2024-05-06T13:58:00-05:00 2023-12-31 366055558 GRANT THORNTON LLP 171 N CLARK ST STE 200 CHICAGO IL 60601 990 2023-01-01 911845900 ANDERSEN CORPORATION VEBA RET HLTH BN TRUST ANDE 6512644071 100 4TH AVE N MN126-01-J6A BAYPORT MN 550031096 TODD CORBO SENIOR TAX DIRECTOR 6512644071 2024-05-06 1 TODD CORBO 999009999 0 BRIDGET T ROCHE P00666837 3128560200 3 AAL1 IAL1 2023 2023-04-26 12:10:37Z TODD CORBO 60 LIVINGSTON AVE ST PAUL MN 55107 19045141 0 X N/A X 1983 MN THE MISSON OF THE VEBA IS TO FUND AND PROVIDE BENEFITS UNDER CERTAIN (CONTINUED IN SCH O)EMPLOYEE WELFARE BENEFIT PLANS SPONSORED BY ANDERSEN CORPORATION. 1 1 0 0 3844980 3836080 0 0 2073435 2302482 2834878 3844988 667 12897671 4908980 19045141 0 0 17562707 18471787 2500 2631 0 0 0 7580596 9080702 25145803 27555120 -20236823 -8509979 159746469 211038553 0 0 159746469 211038553 THE MISSION OF THE VEBA IS TO FUND AND PROVIDE BENEFITS UNDER CERTAIN EMPLOYEE WELFARE BENEFIT PLANS SPONSORED BY ANDERSEN CORPORATION. 0 0 THE EXEMPT PURPOSE OF THE VEBA IS TO PROVIDE HEALTH CARE BENEFITS UNDER CERTAIN EMPLOYEE WELFARE BENEFIT PLANS SPONSORED BY ANDERSEN CORPORATION. 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 1 1 0 1 1 0 0 0 0 1 0 1 0 1 1 1 1 1 1 0 0 0 X LISA M FOSTER US BANK 6514666259 60 LIVINGSTON AVE ST PAUL MN 55107 US BANK NATIONAL ASSOCIATION TRUSTEE 1.00 0.00 X 2500 0 0 2500 0 0 0 0 0 0 0 EMPLOYEE CONTRIBUTIONS 525100 2302482 2302482 2302482 3844980 3844980 8 0 8 8 8 LIFE INSURANCE PROCEED 525100 7445617 7445617 MN LIFE EXP. REFUND 525100 5451429 5451429 SETTLEMENT PAYMENT 525100 625 625 12897671 19045141 15200161 3844980 0 18471787 2500 131 353670 456 50310 TOLI LIFE PREMIUM 6193771 FEDERAL TAXES 1362340 LIFE INSURANCE DISTR 1120155 27555120 1688404 9477350 100745201 154053032 57312864 47508171 159746469 211038553 0 0 X 159746469 211038553 0 0 0 0 159746469 211038553 159746469 211038553 -8509979 59802063 0 X 0 1 X 1 0 0 154053032 F 154053032 INVESTMENT IN TOLI CONTRACT 47508171 47508171 ANDERSEN CORPORATION SPONSORING ORG. 3759500 DIVIDENDS 0 SCHEDULE L, PART IV: BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:ANDERSEN CORPORATION IS THE CREATOR/FOUNDER OF THE VEBA ORGANIZATION AND IS, THEREFORE, CONSIDERED AN INTERESTED PERSON. AS PART OF ITS INVESTMENT STRATEGY, THE VEBA ORGANIZATION HAS COMMON STOCK INVESTMENTS IN ANDERSEN CORPORATION WHICH DISTRIBUTES DIVIDENDS QUARTERLY. DUE TO THE NATURE OF THEIR RELATIONSHIP, THE DISCLOSURE OF THE TRANSACTIONS AND THEIR AMOUNT ARE NECESSARY FOR ACCURATE REPORTING. FORM 990, PART VI, SECTION A, LINE 3 DELEGATION OF MANAGEMENT DUTIES: ANDERSEN CORPORATION EMPLOYEE BENEFICIARY ASSOCIATION RETIREE HEALTH BENEFIT TRUST HAS DELEGATED MANAGEMENT DUTIES TO THE MANAGEMENT COMMITTEE. THE MANAGEMENT COMMITTEE, ESTABLISHED