2024-11-14T09:40:10-06:00 2023-12-31 341874260 CBIZ ADVISORS LLC 700 WEST 47TH STREET SUITE 1100 KANSAS CITY MO 64112 990 2023-01-01 480834445 KOCH EMPLOYEE GROUP BENEFIT TRUST KOCH 4046522109 133 PEACHTREE ST NE 14TH FL ATLANTA GA 30303 KEN DUARTE TRUSTEE 4046522109 2024-11-13 1 1 LISA BURKE P00220718 8169455500 2024-11-13 2023 2024-10-15 13:58:12Z X KEN DUARTE 133 PEACHTREE ST NE 14TH FL ATLANTA GA 30303 374884 0 X N/A X 1975 KS PROVIDE HEALTH AND WELFARE BENEFITS UNDER KOCH RETIREE MEDICAL PLAN 3 0 0 0 0 0 0 0 495034 320414 6729 54470 0 0 501763 374884 0 0 293392 214256 0 0 0 0 0 90017 75829 383409 290085 118354 84799 1776606 1856001 10333 4929 1766273 1851072 PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE FORMER EMPLOYEES AS WELL AS THEIR DEPENDENTS UNDER KOCH RETIREE MEDICAL PLAN (THE "PLAN") AND A CLOSED GROUP OF ACTIVE EMPLOYEES ENTITLED TO FUTURE HEALTH AND WELFARE BENEFITS UNDER THE PLAN. 0 0 PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE FORMER EMPLOYEES AS WELL AS THEIR DEPENDENTS UNDER KOCH RETIREE MEDICAL PLAN (THE "PLAN") AND A CLOSED GROUP OF ACTIVE EMPLOYEES ENTITLED TO FUTURE HEALTH AND WELFARE BENEFITS UNDER THE PLAN.THE 2023 IRS FORM 5500 FOR THE PLAN REPORTED A TOTAL OF 195 PARTICIPANTS UNDER THE PLAN AS OF 01/01/2023; COMPRISING THE TOTAL NUMBER OF FORMER EMPLOYEES AND THEIR ELIGIBLE DEPENDENTS CURRENTLY RECEIVING BENEFITS PLUS THE CLOSED GROUP OF ELIGIBLE ACTIVE EMPLOYEES ENTITLED TO FUTURE BENEFITS. 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 0 0 0 0 X 3 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 X KOCH BUSINESS SOLUTIONS LP 4046522109 133 PEACHTREE ST NE 14TH FL ATLANTA GA 30303 X KEN DUARTE TRUSTEE 0.25 40.00 X 0 0 0 KRISTI PALMER TRUSTEE 0.25 40.00 X 0 0 0 ROSS GOERING TRUSTEE 0.25 40.00 X 0 0 0 0 0 0 0 0 0 0 0 PARTICIPANT CONTRIBUTI 525100 278539 278539 EMPLOYER CONTRIBUTIONS 525100 41875 41875 320414 54470 54470 374884 320414 0 54470 X 214256 27665 48164 290085 X 1716519 1824533 60087 31468 1776606 1856001 10333 4929 10333 4929 X 1766273 1851072 0 0 0 0 1766273 1851072 1776606 1856001 84799 0 X 0 1 X 0 0 0 X 374884 0 374884 0 374884 297253 0 297253 -7168 -7168 290085 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS INTENDED TO QUALIFY PURSUANT TO SECTION 501(C)9 OF THE INTERNAL REVENUE CODE (IRC) AND ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE TRUST HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS), AND THE COMPANY BELIEVES THAT THE TRUST, AS AMENDED, CONTINUES TO QUALIFY AND TO OPERATE IN ACCORDANCE WITH APPLICABLE PROVISIONS OF THE IRC. GAAP REQUIRES PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRC. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN CLAIMS PAYABLE AND CLAIMS INCURRED BUT NOT REPORTED -7,168. FORM 990, PART I, PRIOR YEAR COLUMN: THE PRIOR YEAR REVENUE AND EXPENSES WERE RESTATED TO AGREE TO THE ISSUED AUDITED FINANCIAL STATEMENTS AND 2022 FORM 5500 AS FILED. FORM 990, PART VI, SECTION A, LINE 4 THE TRUST AGREEMENT WAS AMENDED ON NOVEMBER 12, 2024 TO CHANGE THE TRUST'S NAME FROM KOCH INDUSTRIES EMPLOYEE GROUP BENEFIT TRUST TO KOCH EMPLOYEE GROUP BENEFIT TRUST. EFFECTIVE AUGUST 1, 2024, THE PLAN'S SPONSOR (SEE SCHEDULE R) WAS CHANGED FROM KOCH INDUSTRIES, INC. TO KOCH COMPANIES, LLC (EIN 99-2447784) AND THE PLAN WAS RENAMED THE KOCH RETIREE MEDICAL PLAN. FORM 990, PART VI, SECTION A, LINE 8A THE PLAN ADMINISTRATORS DOCUMENT THEIR COMMITTEE MEETINGS; HOWEVER, THE TRUSTEES DO NOT HAVE REGULARLY SCHEDULED MEETINGS. FORM 990, PART VI, SECTION A, LINE 8B THE PLAN ADMINISTRATORS DOCUMENT THEIR COMMITTEE MEETINGS; HOWEVER, THE TRUSTEES DO NOT HAVE REGULARLY SCHEDULED MEETINGS. FORM 990, PART VI, SECTION B, LINE 11B THIS FORM 990 WAS PREPARED BY KOCH BUSINESS SOLUTIONS (KBS). KBS MANAGES THE ANNUAL ERISA AUDIT OF THE PLAN. THIS FORM 990 WAS FIRST REVIEWED BY A REPRESENTATIVE OF MANAGEMENT AND KOCH LEGAL THEN REVIEWED AND EXECUTED BY A TRUSTEE OF THE TRUST. FORM 990, PART VI, SECTION B, LINE 12 ALL ASSETS HELD BY THE TRUST ARE ERISA ASSETS AND THE TRUSTEES ARE FIDUCIARIES UNDER ERISA. AS SUCH ALL TRUSTEES ARE PROHIBITED FROM ACTING IN ANYONE'S INTEREST OTHER THAN THE TRUST. ALL TRUSTEES REQUIRE TRAINING ON THIS REQUIREMENT. FORM 990, PART VI, SECTION C, LINE 19 ANY PLAN PARTICIPANT IS ELIGIBLE TO RECEIVE FORM 990 OR ANY OTHER DOCUMENT UPON REQUEST. FORM 990, PART IX, LINE 11G ADMINISTRATIVE EXPENSES 9,621. BANK FEES 5,824. MEDICAL & DENTAL FEES 32,719. FORM 990, PART X, COLUMN (A): THE BEGINNING BALANCE SHEET WAS RESTATED TO AGREE TO THE ISSUED AUDITED FINANCIAL STATEMENTS AND 2022 FORM 5500 AS FILED. KOCH COMPANIES LLC 4111 E 37TH ST N WICHITA KS 67220 992447784 CREATE, INNOVATE, AND IMPROVE EVERYDAY PRODUCTS AND SERVICES KS N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1