2021-01-12T19:11:30-06:00 2019-04-30 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2018-05-01 510200917 ALASKA PUBLIC SERVICE EMPLOYEES LOCAL UNION NO 71 TRUST FUND ALAS 9072767611 2510 ARCTIC BLVD ANCHORAGE AK 995032515 JORDAN ADAMS CHAIRMAN 9072767611 2020-12-03 1 MICHAEL T MEAD CPA P01893207 4252506100 2020-12-03 2018 2022-09-23 18:48:47Z X JORDAN ADAMS 2510 ARCTIC BLVD ANCHORAGE AK 99701 39555303 0 X LOCAL71.COM/BENEFITS X 1976 AK TO PROVIDE HEALTH AND WELFARE BENEFITS TO QUALIFIED PARTICIPANTS AS SPECIFIED IN THE PLAN. 5 5 0 6 0 0 0 0 37747805 38585669 1042163 871677 0 0 38789968 39457346 0 0 33352730 31586477 0 0 0 0 0 2917194 3477718 36269924 35064195 2520044 4393151 34448649 39768549 8576298 9086533 25872351 30682016 TO PROVIDE HEALTH AND WELFARE BENEFITS TO QUALIFIED PARTICPANTS OF THE PLAN 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO QUALIFIED PARTICIPANTS AS SPECIFIED IN THE PLAN 0 0 0 0 0 0 0 0 0 1 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 7 0 0 1 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 0 0 0 0 X ZENITH AMERICAN SOLUTIONS INC 2062824100 11724 NE 195TH ST SUITE 300 BOTHELL WA 98011 X X DENNIS MOEN CHAIRMAN - PAST 1.00 X X 0 0 0 WILLIAM MEERS TRUSTEE 1.00 X 0 0 0 JORDAN ADAMS CHAIRMAN 1.00 X X 0 0 0 MICHAEL WELANDER TRUSTEE 1.00 X 0 0 0 KRISTINA ROCHE TRUSTEE 1.00 X 0 0 0 ERIC CANADY TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 AETNA 601 UNION ST 810 SEATTLE WA 98101 INSURANCE PROVIDER 1882781 ZENITH AMERICAN SOLUTIONS INC 11724 NE 195TH ST STE 300 BOTHELL WA 98011 CLAIMS ADMIN SERVICES 677314 BEACON COALITION HEALTH CENTER 575 RIVERSTONE WAY FAIRBANKS AK 99709 CLAIMS ADMIN SERVICES 483406 AETNA 601 UNION ST 810 SEATTLE WA 98101 CLAIMS ADMIN SERVICES 418789 VISION SERVICE PLAN 3333 QUALITY DR RANCHO CORDOVA CA 95670 INSURANCE PROVIDER 199747 5 EMPLOYER CONTRIB. 900099 33023111 33023111 EMPLOYEE CONTRIB. 900099 5447207 5447207 COBRA 900099 115351 115351 38585669 835071 835071 134563 97957 36606 36606 36606 39457346 38585669 0 871677 31586477 918059 46580 16955 83748 108779 140724 12000 6343 31675 1250 38963 PPO & MANAGED CARE FEES 1490823 AETNA ADMIN FEE 400648 AK VACCINE ASSESSMENT F 120311 HEALTH FAIR 52704 8156 35064195 4778449 4945390 3387839 4755324 7093 18772 40903 39942 2211 961 26236050 30011238 37007 36864 34448649 39768549 300079 319322 8276219 8767211 8576298 9086533 X 0 0 0 0 25872351 30682016 25872351 30682016 34448649 39768549 4393151 416515 0 X X 0 1 X 1 0 40903 39942 961 961 CLAIMS PAYABLE 1233642 CLAIMS INCURRED BUT NOT REPORTED 7460000 PREMIUMS PAYABLE 46812 DUE TO RELATED PARTY 20301 DEFERRED CONTRIBUTIONS 6456 8767211 X 39790113 416515 416515 39373598 83748 83748 39457346 34451410 0 34451410 83748 529037 612785 35064195 PART X, LINE 2: 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 (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. 