2025-01-27T16:43:55-06:00 2024-03-31 410746749 CLIFTONLARSONALLEN LLP 5335 MEADOWS RD 300 LAKE OSWEGO OR 97035 990 2023-04-01 911106482 CEMENT MASONS AND PLASTERERS HEALTH AND WELFARE TRUST CEME 2064417574 PO BOX 34203 SEATTLE WA 98124 ERIC COFFELT CHAIRMAN 2064419386 2025-01-21 1 0 MICHAEL MEAD CPA P01893207 5032240860 2025-01-21 2023 2025-03-06 01:10:19Z ERIC COFFELT 6362 6TH AVE S SEATTLE WA 98108 33395101 0 X N/A X 1980 WA TO PROVIDE HEALTH AND WELFARE BENEFITS TO QUALIFIED PARTICIPANTS 12 3 20 13 0 0 0 0 21860425 20988444 610512 840641 452302 445265 22923239 22274350 0 0 21768610 16446407 0 0 0 0 0 1608686 2356293 23377296 18802700 -454057 3471650 35177344 38952692 13589605 12762674 21587739 26190018 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 1 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 1 540 0 1 20 1 0 0 0 0 0 0 0 0 X 12 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 CORY YALOWICKI TRUSTEE 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 1.00 X 0 0 0 RAYMOND DUMAS TRUSTEE 1.00 X 0 0 0 BOB TIMMONS END 1123 TRUSTEE 1.00 X 0 0 0 DON MALONE START 324 TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 WPAS INC PO BOX 34203 SEATTLE WA 98124 ADMINISTRATION SERVICES 945420 AETNA INC 151 FARMINGTON AVENUE HARTFORD CT 06156 CLAIMS PROCESSING 307504 ZELIS CLAIMS INTEGRITY LLC 2 CROSSROADS DR BEDMINSTER NJ 07921 CLAIMS ADMINISTRATION 298143 3 EMPLOYER CONTRIBUTIONS 900099 19588312 19588312 RETIREE CONTRIBUTIONS 900099 1273220 1273220 EMPLOYEE CONTRIBUTIONS 900099 126912 126912 20988444 860102 860102 11101290 11120751 -19461 -19461 -19461 FORMULARY REBATES 900099 407184 407184 LIQUIDATED DAMAGES 900099 38081 38081 445265 22274350 21433709 0 840641 16446407 2008746 35540 81607 63223 61044 58649 8437 1309 11191 17061 DUES, REGISTRATIONS AND 9486 18802700 3479304 4585352 1394253 1654322 2625991 3322913 7519 7827 24799362 26333649 2870915 3048629 35177344 38952692 214315 197115 13375290 12565559 13589605 12762674 X 0 0 0 0 21587739 26190018 21587739 26190018 35177344 38952692 3471650 1130629 0 X X 0 1 X 1 0 0 REAL ASSET INCOME 3048629 F 3048629 CLAIMS PAYABLE 414859 ACCUMULATED ELIGIBILITY CREDITS 9666700 CLAIMS INCURRED BUT NOT REPORTED 2484000 12565559 X 23341756 1130629 1130629 22211127 63223 63223 22274350 19549208 0 19549208 63223 -809731 -746508 18802700 PART X, LINE 2: THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF MARCH 31, 2023, 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 CLAIMS PAYABLE 266787. CHANGE IN ACCUMULATED ELIGIBILITY CREDITS -512518. CHANGE IN INCURRED BUT NOT REPORTED CLAIMS -564000. FORM 990, PART VI, SECTION A, LINE 1A 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 SERVICE, 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. FORM 990, PART IX, LINE 4 THE PLAN PROVIDES TAXABLE TIME LOSS BENEFITS TO ELIGIBLE PARTICIPANTS AND REPORTS THOSE BENEFITS ON FORM W-2. THESE BENEFITS ARE INCLUDED ON FORM 990, PART IX, LINE 4. OPCMIA LOCAL 528 6362 6TH AVE S SEATTLE WA 98108 910222689 SUPPORTING LOCAL WA 501(C)(5) N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTI-EMPLOYER TRUST THAT PROVIDES HEALTH BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF MARCH 31, 2024, THERE ARE APPROXIMATELY 184 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 CORPORATION OR TRUST) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATION 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. A.C.S. A-1 LANDSCAPING & CONSTRUCTION, INC. ABOVE & BEYOND ACME CONCRETE PAVING AECON PACIFIC AIR PLACED CONCRETE AK TROWEL TRADES ALASKA FOUNDATION ALBRECHT BIRKENBUEL, INC. ALCAL SPECIALTY AMERICAN BRIDGE CO. ANCHOR CONCRETE ANDERSEN STRUCTURE LLC ANNING-JOHNSON COMPANY APC INDUSTRIAL FLOORING INC ARTECTOR INC ARTISTIC CONCRETE