2022-02-10T12:25:52-06:00 2021-03-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2020-04-01 911106482 CEMENT MASONS AND PLASTERERS HEALTH AND WELFARE TRUST CEME 2064417574 PO BOX 34203 SEATTLE WA 98124 ERIC COFFELT CHAIRMAN 2064419386 2022-01-31 1 ERIC COFFELT 999009999 MICHAEL MEAD CPA P01893207 4252506100 2022-01-31 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z ERIC COFFELT 6362 6TH AVE S SEATTLE WA 98108 56405103 0 X N/A X 1980 WA TO PROVIDE HEALTH AND WELFARE BENEFITS TO QUALIFIED PARTICIPANTS 10 3 4 12 0 0 0 0 20109179 19302381 549120 928378 277538 443591 20935837 20674350 0 0 14894809 14001336 0 0 0 0 0 1441477 1474019 16336286 15475355 4599551 5198995 25982793 31240997 11502365 10250581 14480428 20990416 TO PROVIDE HEALTH AND WELFARE BENEFITS TO QUALIFIED PARTICIPANTS AS SPECIFIED BY THE PLAN. 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO QUALIFIED PARTICIPANTS AS SPECIFIED BY 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 1 426 0 1 4 1 0 0 0 0 0 0 0 0 X 10 3 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X WELFARE & PENSION ADMINISTRATION 2064417574 7525 SE 24TH ST 200 MERCER ISLAND WA 98040 X X ERIC COFFELT CHAIR/TRUSTEE 1.00 X X 0 0 0 GARRETT CONDEL SECRETARY/TRUSTEE 1.00 X X 0 0 0 JOHN SALINAS TRUSTEE 1.00 X 0 0 0 ANDREW LEDBETTER TRUSTEE 1.00 X 0 0 0 FRANK BENISH TRUSTEE 1.00 X 0 0 0 PATRICK MCQUEEN TRUSTEE 1.00 X 0 0 0 LARRY WHITE TRUSTEE (THRU 2/21) 1.00 X 0 0 0 EDWARD CASE TRUSTEE 1.00 X 0 0 0 JUSTIN PALACHUK TRUSTEE 1.00 X 0 0 0 TRAVIS METZGER TRUSTEE 0.50 X 0 0 0 THOMAS PARSONS TRUSTEE (THRU 7/20) 0.50 X 0 0 0 CORY YALOWICKI TRUSTEE 0.50 X 0 0 0 0 0 0 0 0 0 0 WPAS INC PO BOX 34203 SEATTLE WA 98124 ADMINISTRATION SERVICES 875193 AETNA INC 151 FARMINGTON AVENUE HARTFORD CT 06156 CLAIMS PROCESSING 252979 BCMJPS 1325 FOURTH AVENUE SUITE 910 SEATTLE WA 98101 ATTORNEY 123282 3 EMPLOYER CONTRIBUTIONS 900099 17681213 17681213 RETIREE CONTRIBUTIONS 900099 1325281 1325281 EMPLOYEE CONTRIBUTIONS 900099 295887 295887 19302381 420975 420975 36238156 35730753 507403 507403 507403 FORMULARY REBATES 900099 436323 436323 LIQUIDATED DAMAGES 900099 7268 7268 443591 20674350 19745972 0 928378 14001336 1169992 69617 38699 34685 53633 68102 8425 14590 BANK FEES 14676 DUES, REGISTRATIONS AND 1600 15475355 521617 2731542 838332 1071061 2166017 2178462 9655 12020 22447172 25247912 25982793 31240997 440365 465581 11062000 9785000 11502365 10250581 X 0 0 0 0 14480428 20990416 14480428 20990416 25982793 31240997 5198995 1310993 0 X X 0 1 X 1 0 0 LAG MONTH ELIGIBILITY COVERAGE 2161000 ACCUMULATED ELIGIBILITY CREDITS 5679000 CLAIMS INCURRED BUT NOT REPORTED 1945000 9785000 X 21935982 1310993 1310993 20624989 49361 49361 20674350 16713978 0 16713978 49361 -1287984 -1238623 15475355 PART X, LINE 2: THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF MARCH 31, 2021, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. 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 LAG MONTHS ELIGIBILITY COVERAGE -272,000. CHANGE IN ACCUMULATED ELIGIBILITY CREDITS -971,000. CHANGE IN INCURRED BUT NOT REPORTED CLAIMS -34,000. CHANGE IN PREMIUMS PAYABLE -10,984. FORM 990, PART VI, SECTION A, LINE 1 THE GOVERNING BODY HAS NOT DELEGATED BROAD AUTHORITY TO ANY COMMITTEES. FORM 990, PART VI, SECTION A, LINE 3 THE DAY TO DAY OPERATIONS OF THE TRUST ARE MANAGED BY WELFARE & PENSION ADMINISTRATION, INC. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE COMMITTEES THAT ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE ENTIRE BOARD OF TRUSTEES AND THE TRUST ATTORNEY ARE PROVIDED A COPY OF THE FORM 990 FOR THEIR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE TRUSTEES AND SERVICE PROVIDERS ARE SENT LETTERS ON AN ANNUAL BASIS REQUESTING KNOWLEDGE OF ANY CONFLICTS IN INTEREST OR RELATED PARTY TRANSACTIONS. THE TRUST COUNSEL ALSO MONITORS THE PLAN'S THIRD PARTY SERVICE PROVIDERS ON AN ONGOING BASIS AND REPORTS BACK TO THE TRUSTEES. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST FROM THE PLAN'S ADMINISTRATOR. FORM 990, PART VII, SECTION A, LINE 6: TRUSTEES ARE NOT COMPENSATED BY THE TRUST, COMPENSATION PAID TO TRUSTEES EMPLOYED BY OTHER RELATED TAX EXEMPT ORGANIZATIONS IS REPORTED ON FORM 990 FILED WITH THE IRS BY RELATED TAX-EXEMPT ORGANIZATIONS. IF YOU WOULD LIKE ADDITIONAL INFORMATION PLEASE CONTACT THE PLAN ADMINISTRATOR. FORM 990. PAGE 11, PART XI, LINE 2C: THE OVERSIGHT PROCESS AND METHOD OF SELECTING THE INDEPENDENT AUDITOR HAS NOT CHANGED FROM PRIOR YEARS. 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