2022-03-14T12:28:27-05:00 2021-05-31 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2020-06-01 956042868 CALIFORNIA IRONWORKERS FIELD WELFARE PLAN CALI 6267927337 131 N EL MOLINO AVENUE NO 330 PASADENA CA 91101 DAVID OSBORNE TRUSTEE 6267927337 2022-03-14 1 DAVID OSBORNE 999009999 JOSEPH M THIERMANN P01066616 9252779100 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z GREG MCCLELLAND 131 N EL MOLINO AVE 330 PASADENA CA 91101 199920750 0 X IRONWORKERBENNY.COM X 1963 CA TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS. 18 0 903 0 0 0 0 0 207872952 196608989 3645489 3311761 0 0 211518441 199920750 0 0 197810179 186610883 0 0 0 0 0 4954181 5028090 202764360 191638973 8754081 8281777 280928025 295368908 221347817 227893958 59580208 67474950 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS. 0 0 PROVIDED MEDICAL, HOSPITAL, LIFE, VISION, PRESCRIPTION DRUGS, DENTAL AND OTHER BENEFITS TO ACTIVE AND RETIREE PARTICIPANTS. 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 1 230 0 1 903 1 0 0 0 0 0 0 0 0 X 18 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 1 1 1 0 0 0 X IRONWORKER EMPLOYEES BENEFIT CORP 6267927337 131 N EL MOLINO AVE 330 PASADENA CA 91101 X VIDAL ZAMBRANO TRUSTEE 1.00 X 0 0 0 RICH MARTINI TRUSTEE 1.00 X 0 0 0 DONALD ZAMPA UNION CHAIRMAN 1.00 X 0 0 0 DANIEL WELSH TRUSTEE 1.00 X 0 0 0 CHARLES KREBS TRUSTEE 1.00 X 0 0 0 DENNIS ANDERSEN TRUSTEE 1.00 X 0 0 0 DAVE MCEUEN TRUSTEE 1.00 X 0 0 0 GREG MCCLELLAND MANAGEMENT CHAIRMAN 1.00 X 0 0 0 CHARLES HERNANDEZ TRUSTEE 1.00 X 0 0 0 KARL PINEO TRUSTEE 1.00 X 0 0 0 JEFF MCEUEN TRUSTEE 1.00 X 0 0 0 MICHAEL VLAMING TRUSTEE 1.00 X 0 0 0 RICHARD BARBOUR TRUSTEE 1.00 X 0 0 0 DYLAN OLSON TRUSTEE 1.00 X 0 0 0 KEITH HARKEY TRUSTEE 1.00 X 0 0 0 JESS CASTANEDA TRUSTEE 1.00 X 0 0 0 BEAU COLEMAN TRUSTEE 1.00 X 0 0 0 JASON SANGSTER TRUSTEE 1.00 X 0 0 0 SEE SCHEDULE O FOR COMPENSATION PAID BY RELATED ORGANIZATIONS 0.00 X 0 1 0 0 1 0 0 0 0 0 IRONWORKERS EMPLOYEES BENEFITS CORP N EL MOLINO AVE 330 PASADENA CA 91101 PLAN ADMINISTRATION 2990124 ANTHEM BLUE CROSS LIFE & HEALTH 2155 OXNARD STREET WOODLANDS HILLS CA 91367 ASO FEES 2046564 DELTA DENTAL OF CALIFORNIA 17871 PARK PLAZA DRIVE SUITE 200 CERRITOS CA 90703 ASO FEES 550693 THE SEGAL COMPANY 100 MONTGOMERY STREET STE 500 SAN FRANCISCO CA 94104 ACTUARIAL 282244 OPTUM RX 2300 MAIN STREET IRVINE CA 92614 CLAIM PROCESSING FEES 272000 11 EMPLOYER CONTRIBUTIONS 900099 178071454 178071454 RETIREE AND PARTICIPANT CONTRIBUT 900099 17481917 17481917 GOV'T COBRA PREM REIMB. 