2022-11-09T13:22:43-06:00 2021-12-31 470900880 CALIBRE CPA GROUP PLLC 7501 WISCONSIN AVENUE SUITE 1200 WEST BETHESDA MD 20814 990 2021-01-01 956042873 JOINT BOARD OF TRUSTEES SOUTHWEST CARPENTERS HEALTH AND WELFARE TRUST SOUT 2133868590 533 SOUTH FREMONT AVENUE LOS ANGELES CA 90071 PETE RODRIGUEZ TRUSTEE 2133868590 2022-11-09 1 PETE RODRIGUEZ 999009999 SCOTT E HALLBERG CPA P01081188 2023319880 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z PETE RODRIGUEZ 533 SOUTH FREMONT AVENUE LOS ANGELES CA 90071 576626871 0 X CARPENTERSSW.ORG X 1955 CA TO PROVIDE MEDICAL AND RELATED BENEFITS 15 0 0 0 0 0 0 0 456883316 439054167 12559853 5462846 71092 286948 469514261 444803961 0 0 358580555 367349311 0 0 0 0 0 16003715 16331867 374584270 383681178 94929991 61122783 578112268 651095092 21900400 27780101 556211868 623314991 TO PROVIDE MEDICAL AND RELATED BENEFITS TO PARTICIPANTS AND THEIR QUALIFYING DEPENDENTS IN ACCORDANCE WITH THE TRUST AGREEMENT. 0 0 TO PROVIDE MEDICAL AND RELATED BENEFITS TO 31,701 PARTICIPANTS AND THEIR QUALIFYING DEPENDENTS IN ACCORDANCE WITH THE TRUST AGREEMENT. 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 376 0 1 0 0 0 0 0 0 0 0 0 X 15 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 CA X CARPENTERS SOUTHWEST ADMIN CORP 2133868590 533 SOUTH FREMONT AVENUE LOS ANGELES CA 90071 Curtis Conyers Jr Trustee 1.00 X 0 0 0 Kim Fromer Trustee 1.00 X 0 0 0 Richard Harris Trustee 1.00 X 0 0 0 Clint Larison Trustee 1.00 X 0 0 0 Bert Lewitt Trustee 1.00 X 0 0 0 Calvin Yoshida Trustee 1.00 X 0 0 0 Anthony Rosetti Trustee 1.00 X 0 0 0 Tony Cornell Trustee 1.00 X 0 0 0 Pete Rodriguez Trustee 1.00 40.00 X 0 261271 95601 Josh Raper Trustee 1.00 40.00 X 0 155751 69713 Jacob Lopez Trustee 1.00 40.00 X 0 157240 69713 Sean Hartranft Trustee 1.00 40.00 X 0 157571 69713 Barry Jenkins Trustee 1.00 40.00 X 0 235311 89058 Daniel Langford Trustee 1.00 40.00 X 0 350135 118896 Frank Hawk Trustee 1.00 40.00 X 0 263160 101125 Mercy Urrea Former Trustee 1.00 40.00 X 0 217191 64554 Travis Winsor Former Trustee 1.00 X 0 0 0 Steve Jones Former Trustee 1.00 X 0 0 0 0 1797630 678373 0 0 1 0 ANTHEM BLUE CROSS OF CALIFORNIA PO BOX 629 WOODLAND HILLS CA 90071 MEDICAL CLAIMS PROCESSING 9202895 CARPENTERS SOUTHWEST ADMINISTRATIVE CORP 533 SOUTH FREMONT AVENUE LOS ANGELES CA 90071 ADMINISTRATIVE SERVICES 5735886 EXPRESS SCRIPTS 100 PARSON POND DRIVE FRANKLIN LAKES NJ 07417 PRESCRIPTION DRUG PROCESSING FEES 872245 DECARLO SHANLEY ATTORNEYS AT LAW 533 SOUTH FREMONT AVENUE LOS ANGELES CA 90071 LEGAL 552013 COMPSYCH EMPLOYEE ASSISTANCE 455 N CITYFRONT PLAZA DRIVE CHICAGO IL 60611 EMPLOYEE ASSISTANCE SERVICE 506287 6 EMPLOYER CONTRIBUTIONS 900099 434042752 434042752 COBRA Premium Assistance 900099 3052227 3052227 PARTICIPANT CONTRIBUTIONS 900099 1797818 1797818 LIQUIDATED DAMAGES 900099 161370 161370 439054167 9543863 9543863 127741893 131822910 -4081017 -4081017 -4081017 OPEN ENROLLMENT AND CONSUMERISM E 900099 285510 285510 OTHER REVENUE 900099 1438 1438 286948 444803961 439341115 0 5462846 367349311 3192285 772688 40000 198281 11716332 311156 7304 89761 DUES AND SUBSCRIPTIONS 4060 383681178 76371377 83039752 37344374 36983053 28044 49374 460522337 409349437 117586837 3846136 