PROVIDE A MULTI-EMPLOYER/EMPLOYEE HEALTH BENEFIT PROGRAM THAT OFFERS ADMINISTRATIVE, UNDERWRITING, PROVIDER NETWORK, REINSURANCE, SHARED FINANCIAL RISK AND OTHER SERVICES (THE "BEST HEALTH PLAN") TO ITS MEMBER EMPLOYERS. 12 12 2 0 0 0 0 0 41854896 28243676 829 11884 0 0 41855725 28255560 0 0 34248705 25130047 146520 106075 0 0 0 6477164 5385073 40872389 30621195 983336 -2365635 16879557 13705655 8749874 7380637 8129683 6325018 TO PROVIDE A MULTI-EMPLOYER/EMPLOYEE HEALTH BENEFIT PROGRAM THAT OFFERS ADMINISTRATIVE, UNDERWRITING, PROVIDER NETWORK, REINSURANCE, SHARED FINANCIAL RISK AND OTHER SERVICES (THE "BEST HEALTH PLAN") TO ITS MEMBER EMPLOYERS. 0 0 TO PROVIDE A MULTI-EMPLOYER/EMPLOYEE HEALTH BENEFIT PROGRAM THAT OFFERS ADMINISTRATIVE, UNDERWRITING, PROVIDER NETWORK, REINSURANCE, SHARED FINANCIAL RISK AND OTHER SERVICES (THE "BEST HEALTH PLAN") TO ITS MEMBER EMPLOYERS. 0 0 0 0 0 0 0 0 0 0 0 0 1 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 0 0 0 1 5 0 1 2 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 CO X THE ORGANIZATION 3033022716 4950 S YOSEMITE ST F2 351 GREENWOOD VILLAGE CO 80111 BRIAN CHRISTENSEN DIRECTOR 0.50 X 0 0 0 SHAWN EHNES TREASURER 0.50 X X 0 0 0 JULIE OTT DIRECTOR 0.50 X 0 0 0 KATHY GEBHARDT DIRECTOR 0.50 X 0 0 0 JOHN WITTLER VICE PRESIDENT 0.50 X X 0 0 0 RICHARD MARTYR DIRECTOR 0.50 X 0 0 0 JOE SCHOTT PRESIDENT 0.50 X X 0 0 0 KEVIN VICK DIRECTOR 0.50 X 0 0 0 BRIAN CHILDRESS DIRECTOR 0.50 X 0 0 0 BRET MILES DIRECTOR 0.50 X 0 0 0 TONI MILLER DIRECTOR 0.50 X 0 0 0 LESLIE BOGAR DIRECTOR 0.50 X 0 0 0 BEN TAYLOR CHIEF EXECUTIVE OFFICER 40.00 X 103499 0 0 MARY COLEMAN PAST CHIEF EXECUTIVE OFFICER 40.00 X 9231 0 0 112730 0 0 1 0 0 0 THE BEST HEALTH PLAN MANAGER LLC 4950 S YOSEMITE ST F2 352 GREENWOOD VILLAGE CO 80111 HEALTH PLAN SERVICE 776748 1 CONTRIBUTIONS 525100 27409040 27409040 REINSURANCE RECOVERIES 525100 834636 834636 28243676 11884 11884 28255560 28243676 0 11884 25130047 97991 8084 2018033 56393 32300 18458 5052 3219132 BANK FEES 25993 DISCRETIONARY ITEMS 8436 NETWORK TPA FEES 1276 30621195 5771329 1830030 332463 270436 477958 1359362 10297807 10245827 16879557 13705655 8724874 7380637 25000 0 8749874 7380637 X 0 0 0 0 8129683 6325018 8129683 6325018 16879557 13705655 X -2365635 -51981 612951 X 0 1 X 1 0 0 TRUST OWNED LIFE INSURANCE 10245827 10245827 X 28816530 -51981 612951 560970 28255560 0 28255560 30621195 0 30621195 0 30621195 PART X, LINE 2: THE TRUST AND THE TRUST'S TAX COUNCIL BELIEVE THAT THE TRUST IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE TRUST'S FINANCIAL STATEMENTS. THE TRUST HAS ADOPTED THE PROVISIONS OF INCOME TAXES. IN DETERMINING THE RECOGNITION OF UNCERTAIN TAX POSITIONS, THE TRUST APPLIES A MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD AND DETERMINES THE MEASUREMENT OF UNCERTAIN TAX POSITIONS CONSIDERING THE AMOUNTS AND PROBABILITIES OF THE OUTCOMES THAT COULD BE REALIZED UPON ULTIMATE SETTLEMENT WITH TAXING AUTHORITIES. THE TRUST ANALYZED ITS TAX POSITIONS TAKEN ON ITS FEDERAL TAX RETURNS FOR THE OPEN TAX YEARS 2019 THROUGH 2021. BASED ON THIS ANALYSIS, THE TRUST DETERMINED THAT THERE WERE NO UNCERTAIN TAX POSITIONS AND THAT THE TRUST SHOULD PREVAIL UPON EXAMINATION BY THE TAXING AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: RESERVE ESTABLISHMENT 310,951. TOLI DEATH BENEFIT 302,000. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION PROVIDES A COMPLETE COPY OF FORM 990 TO ALL MEMBERS OF ITS GOVERNING BODY FOR REVIEW AND APPROVAL BEFORE FILING. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: RESERVE ESTABLISHMENT 310,951. TOLI DEATH BENEFIT 302,000. FORM 990, PART XI RECONCILIATION OF NET ASSETS LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES: RESERVE ESTABLISHMENT - THE TRUST ESTABLISHED A RESERVE OF $310,951 TO COVER FUTURE COSTS OF DISSOLUTION OF THE TRUST. THE RESERVE ESTABLISHMENT AMOUNT IS $310,951. TRUST OWNED LIFE INSURANCE (TOLI) - THE TRUST IS THE OWNER OF LIFE INSURANCE POLICIES THAT COVER THE LIVES OF CERTAIN CURRENT AND FORMER PARTICIPANTS OF THE MEMBER EMPLOYERS. IN THE CURRENT TAX YEAR THE TRUST RECEIVED A DEATH BENEFIT AND MADE A PAYMENT TO THE HEIR OF THE POLICY NETTING $302,000 FOR THE YEAR END JUNE 30, 2023.