900099 842568 842568 OTHER INCOME 900099 213050 213050 196608989 2018544 2018544 1293217 0 1293217 1293217 1293217 199920750 196608989 0 3311761 186610883 3026576 210910 115569 56760 377621 399077 368307 265450 9958 8063 58455 131344 191638973 23810746 24136223 90596 83389 256695886 270846738 191000 191000 139797 111558 280928025 295368908 334348 271540 221013469 227622418 221347817 227893958 X 0 0 0 0 59580208 67474950 59580208 67474950 280928025 295368908 8281777 -387035 0 X X 0 1 X 1 0 0 ESTIMATED LIABILITY FOR MEDICAL, HOSPITAL, VISION PLAN AND DENTAL CLAIMS 47707000 ESTIMATED LIABILITY UNDER GROUP INSURANCE CONTRACTS 6658000 ESTIMATED FUTURE BENEFITS BASED ON PARTICIPANTS' HOUR BANK PLAN 59800000 BENEFIT IMPREST ACCOUNTS AND OTHER 132099 SUPPLEMENTAL RETIREMENT BENEFIT LIABILITY 113325319 227622418 X 199476955 -387035 -387035 199863990 56760 56760 199920750 190814213 0 190814213 56760 768000 824760 191638973 PART X, LINE 2: THE PLAN'S ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF MAY 31, 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. THE PLAN'S ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL YEARS PRIOR TO 2018. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS 768,000. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS CONTRACTED WITH THE IRONWORKERS EMPLOYEES' BENEFIT CORPORATION, INC. (IEBC), TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE A COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR OF THE IEBC BEFORE FILING THE FORM 990 WITH THE IRS AND AFTER APPROVAL OF THE AUDITED FINANCIAL STATEMENTS BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS ALL TRUSTEES OF THE PLAN. THE BOARD OF TRUSTEES HAS DISCRETIONARY AUTHORITY TO DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS AND TO VOTE ON THE PROPOSED TRANSACTION OR AGREEMENT. SUCH DETERMINATIONS ARE MADE WITHOUT THE INPUT OR PARTICIPATION OF THE CONFLICTED INDIVIDUAL. FORM 990, PART VI, SECTION C, LINE 19 ORGANIZATIONAL DOCUMENTS, FINANCIAL INFORMATION, AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE BY APPOINTMENT AT THE EXECUTIVE DIRECTOR'S OFFICE. PART VII, SECTION A, LINE 1A TRUSTEES ARE NOT COMPENSATED BY THE TRUST. COMPENSATION PAID TO TRUSTEES EMPLOYED BY OTHER RELATED ORGANIZATIONS IS REPORTED ON THE FORM 990 FILED WITH THE INTERNAL REVENUE SERVICE BY THE RELATED TAX-EXEMPT ORGANIZATIONS. IF YOU WOULD LIKE ADDITIONAL INFORMATION, PLEASE CONTACT THE TRUST OFFICE. FORM 990 PART XII - LINE 2B AND 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE ANNUAL AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THERE HAS BEEN NO CHANGE IN THIS PROCESS FROM PRIOR YEAR. FORM 990, PART V, LINE 2A: THE TRUST HAS NO EMPLOYEES. THE TRUST ISSUED W-2'S TO PARTICIPANTS THAT RECEIVED DISABILITY BENEFITS OR DISTRIBUTIONS FROM THE SUPPLEMENTAL RETIREMENT BENEFIT LIABILITY ACCOUNT DURING YEAR ENDED MAY 31, 2021. CALIFORNIA IRONWORKERS FIELD PENSION TRUST 131 N EL MOLINO AVENUE SUITE 330 PASADENA CA 91101 956042866 TO PROVIDE PENSION BENEFITS TO IRONWORKERS PARTICIPANTS CA 401 (A) NONE N/A 0 CALIFORNIA FIELD IRONWORKERS LABOR MANAGEMENTS CO-OP TRUST 990 RESERVE DRIVE SUITE 104 ROSEVILLE CA 95678 943168117 TO PROMOTE RELATIONS BETWEEN MANAGEMENT AND LABOR CA 501 (C) NONE N/A 0 CALIFORNIA FIELD IRON WORKERS VACATIONPERSONAL TIME OFF (PTO) PLAN 131 N EL MOLINO AVENUE SUITE 330 PASADENA