2025-10-15T18:01:12-05:00 2024-12-31 611436956 NOVAK FRANCELLA LLC 40 MONUMENT RD 5TH FLR BALA CYNWYD PA 19004 990 2024-01-01 456218538 PARTICIPATING UNION GM BANKRUPTCY CLAIM HEALTH CARE REIMBURSEMENT TRUST PART 4122012242 60 BLVD OF THE ALLIES 5TH FLR PITTSBURGH PA 15222 RACHAEL DAVIS COMMITTEE MEMBER 4122012242 2025-10-15 1 0 LOUIS VERZELLA CPA P00360279 6106689400 2025-10-15 2024 2025-03-06 01:10:19Z RACHAEL DAVIS 60 BLVD OF THE ALLIES 5TH FLR PITTSBURGH PA 15222 2818786 0 X N/A X 2011 PA THE PARTICIPATING UNION GM BANKRUPTCY CLAIM HEALTH CARE REIMBURSEMENT TRUST WAS ESTABLISHED ON APRIL 11, 2011 AND HAS BEEN CREATED TO FUND BENEFITS FOR CERTAIN RETIRED BARGAINING UNIT MEMBERS WHO LOST THEIR GM POST-RETIREMENT HEALTH BENEFITS IN THE GM BANKRUPTCY, AND FOR CERTAIN SPOUSES AND ELIGIBLE DEPENDENTS OF THOSE RETIREES. 5 5 0 0 0 0 0 0 0 0 769870 109201 0 0 769870 109201 0 0 2632245 2384157 0 0 0 0 0 136506 115063 2768751 2499220 -1998881 -2390019 4566902 2177441 5741 6299 4561161 2171142 TO PROVIDE POST-RETIREMENT HEALTH BENEFITS FOR CERTAIN RETIRED BARGAINING UNIT MEMBERS WHO LOST THEIR HEALTH BENEFITS IN THE GM BANKRUPTCY. 0 0 TO PROVIDE POST-RETIREMENT HEALTH BENEFITS FOR CERTAIN RETIRED BARGAINING UNIT MEMBERS WHO LOST THEIR HEALTH BENEFITS IN THE GM BANKRUPTCY. 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 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 1 0 X CDS ADMINISTRATORS INC 4122012242 60 BLVD OF THE ALLIES 5TH FLR PITTSBURGH PA 15222 X STEVEN ELLICOTT COMMITTEE MEMBER 1.00 X 0 0 0 EMILY WOODWARD COMMITTEE MEMBER 1.00 X 0 0 0 RACHAEL DAVIS COMMITTEE MEMBER 1.00 X 0 0 0 NEIL B DOUGLAS COMMITTEE MEMBER 1.00 X 0 0 0 VIC ALEXANDER COMMITTEE MEMBER 1.00 X 0 0 0 0 0 0 0 0 0 0 0 109201 109201 2709585 2709585 0 109201 0 0 109201 2384157 54741 2406 13500 196 16037 3416 18275 PCORI FEE 6492 2499220 484219 736126 4050540 1422795 14028 13127 18115 5393 4566902 2177441 5741 6299 5741 6299 X 0 0 0 0 4561161 2171142 4561161 2171142 4566902 2177441 -2390019 0 X X 0 1 X 1 0 0 X 109005 0 109005 196 196 109201 2499024 0 2499024 196 196 2499220 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT, MORE LIKELY THAN NOT, WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE U.S. FEDERAL, STATE, OR LOCAL TAXING AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. TYPICALLY, PLAN TAX YEARS WILL REMAIN OPEN FOR THREE YEARS; HOWEVER, THIS MAY DIFFER DEPENDING UPON THE CIRCUMSTANCES OF THE PLAN. FORM 990, PART VI, SECTION A, LINE 8B THE COMMITTEE HAS NOT AUTHORIZED ANY SUBCOMMITTEE TO ACT ON ITS BEHALF. FORM 990, PART VI, SECTION B, LINE 11B THE PARTICIPATING UNION GM BANKRUPTCY CLAIM HEALTH CARE REIMBURSEMENT TRUST FORM 990 IS REVIEWED BY THE COMMITTEE BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE PARTICIPATING UNION GM BANKRUPTCY CLAIM HEALTH CARE REIMBURSEMENT TRUST COMMITTEE MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15B THE ORGANIZATION DOES NOT HAVE ANY EMPLOYEES AND DOES NOT PAY ANY COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PARTICIPATING UNION GM BANKRUPTCY CLAIM HEALTH CARE REIMBURSEMENT TRUST COMMITTEE IS RESPONSIBLE FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT THAT PERFORMS THE AUDIT.