2023-07-17T09:32:35-05:00 2022-08-31 WITHUMSMITHBROWNPC 5000 EXECUTIVE PARKWAY STE 400 SAN RAMON CA 94583 990 2021-09-01 946667029 CALIFORNIA TEACHERS ASSOC EMPLOYEES' HEALTH AND WELFARE BENEFITS TRUST % WC EARHART COMPANY INC CALI 5032825581 PO BOX 4148 PORTLAND OR 97208 Leslie Littman CHAIR 9252779100 2023-07-11 true Leslie Littman 999009999 JAMES N BROWNING P01451906 9252779100 2021 2023-04-26 12:10:37Z Leslie Littman PO BOX 4148 PORTLAND OR 97208 31668406 false X n/a X 1993 CA PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS. 8 0 0 0 0 0 0 0 23312979 23907357 1468526 1006242 6000 0 24787505 24913599 0 0 22672051 24839572 0 0 0 0 0 2028439 1983699 24700490 26823271 87015 -1909672 27598780 22468896 2137935 2346149 25460845 20122747 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS. false false PROVIDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE ACTIVE AND RETIRED PARTICIPANTS AND THEIR DEPENDENTS. false false false false false false false false false false false false true true true false false false false false false false false false false false false false false false false false false false false false false false false true false false true 2 0 true 0 false false false false false false false false X 8 0 false true false false false false false true true false false true true true true true true false false false CA X WC EARHART COMPANY INC 5032825581 12209 NE GLENN WIDING DRIVE PORTLAND OR 97220 X David Goldberg cHAIRMAN 3.0 0.0 X X 0 0 0 Jake Anderson Co-Chairman 3.0 0.0 X X 0 0 0 Rose Luna Nunez Trustee 2.0 0.0 X 0 0 0 E Toby Boyd Trustee 2.0 0.0 X 0 0 0 Jill Coert Trustee 2.0 0.0 X 0 0 0 Jess Lima Trustee 2.0 0.0 X 0 0 0 Halimah Mekki Trustee 2.0 0.0 X 0 0 0 Pamela Miller Trustee 2.0 0.0 X 0 0 0 Wei Pan TRUSTEE 2.0 0.0 X 0 0 0 SEE SCH O FOR COMPENSATION Paid By Related OrganizatiONS 0.0 0.0 X 0 0 0 0 0 0 0 false false false Anthem Blue Cross of California 801 S FIGUEROA STREET 5TH FLOOR LOS ANGELES CA 90017 Claims Admin 1038389 THE WILLIAM C EARHART COMPANY PO BOX 4148 PORTLAND OR 97208 CONTRACT ADMIN 261007 EXPRESS SCRIPTS 1 EXPRESS SCRIPTS WAY ST LOUIS MO 63121 PHARMACY CLAIMS 189516 Milliman 1301 Fifth Avenue Suite 3800 Seattle WA 981012646 Consulting 143928 4 0 Employer Contributions 525100 22661966 22661966 Participant Contributions 525100 128809 128809 MEDICARE PART D AND EGWP SUBSIDY 525100 1116582 1116582 23907357 761049 761049 0 0 0 0 0 7000000 6754807 245193 245193 245193 0 0 0 0 0 0 0 0 0 0 24913599 23907357 0 1006242 0 0 0 24839572 0 0 0 0 0 0 244008 173969 85038 0 0 22917 1314564 0 55830 0 0 0 0 0 22330 0 0 0 65043 26823271 1193843 784975 10621 10655 0 0 4039974 5255451 0 0 0 0 0 0 0 0 14220 0 0 0 22340122 16417815 0 0 0 0 0 0 0 0 27598780 22468896 289235 290649 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1848700 2055500 2137935 2346149 X 0 0 0 0 25460845 20122747 25460845 20122747 27598780 22468896 -1909672 -3428426 X X false true X true false 0 CLAIMS PAYABLE AND IBNR 2055500 2055500 X 21462256 -3428426 -3428426 24890682 22917 22917 24913599 26593554 26593554 22917 206800 229717 26823271 PART X, LINE 2: Accounting principles generally accepted in the United States of America require management to evaluate the tax positions taken by the Plan and to 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 Internal Revenue Service. Management has analyzed the tax positions taken by the Plan and has concluded that, as of August 31, 2022 and 2021, there are no uncertain positions taken, or expected to be taken, that would require recognition of a liability or disclosure in the financial statements. The Plan is subject to routine audits by the taxing jurisdictions; however, there are currently no audits for any tax periods in progress. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION A, LINE 3: THE ORGANIZATION HAS CONTRACTED WITH W.C. EARHART COMPANY, INC. TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B: THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE BOARD PRIOR TO FILING. THE BOARD REVIEWED THE FORM 990 WITH THE ADMINISTRATIVE MANAGER. FORM 990, PART VI, SECTION B, LINE 12C: IF AND WHEN A POTENTIAL CONFLICT OF INTEREST IS DISCLOSED, THE CONFLICT-OF-INTEREST OFFICER (ORGANIZATION'S LEGAL COUNSEL) WILL EVALUATE IF THE MATTER WOULD LIKELY PREVENT AN UNBIASED OR OBJECTIVE DECISION BY A TRUSTEE AND, AS APPROPRIATE, DISCLIPINARY OR CORRECTIVE ACTION WILL BE TAKEN. FORM 990, PART VI, SECTION C, LINE 19: THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT-OF-INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1A: TRUSTEES ARE NOT COMPENSATED BY THE TRUST. COMPENSATION PAID TO TRUSTEES EMPLOYED BY OTHER ORGANIZATIONS IS REPORTED ON THE FORM 990 FILED WITH THE INTERNAL REVENUE SERVICE BY THE RELATED TAX-EXEMPT ORGANIZATION. IF YOU WOULD LIKE ADDITIONAL INFORMATION, PLEASE CONTACT THE THIRD-PARTY ADMINISTRATOR, W.C. EARHART COMPANY, INC. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES HAS RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT AUDITOR. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. California Teachers Association 1705 Murchison Drive Burlingame CA 94010 940362310 Labor Org CA 501(c)(5) N/A NA false California Associate Staff 11745 E TELEGRAPH RD SANTA FE SPRINGS CA 90670 510181184 Labor Org CA 501(c)(5) N/A NA false California Staff Organization Inc 10775 FRANK DANIELS WAY SAN DIEGO CA 92131 954497350 Labor Org CA 501(c)(5) N/A NA false false false false false false false false false false false false false false false false false false false false FORM 990, SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS: THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF AUGUST 31, 2022, THERE ARE APPROXIMATELY 37 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. THE FEDERAL TAX CLASSIFICATION (DISREGARDED ENTITY, TAX EXEMPT ORGANIZATION, PARTNERSHIP, TAXABLE CORPORATION OR TRUST) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT THE NAME OF THE CONTRIBUTING EMPLOYERS ARE LISTED ON PART VII BELOW AND NOT ON PARTS II THROUGH IV BY FEDERAL TAX CLASSIFICATION. 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