2022-03-08T14:40:39-06:00 2021-09-30 MILLER KAPLAN ARASE LLP 275 BATTERY ST STE 1800 SAN FRANCISCO CA 941113346 990 2020-10-01 776009955 California's Valued Trust % ROBERT POWERS CALI 5594372960 520 E Herndon Ave Fresno CA 93720 VALERIE CORNUELLE Executive Director 5594372960 2022-03-07 true VALERIE CORNUELLE 999009999 Catherine Gardner P00350865 4159563600 2 2020 2022-09-23 18:48:47Z Valerie Cornuelle 520 E Herndon Ave Fresno CA 93720 868065413 false X www.cvtrust.org X 1984 CA TO PROVIDE HEALTH AND WELFARE BENEFITS FOR ELIGIBLE EMPLOYEES, RETIREES AND THEIR DEPENDENTS. 12 7 42 0 0 0 0 0 798969638 816655719 5887954 14659155 446456 581487 805304048 831896361 0 0 718593212 787844013 5384796 4998525 0 0 0 30902521 32270897 754880529 825113435 50423519 6782926 207508043 240041607 64504329 77865346 143003714 162176261 TO PROVIDE HEALTH AND WELFARE BENEFITS FOR ELIGIBLE EMPLOYEES, RETIREES AND THEIR DEPENDENTS. false false TO PROVIDE HEALTH AND WELFARE BENEFITS FOR ELIGIBLE EMPLOYEES, RETIREES AND THEIR DEPENDENTS. false false false false false false false false false true false false false true true true false false false false false false false false false false false false true false false false false false false false false false false false true false false true 17 0 true 42 true false false false false false false false false X 12 7 false false false false false false false true true false false true true true true true true true true false X ROBERT POWERS 5594372960 520 E HERNDON AVE Fresno CA 93720 Valerie Cornuelle Executive Director 40.0 0.0 X 242958 0 39864 Robert Powers Dir. of Financial Services 40.0 0.0 X 161042 0 33720 JEFF CORNELIUS DIR. OF STRATEGIC INITIATIVES 40.0 0.0 X 132073 0 31547 BROOK PAULSEN IT MANAGER 40.0 0.0 X 117582 0 30461 TIERNEY O'BRIEN DIR OF MARKETING & BUS DEV 40.0 0.0 X 113723 0 30146 NOLAN CLINARD Business Analyst 40.0 0.0 X 111725 0 30021 MAI THAO SENIOR ACCOUNTANT 40.0 0.0 X 109625 0 27467 Chad Wood Director 4.0 0.0 X 205 0 0 Sue Eustice Director 4.0 0.0 X 205 0 0 Elaine Cash Director 4.0 0.0 X 205 0 0 Nancy Smith Director 4.0 0.0 X 205 0 0 John Pestorich Director 4.0 0.0 X 205 0 0 Debra Cole Director 4.0 0.0 X 205 0 0 Anthony Parreira Director 4.0 0.0 X 205 0 0 Keith Pace Director 4.0 0.0 X 205 0 0 Elizabeth Zulueta Director 4.0 0.0 X 80 0 0 chuck king Director 4.0 0.0 X 0 0 0 Carole Anne Luckenbach Director 4.0 0.0 X 0 0 0 Ken Johnson Director 4.0 0.0 X 0 0 0 990448 0 223226 12 false true false Anthem Blue Cross 11050 Olson Dr Ste 110 RANCHO CORDOVA CA 95670 claims admin service 15756268 Delta Dental 100 First St 6th Fl SAN FRANCISCO CA 94105 Claims admin service 3584944 BLUE SHIELD OF CALIFORNIA ASO 50 BEALE ST SAN FRANCISCO CA 94105 CLAIMS ADMIN SERVICE 1549049 BLUE SHIELD OF CALIFORNIA HMO 50 BEALE ST SAN FRANCISCO CA 94105 admin service 1165392 PRUDENTRX 3820 NORTHDALE BLVD STE 311-A TAMPA FL 33624 CLAIMS ADMIN SERVICE 1335627 21 0 EMPLOYER CONTRIBUTIONS 900099 729519945 729519945 0 0 PARTICIPANT CONTRIBUTIONS 900099 31502913 31502913 0 0 STOP-LOSS REIMBURSEMENTS 900099 5522514 5522514 0 0 DRUG REBATES, DISCOUNTS AND REINSURANCE PAYMENTS 900099 50110347 50110347 0 0 816655719 6199827 0 0 6199827 0 0 0 0 0 44628380 36169052 8459328 8459328 0 0 8459328 0 0 0 0 0 0 0 0 0 ADMINISTRATIVE SERVICES 900099 105440 105440 0 0 OTHER INCOME 900099 476047 476047 0 0 581487 