2021-02-09T13:00:25-06:00 2020-03-31 208149084 ANASTASI MOORE & MARTIN PLLC 9 S WASHINGTON ST STE 600 SPOKANE WA 99201 990 2019-04-01 811094866 LABORERS AGC TRUST OF MONTANA HEALTH AND WELFARE LABO 5093280300 111 WEST CATALDO AVENUE NO 220 SPOKANE WA 99201 RICHARD J MORRISON CHAIRMAN 5093280300 2021-02-08 1 PAUL ANASTASI P00395796 5093230272 2021-02-04 2019 2022-09-23 18:48:47Z RICHARD J MORRISON 111 WEST CATALDO AVENUE NO 220 SPOKANE WA 99201 24829580 0 X N/A X 1961 MT PREMIUM AND BENEFIT PAYMENTS AND OTHER RELATED EXPENSES FOR MEDICAL, DENTAL, VISION, ACCIDENTAL DEATH AND DISMEMBERMENT, LIFE INSRUANCE, AND TIME LOSS BENEFITS. 6 5 20 5 0 0 0 0 15030961 12073716 355520 522547 34944 37374 15421425 12633637 0 0 12959878 9085457 0 0 0 0 0 832250 843924 13792128 9929381 1629297 2704256 16490728 16386741 2992934 1313468 13497794 15073273 PREMIUM AND BENEFIT PAYMENTS AND OTHER RELATED EXPENSES FOR MEDICAL, DENTAL, VISION, ACCIDENTAL DEATH AND DISMEMBERMENT, LIFE INSRUANCE, AND TIME LOSS BENEFITS. 0 0 TO PROVIDE QUALIFIED HEALTH AND WELFARE BENEFITS TO QUALIFIED PARTICIPANTS AND THEIR DEPENDENTS. 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 4 0 1 20 0 0 0 0 0 0 0 0 0 0 0 X 6 5 0 1 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X ZENITH AMERICAN SOLUTIONS INC 5093280300 111 WEST CATALDO AVENUE SUITE 220 SPOKANE WA 99201 RICHARD J MORRISON CHAIRMAN 1.00 X 0 0 0 WARREN SMELTZER SECRETARY 1.00 X 0 98107 0 NICK NEUMAN TRUSTEE 1.00 X 0 0 0 JO PERKINS TRUSTEE 1.00 X 0 0 0 KIM RICKARD TRUSTEE 1.00 X 0 0 0 MICKEY MULHOLLAND TRUSTEE 1.00 X 0 0 0 0 98107 0 0 0 0 0 ZENITH AMERICAN SOLUTIONS INC 111 EAST CATALDO AVENUE SUITE 220 SPOKANE WA 99201 THIRD PARTY ADMINISTRATOR 312163 PREMERA BLUE CROSS 7001 220TH STREET SOUTHWEST MOUNTLAKE TERRACE WA 98043 NETWORK ACCESS 280081 2 EMPLOYER CONTRIBUTIONS 900099 11785770 11785770 RETIREES CONTRIBUTIONS 900099 160551 160551 PARTICIPANTS CONTRIBUTION 900099 127395 127395 12073716 578059 578059 12140431 12195943 -55512 -55512 -55512 INCOME FROM PENALTIES AND 900099 37374 37374 37374 12633637 12111090 0 522547 9085457 602426 38121 53331 54324 37311 37234 12991 8186 9929381 4480094 1497195 285549 459883 1440834 961981 3802 4127 10256719 13407613 23730 55942 16490728 16386741 5744 1188 2987190 1312280 2992934 1313468 X 0 0 13497794 15073273 0 0 13497794 15073273 16490728 16386741 X 2704256 -1064098 -64679 X 0 1 X 0 0 0 CLAIMS PAYABLE 727570 CLAIMS INCURRED BUT NOT REPORTED 584710 1312280 X 11450536 -1064098 -64679 -1128777 12579313 54324 54324 12633637 11549967 0 11549967 54324 -1674910 -1620586 9929381 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS QUALIFIED PURSUANT TO THE APPROPRIATE SECTION OF THE INTERNAL REVENUE CODE (IRC) AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE PLAN HAS OBTAINED A FAVORABLE DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS), BUT HAS SINCE BEEN AMENDED. HOWEVER, THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC. THEREFORE, THEY BELIEVE THAT THE PLAN IS QUALIFIED, AND THE RELATED TRUST IS TAX-EXEMPT AS OF THE FINANCIAL STATEMENT DATES. ACCORDINGLY, 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 (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 ADMINISTRATOR 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 THE LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS AND THE PLAN COULD BE SUBJECT TO INCOME TAX IF CERTAIN ISSUES WERE FOUND BY THE IRS THAT COULD RESULT IN THE DISQUALIFICATION OF THE PLAN'S TAX-EXEMPT STATUS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: MEDICARE GAP REIMBURSEMENT -64,679. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN CLAIMS PAYABLE -672,793. CHANGE IN CLAIMS IBNR -1,002,117. FORM 990, PART VI, SECTION A, LINE 3 DAY TO DAY TASKS WERE DELEGATED TO A THIRD PARTY ADMINISTRATOR, ZENITH AMERICAN SOLUTIONS, INC. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED AND SIGNED BY THE CHAIRMAN OF THE BOARD OF TRUSTEES PRIOR TO FILING. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS THAT ARE AVAILABLE TO PUBLIC WILL BE SENT UPON REQUEST. FORM 990, PART XI, LINE 9: MEDICARE GAP REIMBURSEMENT -64,679. ANACONDA HOUSING AUTHORITY BERT MOONEY AIRPORT AUTHORITY BUTTE PUBLIC HOUSING AUTHORITY LIUNA LOCAL 1686 SUN RIVER VALLEY SCHOOL DIST THE MONTANA NURSES ASSOCIATION ABATEMENT CONTRACTORS OF MT COP CONSTRUCTION H & H CONTRACTING JEFFERY CONTRACTING LLC K & K ROOFING KISSOCK CONSTRUCTION PRECISION PIPELINE LLC WASLEY EXCAVATING LLC WHITE RESOURCES ADVANTAGE DIRT CONTRACTORS INC ANDERSON MASONRY INC AZCO INC BUTTE SILVER BOW CORVAL CONSTRUCTORS INC DRILL TECH DRILLING & SHORING ED BOLAND CONSTRUCTION GAGNON INC GWINNUP'S RESTORATION & ENV HOFFMAN EXCAVATING HOLLOW CONTRACTING INTERCON CONSTRUCTION INC (WY) JE DUNN CONSTRUCTION CO JAY FORTUNE CONSTRUCTION MICHELS PIPELINE CONST INC MOUNTAIN WEST HOLDING COMPANY NAES POWER CONTRACTORS INC PE BEN USA INC POTEET CONSTRUCTION INC PRECISION HIGHWAY CONTRACTORS PRICE GREGORY INTERNATIONAL S & N CONCRETE SLETTEN CONST TABBERT CONSTRUCTION US PIPELINE US TRINITY ENERGY LABOR SVC WELDTECH SERVICES INC WESTERN MUNICIPAL CONST WESTERN REFRACTORY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 CONTRIBUTIONS FROM TAX-EXEMPT ENTITIES AND ORGANIZATIONS S 918339 CASH CONTRIBUTIONS FROM EMPLOYERS TAXED AS PARTNERSHIPS S 2526913 CASH CONTRIBUTIONS FROM EMPLOYERS TAXED AS CORPORATIONS S 6781552 CASH