2021-01-15T17:40:06-06:00 2020-03-31 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2019-04-01 916028570 LOCALS 302 & 612 INTL UNION OF OP ENG CONST IND HEALTH AND SECURITY PLAN LOCA 2064417574 PO BOX 34203 SEATTLE WA 981241203 DAREN KONOPASKI CHAIRMAN 2064417574 2021-01-15 1 TODD M STOKES P01451940 9252779100 2019 2022-09-23 18:48:47Z DAREN KONOPASKI PO BOX 34203 SEATTLE WA 981241203 229209505 0 X WWW.ENGINEERSTRUST.COM X 1953 WA PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS, THEIR DEPENDENTS AND RETIREES. 10 0 70 0 0 0 0 0 144265048 155669818 6896718 8776731 59328 31097 151221094 164477646 0 0 132711548 138405530 0 0 0 0 0 7308941 8149386 140020489 146554916 11200605 17922730 273666160 282589426 100721547 94009741 172944613 188579685 PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS, THEIR DEPENDENTS, AND RETIREES. 0 0 PROVIDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS, THEIR DEPENDENTS, AND RETIREES. 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 2558 0 1 70 1 0 0 0 0 0 0 0 0 X 10 0 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 1 0 0 0 X WELFARE & PENSION ADMINISTRATION SE 2064417574 7525 SE 24TH STREET SUITE 200 MERCER ISLAND WA 98040 X CURT KOEGEN TRUSTEE 1.00 X 0 0 0 MIKE TUCCI TRUSTEE 1.00 X 0 0 0 COREY CHRISTENSEN TRUSTEE 1.00 X 0 0 0 MIKE MILLER TRUSTEE 1.00 X 0 0 0 ANDREW LEDBETTER TRUSTEE/SECRETARY 1.00 X 0 0 0 DAREN KONOPASKI TRUSTEE/CHAIRMAN 1.00 X 0 0 0 TODD MICKELSON TRUSTEE 1.00 X 0 0 0 SEAN JEFFRIES TRUSTEE 1.00 X 0 0 0 MIKE LEE TRUSTEE 1.00 X 0 0 0 JASON ALWARD 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 WELFARE & PENSION ADMINISTRATION SERVICE PO BOX 34203 SEATTLE WA 98124 ADMINISTRATION 2119180 PREMERA 7001 220TH ST SW BUILDING 1 MOUNTLAKE TERRACE WA 98043 BENEFIT ADMINISTRATION 2054904 FIRST CHOICE HEALTH 600 UNIVERSITY STREET SUITE 1400 SEATTLE WA 98101 PPO NETWORK PROVIDER 557139 UNITED HEALTHCARE 7525 SE 24TH STREET MERCER ISLAND WA 98040 BENEFIT ADMINISTRATION 299712 RAEL & LETSON 999 THIRD AVENUE STE 1530 SEATTLE WA 98104 CONSULTANT 186225 8 EMPLOYER CONTRIBUTIONS 900099 128197947 128197947 PARTICIPANT CONTRIBUTIONS 900099 15531212 15531212 FORMULARY & OTHER REBATES 900099 11107620 11107620 EXPERIENCE RATED REFUND 900099 471931 471931 EGWP SUBSIDY 900099 361108 361108 155669818 8478029 8478029 65030561 64731859 298702 298702 298702 LEGAL FEES COLLECTED 900099 27087 27087 SEC. LITIGATION INC. 900099 4010 4010 31097 164477646 155696905 0 8780741 138405530 825552 173678 166955 518765 5675569 498554 10963 40196 33187 ALASKA VACCINE ASSESSME 163425 PCORI FEE 42542 146554916 15981798 19498953 8281049 10618232 15883407 16205628 9400 9700 208054424 209931592 25456082 26325321 273666160 282589426 1969574 464564 98751973 93545177 100721547 94009741 X 0 0 0 0 172944613 188579685 172944613 188579685 273666160 282589426 17922730 -2287658 0 X X 0 1 X 1 0 0 LIMITED PARTNERSHIP 26325321 F 26325321 ACCUMULATED ELIGIBILITY CREDITS 69569000 CLAIMS PAYABLE AND IBNR 23976177 93545177 X 161671223 -2287658 -2287658 163958881 518765 518765 164477646 151242947 0 151242947 518765 -5206796 -4688031 146554916 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE THE 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 INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF MARCH 31, 2020, 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 BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE YEARS PRIOR TO 2017. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION A, LINE 3 THE PLAN HAS CONTRACTED WITH WELFARE & PENSION ADMINISTRATION SERVICE, INC. TO PROVIDE DAY TO DAY ADMINISTRATIVE SERVICES TO THE PLAN. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 WILL BE REVIEWED BY THE TRUST CHAIRMAN FOR ACCURACY AND COMPLETENESS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1A: TRUSTEES ARE NOT COMPENSATED BY THE TRUST. COMPENSATION PAID TO TRUSTEES EMPLOYED BY THE OTHER RELATED ORGANIZATIONS IS REPORTED ON THE FORM 990 FILED WITH THE INTERNAL REVENUE SERVICE BY THE RELATED TAX-EXEMPT ORGANIZATION. IF YOU WOULD LIKE ADDITIONAL INFORMATION, PLEASE CONTACT THE THIRD-PARTY ADMINISTRATOR, WELFARE & PENSION ADMINISTRATION SERVICE, INC. FORM 990, PART V, LINE 2A: THE PLAN PROVIDES TAXABLE DISABILITY BENEFIT PAYMENTS TO ELIGIBLE PARTICIPANTS AND REPORTS THOSE BENEFITS ON FORM W-2. THESE BENEFITS ARE INCLUDED ON FORM 990, PART IX, LINE 4. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A BOARD OF TRUSTEES THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED. WESTERN WA OPERATING ENGINEERS - EMPLOYERS TRAINING TRUST 16921 VANTAGE HIGHWAY ELLENSBURG WA 98926 916134083 TO PROVIDE TRAINING BENEFITS WA 501(C)3 9 N/A 0 LOCALS 302 & 612 OF THE IUOE RETIREMENT PLAN PO BOX 34203 SEATTLE WA 981241203 916028571 TO PROVIDE PENSION BENEFITS WA 501(A) N/A N/A 0 INTL UNION OF OPERATING ENGINEERS LOCAL 302 18701 120TH AVENUE NE BOTHELL WA 980119514 910257483 LABOR UNION WA 501(C)5 N/A N/A 0 INTL UNION OF OPERATING ENGINEERS LOCAL 612 1555 SOUTH FAWCETT AVENUE TACOMA WA 98401 910268531 LABOR UNION WA 501(C)5 N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE R, RELATED ORGANIZATIONS: THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF MARCH 31, 2020, THERE ARE APPROXIMATELY 538 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 ADMINISTATIVE 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 1 ALLIANCE GEOMATICS 509 EXCAVATING, LLC A & L CONSTRUCTION A & M CONTRACTORS, LLC A MILLICAN CRANE SERV A-1 LANDSCAPING & CONS AAA CONTRACTORS INC AAA VALLEY GRAVEL ABERCROMBIE PIPE LN SE ABLE ENGINEERING SVCS ABM ENGINEERING SERV ABSHER CONSTRUCTION CO ACCURATE ENTERPRISES ACME CONCRETE PAVING ACTIVE CONST INC ADMIRALTY CONSTRUCTION ADVANCED AMERICAN ADVANCED BLASTING ADVANCED EXCAVATING ADVANTAGE DIRT AGOSTINO CONSTRUCTION AHBL, INC. 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