2022-04-06T17:57:46-05:00 2021-06-30 208149084 ANASTASI MOORE & MARTIN PLLC 9 S WASHINGTON ST STE 600 SPOKANE WA 99201 990 2020-07-01 920174160 ASEAAFSCME LOCAL 52 HEALTH BENEFITS TRUST ASEA 5093280300 111 WEST CATALDO AVENUE SUITE 220 SPOKANE WA 99201 SHAWN STAKER CHAIRMAN 5093280300 2022-04-06 1 SHAWN STAKER 999009999 PAUL J ANASTASI CPA P00395796 5093230272 2022-04-06 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z SHAWN STAKER 111 WEST CATALDO AVENUE SUITE 220 SPOKANE WA 99201 281938140 0 X WWW.ASEAHEALTH.ORG X 2000 AK TO PROVIDE HEALTH BENEFITS TO QUALIFIED PARTICIPANTS 7 7 0 8 0 0 0 0 163247710 168691550 3545331 19011893 0 0 166793041 187703443 0 0 150137817 164663603 0 0 0 0 0 3355369 3546246 153493186 168209849 13299855 19493594 227489356 292530544 22451545 25854574 205037811 266675970 TO PROVIDE HEALTH BENEFITS TO QUALIFIED PARTICIPANTS 0 0 EMPLOYEE WELFARE BENEFIT 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 0 0 0 0 0 0 0 0 0 0 0 X 7 7 1 1 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X X ZENITH AMERICAN SOLUTIONS INC 5093280300 111 WEST CATALDO SUITE 220 SPOKANE WA 992010434 X SHAWN STAKER CHAIRMAN (AS OF 9/30/20) 1.00 X X 0 0 0 MICHAEL WILLIAMS CHAIRMAN (THROUGH 9/30/20) 1.00 X X 0 0 0 JAKE LAUTEN SECRETARY 1.00 X X 0 0 0 BRITTANY STAKER TRUSTEE 1.00 X 0 0 0 CHARISSE MILLETT TRUSTEE 1.00 X 0 0 0 CHELSEA SIEH TRUSTEE 1.00 X 0 0 0 JODI ANDRES TRUSTEE 1.00 X 0 0 0 RICHARD SEWELL TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 ZENITH AMERICAN SOLUTIONS INC 111 WEST CATALDO AVENUE SUITE 220 SPOKANE WA 99201 ADMINISTRATION 2997385 AETNA 151 FARMINGTON AVENUE HARTFORD CT 06156 HEALTHCARE MGMT 2086822 PRONOUNCED HEALTH SOLUTIONS INC 3200 WINDY HILL ROAD SUITE B-100 ATLANTA GA 30339 HEALTHCARE MGMT 982818 HEALTH CARE COST MANAGEMENT CORPORATION 3000 A STREET SUITE 300 ANCHORAGE AK 99503 HEALTH COST MGMT 758116 PARKER SMITH & FEEK 2233 112TH AVE NE BELLEVUE WA 98004 BENEFITS CONSULTING 222354 15 EMPLOYER CONTRIBUTIONS 900099 147396423 147396423 EMPLOYEE CONTRIBUTIONS 900099 21295127 21295127 168691550 3115094 3115094 110131496 94234697 15896799 15896799 15896799 187703443 168691550 0 19011893 164663603 300056 112339 24495 1236164 1151528 407506 2353 7540 59134 WEBSITE MAINTENANCE 71666 PRIVACY AND SECURITY 55958 COMMUNICATIONS SPECIALI 48011 PCORI FEES 38388 31108 168209849 17516860 11756661 2900193 3720239 207072303 277053644 227489356 292530544 643600 707346 21807945 25147228 22451545 25854574 X 0 0 0 0 205037811 266675970 205037811 266675970 227489356 292530544 X 19493594 45695672 -3551107 X 0 1 X 0 0 0 BENEFIT OBLIGATIONS 24261886 CHECKS WRITTEN IN EXCESS OF DEPOSITS 885342 25147228 X 232162951 45695672 45695672 186467279 1236164 1236164 187703443 166973685 0 166973685 1236164 1236164 168209849 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS QUALIFIED UNDER SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE (IRC) AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. HOWEVER, AS A RESULT OF THE PLAN'S FUNDING POLICY, FROM TIME TO TIME THE TRUST MAY BE SUBJECT TO INCOME TAXES. NO FEDERAL OR STATE INCOME TAXES HAVE BEEN RECORDED FOR THE YEARS ENDED JUNE 30, 2021 OR 2020, FOR UNRELATED BUSINESS TAXABLE INCOME. THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC. THEREFORE, THEY BELIEVE THAT THE PLAN IS QUALIFIED AND THE RELATED TRUST IS TAX-EXEMPT AS OF THE FINANCIAL STATEMENT DATES. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE PLAN'S FINANCIAL STATEMENTS. 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 ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS). THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF JUNE 30, 2021, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF THE LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS, AND THE PLAN COULD BE SUBJECT TO INCOME TAX IF CERTAIN ISSUES WERE FOUND BY THE IRS THAT COULD RESULT IN THE DISQUALIFICATION OF THE PLAN'S TAX-EXEMPT STATUS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. FORM 990, PART VI, SECTION A, LINE 2 TWO BOARD MEMBERS, SHAWN STAKER AND BRITTANY STAKER, ARE MARRIED. FORM 990, PART VI, SECTION A, LINE 3 THE BOARD OF TRUSTEES HAS HIRED A PROFESSIONAL ADMINISTRATION COMPANY TO OPERATE THE TRUST ON A DAY TO DAY BASIS. THE BOARD OF TRUSTEES RETAINS ULTIMATE RESPONSIBILITY FOR THE ACTIONS OF THE PROFESSIONAL ADMINISTRATORS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PROVIDED TO THE BOARD OF TRUSTEES FOR THEIR REVIEW AND APPROVAL PRIOR TO FILING. FORM 990, PART VI, SECTION C, LINE 18 DOCUMENTS ARE PROVIDED TO PARTICIPANTS OF THE PLAN UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 NO OTHER DOCUMENTS ARE AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CHANGE IN BENEFIT OBLIGATIONS -3,551,107. STATE OF ALASKA DEPARTMENT OF ADMINISTRATION P O BOX 110204 JUNEAU AK 99811 926001185 STATE GOVERNMENTAL ENTITY AK GOVERNMENTAL ENTITY NONE 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1