4086639 578112268 651095092 714300 558509 21186100 27221592 21900400 27780101 X 0 0 0 0 556211868 623314991 556211868 623314991 578112268 651095092 61122783 5980340 0 X X 0 1 X 1 0 0 U.S. EQUITY PRIVATE PLACEMENT 117586837 F 117586837 ESTIMATED LIABILITY FROM CLAIMS IBNR 27120400 Due to Carpenters Southwest Administrative Corporation 101192 27221592 X 450586020 5980340 5980340 444605680 198281 198281 444803961 377548597 0 377548597 198281 5934300 6132581 383681178 Part X, Line 2: The trust established under the Plan to hold the Plan's assets is qualified pursuant to Section 501(c)(9) of the Internal Revenue Code (IRC) as a tax exempt organization. The Plan has obtained a favorable determination letter from the Internal Revenue Service and the Plan Sponsor believes that the Plan, as amended, continues to qualify and to operate in accordance with applicable provisions of the IRC. Therefore, 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 if the Plan has taken an uncertain position that more likely than not would not be sustained upon examination by the taxing authorities. 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: INCREASE IN ESTIMATED LIABILITY FOR CLAIMS IBNR 5,934,300. 0 0 0 Daniel Langford Trustee 0 350135 0 0 0 0 0 102192 0 16704 0 469031 0 0 Frank Hawk Trustee 0 263160 0 0 0 0 0 84421 0 16704 0 364285 0 0 Pete Rodriguez Trustee 0 261271 0 0 0 0 0 78897 0 16704 0 356872 0 0 Barry Jenkins Trustee 0 235311 0 0 0 0 0 72354 0 16704 0 324369 0 0 Mercy Urrea Former Trustee 0 217191 0 0 0 0 0 49770 0 14784 0 281745 0 0 Sean Hartranft Trustee 0 157571 0 0 0 0 0 53009 0 16704 0 227284 0 0 Jacob Lopez Trustee 0 157240 0 0 0 0 0 53009 0 16704 0 226953 0 0 Josh Raper Trustee 0 155751 0 0 0 0 0 53009 0 16704 0 225464 0 0 Form 990, Part VI, Section B, line 11b FORM 990 IS REVIEWED BY THE ADMINISTRATOR PRIOR TO FILING, AND AFTER APPROVAL OF THE AUDITED FINANCIAL STATEMENTS BY THE BOARD OF TRUSTEES . Form 990, Part VI, Section C, line 19 ORGANIZATIONAL DOCUMENTS AND FINANCIAL INFORMATION ARE AVAILABLE BY APPOINTMENT AT THE ADMINISTRATORS OFFICE. Form 990, Part XII, Line 2c THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. SOUTHWEST CARPENTERS PENSION TRUST 533 SOUTH FREMONT AVENUE LOS ANGELES CA 90071 956042875 TO PROVIDE PENSION BENEFITS CA 501(A) 0 SOUTHWEST CARPENTERS TRAINING TRUST 533 SOUTH FREMONT AVENUE LOS ANGELES CA 90071 952106266 TO PROVIDE EDUCATION BENEFITS CA 501(c)(5) 0 SOUTHWEST CARPENTERS VACATION TRUST 533 SOUTH FREMONT AVENUE LOS ANGELES CA 90071 956042279 TO PROVIDE VACATION BENEFITS CA 501(c)(9) 0 UNITED BROTHERHOOD OF CARPENTERS AND JOINERS OF AMERICA SW REGIONAL COUNCIL CABINET MAKERS LOC 721 CALIFORNIA DEPT OF CORREC CARP INTERNATIONAL TRNG F CARPENTERS LOCAL #1319 CARPENTERS LOCAL #1607 CARPENTERS LOCAL #1912 CARPENTERS LOCAL #1977 CARPENTERS LOCAL #213 CARPENTERS LOCAL #562 CARPENTERS LOCAL #619 CARPENTERS LOCAL #661 CARPENTERS LOCAL #714 CARPENTERS LOCAL #805 CARPENTERS LOCAL #909 CARPENTERS LOCAL #951 CARPENTERS-CONTRS COOP CO CITY OF LOS ANGELES COUNTY OF LOS ANGELES COUNTY OF LOS ANGELES ART MUSEUM LOS ANGELES DEPT OF WATER & POWER UNITED BROTHERHD CARP-CET UNITED BRTHRD 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