BY ANDERSEN CORPORATION, HAS BEEN GIVEN ALL OF THE PLAN ADMINISTRATIVE AND CERTAIN PLAN SPONSOR (SETTLOR) AUTHORITY AND RESPONSIBILITY. FORM 990, PART VI, SECTION A, LINE 4 CHANGES TO RETIREE MEDICAL GUIDE BOOKLET EFFECITVE 01/01/2023, THE FOLLOWING UPDATES WERE MADE TO THE RETIREE MEDICAL GUIDE BOOKLET IN REGARDS TO DEPEDENT'S ELIGIBILITY: - RETIREES WOULD BE ABLE TO ADD ELIGIBLE DEPENDENT(S) TO THEIR RETIREE MEDICAL COVERAGE AT THE SAME TIME AS THEIR INITIAL ENROLLMENT WHEN THEY RETIRE, OR ONE-TIME ONLY WITH THE DEPENDENT'S LOSS OF OTHER COVERAGE DURING THE YEAR. - ELIGIBLE DEPENDENTS MUST BE ELIGIBLE FOR COVERAGE AT TIME OF RETIREMENT. - OPEN ENROLLMENT IN 2023 GOING FORWARD WILL ONLY BE USED FOR PLAN OPTION CHANGES (I.E., CHANGING FROM THE CO-PAY PLAN). TO ADD DEPENDENTS (WITH A ONE-TIME LOSS OF OTHER COVERAGE) THAT WERE ELIGIBLE AT TIME OF RETIREMENT, THE RETIREE NEEDS TO CONTACT THE BENEFITS AT ANDERSEN SERVICE CENTER. FORM 990, PART VI, SECTION A, LINE 8B DOCUMENTATION OF MEETINGS HELD OR WRITTEN ACTIONS TAKEN: NO SUCH COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY EXISTS. FORM 990, PART VI, SECTION A, LINE 9: TRUSTEE WHO CANNOT BE REACHED AT THE TRUST'S MAILING ADDRESS: THE TRUSTEE, U.S. BANK NATIONAL ASSOCIATION, CANNOT BE REACHED AT THE ORGANIZATION'S MAILING ADDRESS. CURRENT CONTACT INFORMATION FOR THE TRUSTEE IS: U.S. BANK NATIONAL ASSOCIATION, C/O LISA M. FOSTER, 60 LIVINGSTON AVENUE, ST. PAUL, MN 55107, (651)466-6259. FORM 990, PART VI, SECTION B, LINE 11B REVIEW PROCESS: THE FINAL FORM 990 AND ITS VARIOUS SCHEDULES WERE PREPARED BY A NATIONAL CPA FIRM AND REVIEWED BY THE KEY OFFICERS OF THE PLAN SPONSOR, ANDERSEN CORPORATION, AND TRUSTEE OF THE TRUST. IDENTIFIED CHANGES WERE INCORPORATED PRIOR TO FILING FORM 990 WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: THE TRUSTEE HAS ADOPTED A CODE OF BUSINESS CONDUCT AND ETHICS THAT INCLUDES A SECTION ON CONFLICT OF INTEREST. THE TRUSTEE REQUIRES KEY STAFF MEMBERS TO ANNUALLY (A) DISCLOSE THEIR OUTSIDE CONNECTIONS AND OWNERSHIP INTEREST IN A CONFLICT OF INTEREST POLICY DISCLOSURE AND RETURN IT TO THE OFFICE OF THE GENERAL COUNSEL AND (B) AFFIRM THAT THEY HAVE REVIEWED AND ARE IN COMPLIANCE WITH A NUMBER OF THE TRUSTEE'S POLICIES INCLUDING THE CODE OF BUSINESS CONDUCT AND ETHICS AND ITS GUIDELINES RELATING TO STANDARDS OF CONDUCT, WHICH ALSO INCLUDES A SECTION ON CONFLICTS OF INTEREST. POTENTIAL CONFLICTS OF INTEREST ARE DISCLOSED IMMEDIATELY. FORM 990, PART VI, SECTION C, LINE 19 HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC: NO DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC. ANDERSEN CORPORATION 100 4TH AVENUE N BAYPORT MN 550031096 410123208 MANUFACTURING MN N/A C 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0