TEAMSTERS 206 EMPLOYERS TRUST: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- TEAMSTERS 206 EMPLOYERS TRUST (EIN 93-6027865)
- Tax period
- 2019-08-01 to 2020-07-31
- Filed
- 2021-05-15
- IRS object ID
- 202101359349303015
- Schema version
- 2019v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-05-15T17:20:51-05:00 | ReturnTs |
| Tax Period End | 2020-07-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 931015766 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BJORKLUND & MONTPLAISIR CPA'S | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9020 SW WASHINGTON SQ RD SUITE 46 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97223 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-08-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 936027865 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TEAMSTERS 206 EMPLOYERS TRUST | BusinessNameLine1Txt |
| Business Name Line2 | BOARD OF TRUSTEES | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | TEAM | BusinessNameControlTxt |
| Phone | 5032386961 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 NE MULTNOMAH STREET SUITE 350 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 972324197 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GENE BLACKBURN | PersonNm |
| Person Title | TRUSTEE | PersonTitleTxt |
| Phone | 5032386961 | PhoneNum |
| Signature | 2021-05-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RICHARD A LAYNE | PreparerPersonNm |
| PTIN | P00359754 | PTIN |
| Phone | 5036436400 | PhoneNum |
| Preparation | 2021-05-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | GENE BLACKBURN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1860 NE 162ND AVE | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97230 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $38,413,014 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Type Of Organization Trust | Yes (X) | TypeOfOrganizationTrustInd |
| Formation | 1958 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE HEALTH AND WELFARE BENEFITS TO PLAN PARTICIPANTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $35,342,623 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $34,041,734 | CYProgramServiceRevenueAmt |
| PY Investment Income | $919,237 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,026,114 | CYInvestmentIncomeAmt |
| CY Other Revenue | $5,303 | CYOtherRevenueAmt |
| PY Total Revenue | $36,261,860 | PYTotalRevenueAmt |
| CY Total Revenue | $35,073,151 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $32,444,603 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $29,629,038 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,299,493 | PYOtherExpensesAmt |
| CY Other Expenses | $1,342,007 | CYOtherExpensesAmt |
| PY Total Expenses | $33,744,096 | PYTotalExpensesAmt |
| CY Total Expenses | $30,971,045 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,517,764 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,102,106 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $40,271,585 | TotalAssetsBOYAmt |
| Total Assets EOY | $45,723,043 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,127,734 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,342,812 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $35,143,851 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $41,380,231 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE HEALTH AND WELFARE BENEFITS TO PLAN PARTICIPANTS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Desc | PROVIDE HEALTH AND WELFARE BENEFITS TO PLAN PARTICIPANTS. | Desc |
| Described In Section501c3 | false | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 595 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NORTHWEST ADMINISTRATORS INC | PersonNm |
| Phone | 5034166901 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 NE MULTNOMAH | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97232 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (3 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| GENE BLACKBURN | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| THOMAS LEEDHAM | ||||||
| TRUSTEE/CHAI | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| DONA PIERCY | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| NORTHWEST ADMINISTRATORS INC | |||||
| 700 NE MULTNOMAH ST SUITE 350 | PORTLAND | OR | 972324197 | ADMINISTRATION | $452,781 |
| CIGNA | |||||
| 701 5TH AVE | SEATTLE | WA | 98104 | MEDICAL MANAGMT | $348,054 |
| MODA HEALTH | |||||
| 601 SW SECOND | PORTLAND | OR | 97204 | CLAIMS ADMINITR | $151,026 |
| MILLER NASH GRAHAM DUNN LLP | |||||
| 111 SW 5TH AVENUE | PORTLAND | OR | 97201 | LEGAL COUNSEL | $149,736 |
| WILLIAM LACOUR LLC | |||||
| 6146 CHURCHILL DOWNS DRIVE | WEST LINN | OR | 97068 | CONSULTANT | $119,212 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| EMPLOYER CONTRIBUTIONS | $31,601,418 | $31,601,418 |
| PARTICIPANT CONTRIBUTIONS | $2,440,316 | $2,440,316 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $34,041,734 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,024,054 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,024,054 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,341,923 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,339,863 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,060 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,060 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,060 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LITIGATION SETTLEMENT | Desc |
