2024-11-13T08:30:37-06:00 2023-12-31 481111111 CBIZ ADVISORS LLC 3925 RIVER CROSSING PKWY STE 100 INDIANAPOLIS IN 46240 990 2023-01-01 264594868 DSRA BENEFIT TRUST INC DSRA 5854242079 150 BASTIAN ROAD ROCHESTER NY 14623 LORI OSTRANDER TREASURER 8103472829 2024-11-12 1 0 MATTHEW W UTTERBACK P00176537 3174722200 2024-11-12 2023 2024-10-15 13:58:12Z LORI OSTRANDER 2742 HUNTINGTON HILLS DR LAKELAND FL 33810 326731 0 X WWW.DSRABENEFITTRUST.NET X 2009 DE TO PROVIDE RETIREMENT WELFARE BENEFITS TO ELIGIBLE RETIREES OF DELPHI CORP AND/OR THEIR SURVIVORS. 5 5 0 0 0 0 0 0 0 0 25247 56766 57395 54675 82642 111441 0 0 153293 138482 0 0 0 0 0 82390 137831 235683 276313 -153041 -164872 805926 723763 0 0 805926 723763 TO PROVIDE RETIREMENT WELFARE BENEFITS TO ELIGIBLE RETIREES OF DELPHI CORP AND/OR THEIR SURVIVORS. 0 0 138482 DSRA BENEFIT TRUST, INC. PROVIDES HEALTH CARE INSURANCE BENEFITS TO ELIGIBLE PLAN PARTICIPANTS IN ACORDANCE WITH THE TERMS OF THE TRUST AGREEMENT & AMENDED PROVISIONS. 138482 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 0 0 0 X LORI OSTRANDER (TREASURER) 8103472829 2742 HUNTINGTON HILLS DRIVE LAKELAND FL 33810 PAUL BEITER CHAIRPERSON 10.00 X X 6000 0 0 STEPHEN DUCA MEMBER AT LARGE 8.00 X 6000 0 0 LORI OSTRANDER TREASURER 10.00 X X 6000 0 0 GREG WHITE MEMBER AT LARGE 8.00 X 6000 0 0 SHARON DELEZENNE SECRETARY 10.00 X X 6000 0 0 30000 0 0 0 0 0 0 0 97563 97563 174493 215290 -40797 -40797 -40797 ADMINISTRATIVE FEE 561000 54675 54675 54675 111441 54675 0 56766 138482 138482 82829 82829 16203 16203 8799 8799 BOARD OF DIRECTOR FEES 30000 30000 276313 138482 137831 0 42345 38291 763581 685472 805926 723763 0 0 X 0 0 0 0 805926 723763 805926 723763 805926 723763 -164872 82709 0 X 0 1 X 0 0 0 11135121 11023680 11023680 111441 0 111441 11217374 10941061 10941061 276313 0 276313 PART XI, LINE 2D - OTHER ADJUSTMENTS: PARTICIPANT CONTRIBUTIONS 10,982,883. REALIZED LOSS ON INVESTMENTS 40,797. PART XII, LINE 2D - OTHER ADJUSTMENTS: INSURANCE PREMIUMS PAID FOR PARTICIPANTS 10,325,108. CONTRACT ADMINISTRATION FEES 603,146. REALIZED LOSS ON INVESTMENTS 12,807. FORM 990, PART VI, SECTION B, LINE 11B EACH MEMBER OF THE GOVERNING BODY WILL REVIEW THE FORM 990 PRIOR TO IRS FILING. THE EXTENT OF EACH MEMBERS REVIEW WILL DEPEND UPON HIS OR HER KNOWLEDGE OF THE SUBJECT MATTER. HOWEVER, EACH MEMBER WILL HAVE SUFFICIENT KNOWLEDGE TO REVIEW THE QUESTION REGARDING THE MANAGEMENT AND GOVERNANCE OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES EACH MEMBER OF THE VEBA COMMITTEE (THE TRUSTEES) TO REVIEW AND EXCUTE A COPY OF THE ORGANIZATION'S CONFLICT OF INTEREST POLICY EACH YEAR. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THESE DOCUMENTS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST.