2021-02-10T18:33:10-06:00 2020-03-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2019-04-01 911106482 CEMENT MASONS AND PLASTERERS HEALTH AND WELFARE TRUST CEME 2064417574 PO BOX 34203 SEATTLE WA 98124 ERIC COFFELT CHAIRMAN 2064419386 2021-02-02 1 MICHAEL MEAD CPA P01893207 4252506100 2021-02-01 2019 2022-09-23 18:48:47Z ERIC COFFELT 6362 6TH AVE S SEATTLE WA 98108 59073791 0 X N/A X 1980 WA TO PROVIDE HEALTH AND WELFARE BENEFITS TO QUALIFIED PARTICIPANTS 10 3 18 10 0 0 0 0 2655481 20109179 368762 549120 299867 277538 3324110 20935837 0 0 17617399 14894809 0 0 0 0 0 1288338 1441477 18905737 16336286 -15581627 4599551 22778001 25982793 12533539 11502365 10244462 14480428 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 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 1 476 0 1 18 1 0 0 0 0 0 0 0 0 X 10 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 LARRY WHITE 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 THOMAS PARSONS TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 WPAS INC PO BOX 34203 SEATTLE WA 98124 ADMINISTRATION SERVICES 749794 AETNA INC 151 FARMINGTON AVENUE HARTFORD CT 06156 CLAIMS PROCESSING 301045 BCMJ PS 1325 FOURTH AVENUE SUITE 910 SEATTLE WA 98101 ATTORNEY 130466 3 EMPLOYER CONTRIBUTIONS 900099 18560235 18560235 RETIREE CONTRIBUTIONS 900099 1314769 1314769 EMPLOYEE CONTRIBUTIONS 900099 234175 234175 20109179 472862 472862 38214212 38137954 76258 76258 76258 FORMULARY REBATES 900099 259897 259897 LIQUIDATED DAMAGES 900099 17641 17641 277538 20935837 20386717 0 549120 14894809 1029181 157749 53582 37605 54782 59002 7500 710 8358 9454 BANK FEES 13813 DUES, REGISTRATIONS AND 8680 LOST WAGES 1061 16336286 111183 521617 949332 838332 2402274 2166017 2786 9655 19312426 22447172 22778001 25982793 354039 440365 12179500 11062000 12533539 11502365 X 0 0 0 0 10244462 14480428 10244462 14480428 22778001 25982793 4599551 -363585 0 X X 0 1 X 1 0 0 LAG MONTH ELIGIBILITY COVERAGE 2433000 ACCUMULATED ELIGIBILITY CREDITS 6650000 CLAIMS INCURRED BUT NOT REPORTED 1979000 11062000 X 20520834 -363585 -363585 20884419 51418 51418 20935837 17345056 0 17345056 51418 -1060188 -1008770 16336286 PART X, LINE 2: 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 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 LAG MONTHS ELIGIBILITY COVERAGE 17000. CHANGE IN ACCUMULATED ELIGIBILITY CREDITS -256000. CHANGE IN INCURRED BUT NOT REPORTED CLAIMS -878500. CHANGE IN PREMIUMS PAYABLE 57312. FORM 990, PART VI, SECTION A, LINE 1 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, 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. 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