2023-02-02T17:03:32-06:00 2022-03-31 410746749 CLIFTONLARSONALLEN LLP 601 W RIVERSIDE AVE SUITE 700 SPOKANE WA 99201 990 2021-04-01 910589283 NORTHWEST SHEET METAL WORKERS WELFARE FUND NORT 5095340600 1322 NORTH POST SPOKANE WA 99201 KOLBY HANSON CHAIRMAN 5095340600 2023-02-01 1 KOLBY HANSON XXX-XX-XXXX LISA N RYSSEL CPA P00643670 5093636300 2023-01-31 3 AAL1 IAL1 2021 2023-03-07 01:45:13Z KOLBY HANSON 1322 NORTH POST SPOKANE WA 99201 126640549 0 X N/A X 1952 WA HEALTH AND WELFARE BENEFITS 9 9 224 9 0 0 0 0 96866586 102166516 4524452 8764740 12709 0 101403747 110931256 0 0 94027962 92613394 0 0 0 0 0 2076033 2235608 96103995 94849002 5299752 16082254 152365882 157951543 52805351 50388617 99560531 107562926 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AS SPECIFIED IN THE PLAN. 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AS SPECIFIED IN THE PLAN. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 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 1 512 0 224 1 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 X DAVID KIMMET 5095340600 1322 N POST ST SPOKANE WA 99201 X KOLBY HANSON CHAIRMAN 1.00 X X 0 0 0 JOHN CARTER TRUSTEE 1.00 X 0 0 0 JEFF LINK SECRETARY 1.00 X X 0 0 0 GREG HAYTER TRUSTEE 1.00 X 0 0 0 TIM CARTER TRUSTEE 1.00 X 0 0 0 RANDY GOLDING TRUSTEE 1.00 X 0 0 0 JULIE MULLER TRUSTEE 1.00 X 0 0 0 LANCE DEYETTE TRUSTEE 1.00 X 0 0 0 VALERIE MITCHELL TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 AETNA 151 FARMINGTON AVENUE HARTFORD CT 06156 PPO FEES 1831920 AW REHN AND ASSOCIATES 1322 N POST ST SPOKANE WA 99201 ADMINISTRATION 1153842 DELTA DENTAL OF WA PO BOX 75983 SEATTLE WA 98175 DENTAL CLAIMS ADMINISTRATOR 325842 PAYDHEALTH 4100 ALPHA RD SUITE 500 DALLAS TX 75244 CONSULTING FEES 299185 UNITED CLAIMS SOLUTIONS 10835 N 25TH AVE SUITE 105 PHOENIX AZ 85029 PPO FEES 267320 8 EMPLOYER CONTRIBUTIONS 900099 87210708 87210708 SUPP. BENEFIT CONTRIBS 900099 7978656 7978656 PARTICIPANT CONTRIBUTI 900099 6760102 6760102 LIQUIDATED DAMAGES 900099 217050 217050 102166516 4289490 4289490 20184543 15709293 4475250 4475250 4475250 110931256 102166516 0 8764740 92613394 1289629 79240 183267 111254 199213 217155 44870 7138 50895 AFFORDABLE CARE ACT FEE 26464 26483 94849002 9603380 14125219 9001416 9489229 133761086 134337095 152365882 157951543 117095 302390 52688256 50086227 52805351 50388617 X 0 0 0 0 99560531 107562926 99560531 107562926 152365882 157951543 16082254 -8079859 0 X X 0 1 X 1 0 0 ACCUMULATED ELIGIBILITY CREDITS 19154452 ESTIMATED LIABILITY FOR INCURRED BUT UNREPORTED CLAIMS 9508000 ESTIMATED LIABILITY FOR EXTENDED MEDICAL COVERAGE 19767031 ESTIMATED LIABILITY FOR SEVERANCE BENEFITS 892012 CHECKS IN EXCESS OF DESPOSITS 764732 50086227 X 102740143 -8079859 -8079859 110820002 111254 111254 110931256 97413067 0 97413067 111254 -2675319 -2564065 94849002 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS QUALIFIED PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE PLAN OBTAINED A FAVORABLE DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS) ON JUNE 21, 1988, AND THE PLAN SPONSOR BELIEVES THE PLAN, AS AMENDED, CONTINUES TO QUALIFY AND OPERATE AS DESIGNED. 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 (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. 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: DECREASE IN ACCUMULATED ELIGIBILITY CREDITS 31,220. INCREASE IN ESTIMATED LIABILITY FOR CLAIMS IBNR -4,735,000. INCREASE IN ESTIMATED LIABILITY FOR EXTENDED MEDICAL COVERAGE 2,119,289. INCREASE IN ESTIMATED LIABILITY FOR SEVERANCE BENEFITS -90,828. FORM 990, PART VI, SECTION A, LINE 3 THE DAY TO DAY OPERATIONS OF THE PLAN ARE MANAGED BY AW REHN & ASSOCIATES FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PRESENTED TO THE BOARD OF TRUSTEES AND LEGAL COUNSEL BEFORE SIGNATURE AND FILING FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES ARE ASKED ANNUALLY IN WRITING IF ANY CONFLICTS EXIST. ANY CONFLICTS ARE BROUGHT TO THE BOARD OF TRUSTEES FOR RESOLUTION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. A SUMMARY ANNUAL REPORT REQUIRED BY ERISA IS SENT TO THE PARTICIPANTS ANNUALLY. ACCORDING TO THE REGULATIONS OF THE EBSA, PARTICIPANTS CAN REQUEST THE FULL ANNUAL REPORT AND FORM 5500 FROM THE PLAN ADMINISTRATOR. FORM XII, LINE 2C THE OVERSIGHT PROCESS AND METHOD FOR CHOOSING THE INDEPENDENT AUDITOR HAS NOT CHANGED FROM PRIOR YEARS. 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