ASCENDENT LLC, MLA ASI STRUCTURES LLC B ANDERSON CONST, INC. BELARDE CONSTRUCTION INC BELSHIRE CONCRETE BLACKFISH CIVIL BLUE CONCRETE, LLC BOUTEN CONSTRUCTION CO CALIBER CONCRETE CONSTRUCTION CAMERON REILLY LLC CAPSTONE STRUCTURES CASCADE DRILLING LP CECO CONCRETE CONSTRUCTION CELL-CRETE CORPORATION CEMENT MASONS INSTRUCTOR BILLING CEMENT MASONS LOCAL 72 CLARK PACIFIC CLEMENTS GENENERAL CONSTRUCTION INC CODY JAMES CONSTRUCTION COLBECK & COMPANY COLE CONCRETE LLC COMBINED CONSTRUCTION COMPASS CONSTRUCTION LLC CONCRETE RESTORATION CONCRETE STRATEGIES CONTECH SERVICES INC CRJ CONCRETE LLC. D L HENRICKSEN CONSTRUCTION DAY & ZIMMERMAN NPS DEGERSTROM N.A., INC. DENALI CONCRETE INC DIAMOND POLISHING SYST DIXON STUDIOS LLC ELITE CONSTRUCTION EXTERIORS PLUS NORTHWEST LLC F.D. THOMAS, INC FAIRWEATHER MASONRY CO FDT STRUCTURAL SPC LLC FICKLIN CONSTRUCTION FINISHING EDGE LLC FIVE STAR CONCRETE INC FLATIRON WEST INC FLOORING SOLUTIONS LLC FOUR SEASONS CONCRETE CONSTRUCTION LLC FOWLER GENERAL CONSTRUCTION FPC CONSTRUCTION LLC FRANKLIN PACIFIC CONSTRUCTION FRYER-KNOWLES INC GARCO CONSTRUCTION INC GARY MERLINO CONSTRUCTION CO GENERAL CONSTRUCTION COMPANY GLY CONSTRUCTION GRAHAM CONTRACTING LTD GRANITE CONSTRUCTION CO GRAYHAWK CONSTRUCTION GRIFFIN FOUNDATION GUY F ATKINSON HARBOR PACIFIC HB HANSEN CONSTRUCTION HENSEL PHELPS CONSTRUCTION CO HIGHMARK CONCRETE CONTRACTORS LLC HOFFMAN STRUCTURES INC HOWARD S WRIGHT CONSTRUCTORS INDUSTRIAL CONCRETE INTERWEST CONSTRUCTION INC J & K CONCRETE J.H. KELLY LLC J+V DRYWALL & PLASTER JANSEN INC JEM CONTRACTORS JETT CONCRETE JIM JOHNSON CEMENT JOHN WAYNE CONSTRUCTION CO JOS J JEFFERSON & SON INC. KASSEL & ASSOCIATES KIEWIT HOFFMAN AJV KIEWIT INFRA WEST CO. KING CONCRETE CO INC KRAEMER NORTH AMERICA KT CONTRACTING KULCHIN FOUNDATION KUNEY CO LAMB CONTRACTING, MLA LANE CONSTRUCTION CORP LARGO CONCRETE LARUSSO CONCRETE LASER UNDERGROUND & EARTHWORKS, INC. LEASE CRUTCHER LEWIS LEROY NEWTON CONSTRUCTION LLC LIGHTNING CONCRETE LLC LNC STRUCTURES, LLC LOCAL 867 CEMENT MASON APPRENTICESHIP SCHOOL LUNDEEN SIMONSON INC M A MORTENSON CO MACK & SONS CONCRETE MALONE CONSTRUCTION CO MASS EXCAVATION INC MCCLONE CONSTRUCTION CO. MICHELS CONSTRUCTION MIDDLETON CONSTTRUCTION, INC. MIDMOUNTAIN CONTRACTORS, INC. MILLER & SONS INC MITCHELL CONCRETE LLC MJ HUGHES CONSTRUCTION MOUNTAIN VIEW CONCRETE MQI CONTRACT FLOORING NATIONAL PLASTERING INDUSTRY NORKOTE, INC NPIJATF - OPCMIA JOB O-CO CONCRETE CONSTRUCTION LLC OJEDA BUSINESS OLYMPIC CONCRETE FINISHING INC OMEGA GENERAL INC. OPCMIA LOCAL 72 PATCHWORKS CONCRETE PAVING PRODUCTS INC PCL CONSTRUCTION SERVICES INC PERFORMANCE CONTRACTING, INC. PERIMETER SECURITY PHAMPENA INC PLASTERING PLUS NW PNW CUSTOM CONCRETE LLC PORT OF SEATTLE PRECISION CONCRETE LLC PRECISION PRECAST PROSPECT CONSTRUCTION, INC. R.L. ALIA COMPANY RAILWORKS TRACK SYSTEMS, LLC. RAINIER CONCRETE CONSTRUCTION INC REIGN CITY SERVICES, LLC ROJAS PLASTERING LLC RX CONCRETE LLC SAK BUILDERS INC SALINAS CONSTRUCTION INC SASQUATCH CONCRETE RESTORATION LLC SB STRUCTURES LLC SEBASTIAN GC INC. SELBY BRIDGE INC SELLEN CONSTRUCTION INC SHAWN CANEPA CONTRACTORS SILMAN INDUSTRIES SKANSKA USA BLDG INC STACY & WITBECK KUNEY STARCH CONCRETE STREAMLINE GENERAL CONSTRUCTION, LLC SUMMIT SEALANTS INC SUPERIOR STUCCO SERVICES SWALLING GENERAL CONTRACTORS LLC THE CONCO COMPANIES TRANSPORTATION SYSTEMS TURNER CONSTRUCTION CO TYEE CONCRETE CONSTRUCTION INC UNIPRO W WA CEMENT MASONS WALSH CONSTRUCTION CO II LLC WASTE TREATMENT WEST COAST CONCRETE RESTORATION, LLC WESTERN PARTITIONS INC WESTERN SPECIALTY CONTRACTORS WESTERN WASHINGTON CEMENT MASONS J.A.T.C. WESTERN WATERPROOFING WILLIAM WINKLER WILLIAMS PLANT SERVICES, LLC WILSON CONCRETE CONSTRUCTION INC ZAVALA CORPORATION ZEMEK CONSTRUCTION