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 -10,607. CHANGE IN CLAIMS INCURRED BUT NOT REPORTED 675,000. CHANGE IN PREMIUMS PAYABLE -135,356. FORM 990, ITEM B THE 990 WAS AMENDED TO REFLECT THE FOLLOWING: PART VI, LINE 8B, AS ORIGINALLY FILED YES PART VI, LINE 8B, AS AMENDED NO PART VI, LINE 8B EXPLANATION IN SCHEDULE O: THE TRUST DOES NOT HAVE COMMITTEES THAT ACTS ON BEHALF OF THE GOVERNING BODY CHANGES MADE RELATED TO THE ORGANIZATION'S FINANCIAL STATEMENTS REFLECTED IN THE ISSUED AUDIT REPORT ARE SUMMARIZED BELOW: PART I, LINE 18, AS ORIGINALLY FILED 34,025,348 PART I, LINE 18, AS AMENDED 35,064,195 PART I, LINE 22, AS ORIGINALLY FILED 31,720,864 PART I, LINE 22, AS AMENDED 30,682,016 PART I, LINE 19, AS ORIGINALLY FILED 5,431,998 PART I, LINE 19, AS AMENDED 4,393,151 PART IX, LINE 4, AS ORIGINALLY FILED 30,727,003 PART IX, LINE 4, AS AMENDED 31,586,477 PART IX, LINE 24A, AS ORIGINALLY FILED 1,311,450 PART IX, LINE 24A, AS AMENDED 1,490,823 PART IX, LINE 25, AS ORIGINALLY FILED 34,025,348 PART IX, LINE 25, AS AMENDED 35,064,195 PART X, LINES 32 AND 33, AS ORIGINALLY FILED 31,720,864 PART X, LINES 32 AND 33, AS AMENDED 30,682,016 PART XI, LINE 2, AS ORIGINALLY FILED 34,025,348 PART XI, LINE 2, AS AMENDED 35,064,195 PART XI, LINE 3, AS ORIGINALLY FILED 5,431,998 PART XI, LINE 3, AS AMENDED 4,393,151 PART XI, LINE 10, AS ORIGINALLY FILED 31,720,864 PART XI, LINE 10, AS AMENDED 30,682,016 SCHEDULE D, PART X: LINE 1 (1), AS ORIGINALLY FILED 1,233,643 LINE 1 (1), AS AMENDED 1,233,642 LINE 1 (2), AS ORIGINALLY FILED 6,450,000 LINE 1 (2), AS AMENDED 7,460,000 LINE 1 (3), AS ORIGINALLY FILED 197,337 LINE 1 (3), AS AMENDED 46,812 SCHEDULE D, PART XII, LINE 1 AND 3, AS ORIGINALLY FILED 34,272,037 SCHEDULE D, PART XII, LINE 1 AND 3, AS AMENDED 34,451,410 SCHEDULE D, PART XII, LINE 4B, AS ORIGINALLY FILED (330,437) SCHEDULE D, PART XII, LINE 4B, AS ORIGINALLY AMENDED 529,037 SCHEDULE D, PART XII, LINE 5, AS ORIGINALLY FILED 34,025,348 SCHEDULE D, PART XII, LINE 5, AS ORIGINALLY AMENDED 35,064,195 SCHEDULE D, PART XIII: CHANGE IN CLAIMS PAYABLE AS ORIGINALLY FILED (10,606) CHANGE IN CLAIMS PAYABLE AS AMENDED (10,607) CHANGE IN CLAIMS INCURRED BUT NOT REPORTED, AS ORIGINALLY FILED (335,000) CHANGE IN CLAIMS INCURRED BUT NOT REPORTED, AS AMENDED 675,000 CHANGE IN PREMIUMS PAYABLE, AS ORIGNALLY FILED 15,169 CHANGE IN PREMIUMS PAYABLE, AS AMENDED (135,356) TOTAL, AS ORIGINALLY FILED (330,437) TOTAL, AS AMENDED 529,037 FORM 990, PART VI, SECTION A, LINE 8B THE TRUST DOES NOT HAVE COMMITTEES THAT ACTS ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE 990 IS PROVIDED TO THE FULL BOARD OF TRUSTEES FOR REVIEW AND DISCUSSION PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE TRUST ATTORNEY OBTAINS WRITTEN RESPONSES FROM TRUSTEES TO DETERMINE ANY ISSUES WITH RESPECT TO CONFLICT OF INTEREST. 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 WRITTEN REQUEST. 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 INTERNAL REVENUE SERVICE BY THE RELATED TAX EXEMPT ORGANIZATION. IF YOU WOULD LIKE ADDITIONAL INFORMATION, PLEASE CONTACT THE PLAN ADMINISTRATOR. FORM 990, PART XII, LINE 2C: THE PROCESS AND METHOD FOR SELECTING THE INDEPENDENT AUDITOR HAS NOT CHANGED FROM PRIOR YEARS. STATE OF ALASKA PUBLIC EMPLOYEES LOCAL 71 HAINES BOROUGH ANCHORAGE SCHOOL DISTRICT MUNICIPALITY OF ANCHORAGE 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 PUBLIC EMPLOYEES LOCAL 71 P 108801 CASH PUBLIC EMPLOYEES LOCAL 71 K 12000 CASH