CA 91101 956042867 TO PROVIDE VACATION BENEFITS TO IRONWORKER PARTICIPANTS CA 501 (C) NONE N/A 0 CALIFORNIA FIELD IRONWORKERS APPRENTICE TRAINING & JOURNEYMAN RETRAINING 131 N EL MOLINO AVENUE SUITE 330 PASADENA CA 91101 956042917 TO PROVIDE TRAINING TO IRONWORKERS APPRENTICES CA 501 (C) NONE N/A 0 IRONWORKERS WORKERS COMPENSATION TRUST 131 N EL MOLINO AVENUE SUITE 330 PASADENA CA 91101 436895772 TO PROVIDE ASSISTANCE TO IRONWORKERS REGARDING WORKERS COMPENSATION CA 501 (C) NONE N/A 0 CALIFORNIA FIELD IRON WORKERS ADMINISTRATIVE TRUST 1909 CAPITOL AVE STE 202 SACRAMENTO CA 95811 946313717 TO PROMOTE WORK OF THE FIELD IRONWORKERS INDUSTRY CA 501 (C) NONE N/A 0 CIECDCIW MARKET RETENTION COMMITTEE 990 RESERVE DRIVE SUITE 104 ROSEVILLE CA 95678 680414047 TO ACTIVELY PARTICIPATE IN THE ENHANCEMENT OF UNIONIZED CONSTRUCTION CA 501 (C) NONE N/A 0 CALIFORNIA IRONWORKERS FIELD DEFINED CONTRIBUTION PENSION TRUST FUND 131 N EL MOLINO AVENUE SUITE 330 PASADENA CA 91101 953304279 TO PROVIDE FINANCIAL ASSISTANCE UPON RETIREMENT. CA 401 (A) NONE N/A 0 IRONWORKERS WORKERS LOCAL #75 950 E ELWOOD ST PHOENIX AZ 85040 860029434 MEMBER REPRESENTATION AZ 501(C)(5) NONE N/A 0 IRONWORKERS WORKERS LOCAL #118 2840 EL CENTRO RD SACRAMENTO CA 95833 940340157 MEMBER REPRESENTATION CA 501(C)(5) NONE N/A 0 IRONWORKERS WORKERS LOCAL #155 5407 E OLIVE AVE 106 FRESNO CA 93727 940578605 MEMBER REPRESENTATION CA 501(C)(5) NONE N/A 0 IRONWORKERS WORKERS LOCAL #229 5155 MERCURY POINT SAN DIEGO CA 92111 330281624 MEMBER REPRESENTATION CA 501(C)(5) NONE N/A 0 IRONWORKERS WORKERS LOCAL #377 570 BARNEVELD AVE SAN FRANCISCO CA 94124 940577195 MEMBER REPRESENTATION CA 501(C)(5) NONE N/A 0 IRONWORKERS WORKERS LOCAL #378 3120 BAYSHORE RD BENICIA CA 94510 950577193 MEMBER REPRESENTATION CA 501(C)(5) NONE N/A 0 IRONWORKERS WORKERS LOCAL #416 PO BOX 1166 NORWALK CA 90651 951141502 MEMBER REPRESENTATION CA 501(C)(5) NONE N/A 0 IRONWORKERS WORKERS LOCAL #433 17495 HURLEY STREET EAST INDUSTRY CA 91744 951272140 MEMBER REPRESENTATION CA 501(C)(5) NONE N/A 0 DISTRICT COUNCIL OF IRONWORKERS OF THE STATE OF CA AND VICINITY 1660 SAN PABLO AVENUE ROOM C PINOLE CA 94564 941252975 MEMBER REPRESENTATION CA 501(C)(5) NONE N/A 0 IRONWORKERS EMPLOYEES' BENEFIT CORPORATION 131 N EL MOLINO AVENUE SUITE 330 PASADENA CA 91101 953084599 PAYS COMMON ADMINISTRATIVE EXPENSES CA C 0.56000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 IRONWORKERS EMPLOYEES' BENEFIT CORPORATION P 5029000 BASED ON A COST ALLOCATION STUDY SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS: THE FILING ORGANIZATION IS A HEALTH AND WELFARE PLAN THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF MAY 31, 2021, THERE ARE APPROXIMATELY 527 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 ORPORATION 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 NAMES 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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