831896361 817237206 0 14659155 0 0 0 787844013 479304 0 3264599 230606 794837 229179 0 204000 156020 0 0 182173 29990118 188196 606030 232803 0 129670 27905 0 2065 0 0 239866 111116 ACA FEES 200935 825113435 120 119 6642872 8528978 0 0 23293305 24476242 0 0 0 0 0 0 0 0 309489 267242 6212101 4290830 2067505 1921271 175194752 204847755 0 0 0 0 0 0 0 0 207508043 240041607 951575 1492147 0 0 6650868 7101911 0 0 0 0 0 0 0 0 0 0 56901886 69271288 64504329 77865346 X 0 0 0 0 143003714 162176261 143003714 162176261 207508043 240041607 6782926 12389621 X false true X true 1012000 1012000 1579699 1088337 491362 29443 29443 0 3590958 3173050 417909 1921271 0 CLAIMS PAYABLE AND INCURRED BUT 0 NOT PAID 64599020 POSTRETIREMENT BENEFIT COST 2789200 OBLIGATIONS FOR THE BENEFIT OF 0 OTHERS 1883068 69271288 X 788470948 12389621 12389621 776081327 182173 55632861 55815034 831896361 757502251 -55632861 -55632861 813135112 182173 11796150 11978323 825113435 Part X, Line 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN A TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY A TAX AUTHORITY. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 4B: STOP-LOSS REIMBURSEMENTS $ 5,522,514 DRUG REBATES, DISCOUNTS AND REINSURANCE 50,110,347 TOTAL 55,632,861 PART XII, LINE 2D: STOP-LOSS REIMBURSEMENTS ($ 5,522,514) DRUG REBATES, DISCOUNTS AND REINSURANCE ( 50,110,347) TOTAL ( 55,632,861) PART XII, LINE 4B: CHANGE IN BENEFIT OBLIGATIONS $11,796,150 X false false false Valerie Cornuelle Executive Director 242958 0 18222 0 21642 0 282822 0 Robert Powers Dir. of Financial Services 161042 0 12078 0 21642 0 194762 0 JEFF CORNELIUS DIR. OF STRATEGIC INITIATIVES 132073 0 9905 0 21642 0 163620 0 PART VI, SECTION B, LINE 11B: A COPY OF THE FORM 990 WAS PROVIDED TO THE PLAN'S GOVERNING BODY PRIOR TO BEING FILED AND WAS REVIEWED BY THE PLAN'S AUDIT COMMITTEE AND THE DIRECTOR OF FINANCIAL SERVICES BEFORE IT WAS FILED. PART VI, SECTION B, LINE 12C: AT LEAST ANNUALLY, DIRECTORS AND OTHER FIDUCIARIES ARE ASKED TO DISCLOSE ANY RELATIONSHIPS OR INTERESTS THAT COULD GIVE RISE TO A CONFLICT. IF THERE IS A CONFLICT OF INTEREST, THE CONFLICTING INTEREST IS FULLY DISCLOSED AND DOCUMENTED IN WRITING. THE DIRECTOR OR FIDUCIARY WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTIONS; THE BOARD DETERMINES IF THE TRANSACTION IS IN THE BEST INTEREST OF THE PLAN, AND THE TERMS OF THE TRANSACTION ARE FAIR WITH RESPECT TO TERMS AVAILABLE THROUGH ARMS-LENGTH TRANSACTIONS IN THE MARKETPLACE. PART VI, SECTION B, LINE 15: COMPENSATION FOR THE EXECUTIVE DIRECTOR WAS APPROVED BY THE BOARD OF TRUSTEES. PART VI, SECTION C, LINE 19: THE PLAN MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PART VII, SECTION A, COLUMN E: ANY TRUSTEES' COMPENSATION AND/OR BENEFITS FROM THE RELATED TAX-EXEMPT ORGANIZATIONS ARE AVAILABLE AT THE TRUST. PART XII, LINE 2C: THE AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF BOTH THE AUDIT AND THE SELECTION OF THE CERTIFIED PUBLIC ACCOUNTANTS THAT AUDIT THE PLAN'S FINANCIAL STATEMENTS. THE FULL BOARD ANNUALLY APPROVES THE AUDIT AND ANY CHANGE TO THE CERTIFIED PUBLIC ACCOUNTANTS. SEE PART VII SUPPLEMENTAL INFORMATION false false false false false false false false false false false false false false false false false false true SCHEDULE R, PART II: THE LIST OF CONTRIBUTING EMPLOYERS IS MAINTAINED BY THE ADMINISTRATIVE OFFICE.