| Total Revenue Column | $5,303 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,303 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $5,303 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,073,151 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $35,073,151 | RelatedOrExemptFuncIncomeAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,629,038 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $162,981 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,833 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,975 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,027,506 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,834 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,065 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,813 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,971,045 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,937 | BOYAmt |
| EOY | $10,721 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,269,549 | BOYAmt |
| EOY | $6,031,263 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,940,272 | BOYAmt |
| EOY | $2,334,217 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,602 | BOYAmt |
| EOY | $8,243 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,436,522 | BOYAmt |
| EOY | $36,836,499 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $570,703 | BOYAmt |
| EOY | $502,100 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,271,585 | BOYAmt |
| EOY | $45,723,043 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,576 | BOYAmt |
| EOY | $123,287 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,057,158 | BOYAmt |
| EOY | $4,219,525 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,127,734 | BOYAmt |
| EOY | $4,342,812 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,143,851 | BOYAmt |
| EOY | $41,380,231 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,143,851 | BOYAmt |
| EOY | $41,380,231 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,271,585 | BOYAmt |
| EOY | $45,723,043 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $4,102,106 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,134,274 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| INSURANCE PREMIUMS PAYABLE | $1,853,859 |
| CLAIMS INCURRED BUT NOT PAID | $1,450,000 |
| CLAIMS PAYABLE FOR MEDICAL BENEFITS | $915,666 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,219,525 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $37,142,450 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $2,134,274 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $2,134,274 | RevenueNotReportedAmt |
| Revenue Subtotal | $35,008,176 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $64,975 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $64,975 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $35,073,151 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $31,743,703 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $837,633 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $837,633 | ExpensesNotReportedAmt |
| Expenses Subtotal | $30,906,070 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $64,975 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $64,975 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $30,971,045 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 4, PART XII, LINE 2D | FormAndLineReferenceDesc |
| Explanation | CHANGE IN BENEFIT OBLIGATIONS 837,633 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | FORM 990 IS REVIEWED BY THE PLAN'S LEGAL COUNSEL AND THIRD PARTY ADMINISTRATOR, AND PRESENTED TO THE BOARD OF TRUSTEES FOR REVIEW BEFORE FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE TRUSTEES AND SERVICE PROVIDERS ARE EXPECTED TO DISCLOSE ANY POTENTIAL OR ACTUAL CONFLICT OF INTEREST UPON DISCOVERY. IT WILL THEN BE REVIEWED BY THE PLAN'S LEGAL COUNSEL. |
| FORM 990, PAGE 6, PART VI, LINE 15A | NO COMPENSATION IS PAID. |
| FORM 990, PAGE 6, PART VI, LINE 15B | NO COMPENSATION IS PAID. |
| FORM 990, PAGE 6, PART VI, LINE 19 | MADE AVAILABLE UPON REQUEST THROUGH THE PLAN'S THIRD PARTY ADMINISTRATOR. ALSO AVAILABLE AT WWW.GUIDESTAR.ORG |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|
| CITY OF BANDON | |
| N/A | false |
| CITY OF COQUILLE | |
| N/A | false |
| CITY OF REEDSPORT | |
| N/A | false |
| CITY OF TURNER | |
| N/A | false |
| CURRY COUNTY | |
| N/A | false |
| PORTLAND PUBLIC SCHOOLS | |
| N/A | false |
| WAREHOUSEMEN'S LOCAL | |
| N/A | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMALGAMATED SUGAR CO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Direct Controlling NA | N/A | DirectControllingNACd |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (24 entries)
| Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|
| ALASKAN COPPER & BRASS | |
| N/A | false |
| AMERICAN STEEL CORPORATION | |
| N/A | false |
| ARAMARK UNIFORM & CAREER APPAREL | |
| N/A | false |
| BAY AREA HOSPITAL | |
| N/A | false |
| BOYD COFFEE CO | |
| N/A | false |
| CALBAG METALS CO | |
| N/A | false |
| DISTRIBUTION INTERNATIONAL | |
| N/A | false |
| EARLE M JORGENSEN CO | |
| N/A | false |
| FOOD SERVICES OF AMERICA | |
| N/A | false |
| KROGER | |
| N/A | false |
| LEHIGH NORTHWEST CEMENT CO | |
| N/A | false |
| LOWER UMPQUA HOSPITAL | |
| N/A | false |
| MCDONALD WHOLESALE CO | |
| N/A | false |
| NATIONAL BISCUIT COMPANY | |
| N/A | false |
| OAK HARBOR FREIGHT | |
| N/A | false |
| REYES HOLDINGS | |
| N/A | false |
| SMART & FINAL | |
| N/A | false |
| SUPERVALU | |
| N/A | false |
| SYSCO PORTLAND INC | |
| N/A | false |
| UNIVAR SOLUTIONS USA | |
| N/A | false |
| VALLEY CREST FOODS INC | |
| N/A | false |
| VERITIV | |
| N/A | false |
| VIKING AUTOMATIC SPRINKER CO | |
| N/A | false |
| WANKE CASCADE DISTRIBUTION LTD | |
| N/A | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |