2021-10-06T15:15:37-05:00 2020-12-31 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2020-01-01 946078226 AUTOMOTIVE INDUSTRIES WELFARE FUND AUTO 8006353105 4160 DUBLIN BOULEVARD NO 400 DUBLIN CA 945687756 JIM BENO SECRETARY 8006353105 2021-10-06 1 JIM BENO 999009999 JESSICA R ROSTER P01317380 9252779100 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z JIM BENO 4160 DUBLIN BOULEVARD NO 400 DUBLIN CA 945687756 102760428 0 X N/A X 1956 CA TO PROVIDE HEALTH AND WELFARE BENEFITS. 8 0 149 0 0 0 0 0 55494187 54482144 973295 1415263 0 0 56467482 55897407 0 0 50527774 46323127 0 140396 0 0 0 2499070 2291075 53026844 48754598 3440638 7142809 41178897 49462087 3668206 2717774 37510691 46744313 TO PROVIDE HEALTH AND WELFARE BENEFITS. 0 0 PROVIDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER COLLECTIVE BARGAINING AGREEMENTS. 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 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 30 0 1 149 1 0 0 0 0 0 0 0 0 X 8 0 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X HEALTH SERVICES & BENEFITS ADMINISTRATORS INC 8006353105 4160 DUBLIN BOULEVARD 400 DUBLIN CA 945687756 X DON CROSATTO TRUSTEE 1.00 X 0 0 0 STEPHEN MACK TRUSTEE 1.00 X 0 0 0 JOHN DIBERNARDO TRUSTEE 1.00 X 0 0 0 RICH MORALES TRUSTEE 1.00 X 0 0 0 JIM BENO SECRETARY 2.00 X 0 0 0 TOM DILLON CHAIRMAN 2.00 X 0 0 0 RYAN THIBODEAU TRUSTEE 1.00 X 0 0 0 JIM SCHWANTZ TRUSTEE 1.00 X 0 0 0 CHARLES BESOCKE FUND MANAGER 40.00 X 177246 0 43820 SEE SCHEDULE O FOR COMPENSATION PAID BY RELATED ORGANIZATIONS 0.00 X 0 1 0 177246 1 43820 1 0 1 0 HEALTH SERVICES & BENEFIT ADMINISTRATORS 4160 DUBLIN BLVD SUITE 400 DUBLIN CA 94568 ADMINISTRATION 1071677 LINDQUIST LLP 5000 EXECUTIVE PKWY SUITE 400 SAN RAMON CA 94583 AUDIT 233377 ANTHEM BLUE CROSS 11050 OLSON DR SUITE 110 RANCHO CORDOVA CA 95670 CLAIMS PROCESSING 229212 THE SEGAL COMPANY 120 MONTGOMERY ST SAN FRANCISCO CA 94104 CONSULTING 162761 DELTA DENTAL OF CALIFORNIA 100 FIRST STREET SAN FRANCISCO CA 94105 CLAIMS PROCESSING 137017 5 EMPLOYER CONTRIBUTIONS 900099 53500854 53500854 STOP LOSS REIMBURSMENT 900099 413400 413400 PRESCRIPTION REBATES 900099 290933 290933 PARTICIPANT CONTRIBUTIONS 900099 244028 244028 LIQUIDATED DAMAGES 900099 32929 32929 54482144 647406 647406 47630878 46863021 767857 767857 767857 55897407 54482144 0 1415263 46323127 106862 12000 14292 7242 1082747 31553 233376 62877 592567 211234 1629 75092 48754598 11848298 17132153 374644 60529 25023 32639 28930932 32236766 41178897 49462087 805128 590045 2863078 2127729 3668206 2717774 X 0 0 0 0 37510691 46744313 37510691 46744313 41178897 49462087 7142809 2090813 0 X X 0 1 X 1 0 0 ACCUMULATED ELIGIBILITY CREDITS 200000 BENEFIT CLAIMS PAYABLE AND IBNR 1927729 2127729 X 57925343 2090813 2090813 55834530 62877 62877 55897407 49447885 0 49447885 62877 -756164 -693287 48754598 PART X, LINE 2: THE PLAN'S ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF DECEMBER 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'S ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL YEARS PRIOR TO 2017. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS X 0 0 0 CHARLES BESOCKE FUND MANAGER 177246 0 0 0 0 0 20000 0 23820 0 221066 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE TRUST HAS CONTRACTED WITH HEALTH SERVICES AND BENEFIT ADMINISTRATORS TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY WHO REVIEW THE RETURN PRIOR TO BEING FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE, OFFICER AND MANAGEMENT EMPLOYEE WITH DELEGATED POWERS WHO CAN INFLUENCE THE ACTIONS OF AUTOMOTIVE INDUSTRIES WELFARE FUND IS COVERED UNDER THE CONFLICT-OF-INTEREST POLICY. IF A CONFLICTING INTEREST EXISTS, THE PERSON WITH THE CONFLICT IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT-OF-INTEREST POLICY AND FINANCIAL INFORMATION AVAILABLE TO THE PUBLIC AND THE ORGANIZATION'S MEMBERS UPON REQUEST. PART VII, SECTION A, LINE 1A: TRUSTEES ARE NOT COMPENSATED BY THE TRUST. COMPENSATION PAID TO TRUSTEES EMPLOYED BY 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, HEALTH SERVICES & BENEFIT ADMINISTRATORS. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT AUDITOR. THERE HAS BEEN NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. FORM 990, PART XI, LINE 7: THE REPORTABLE COMPENSATION REPORTED ON PART VII FOR CHARLES BESOCKE INCLUDES TOTAL COMPENSATION OF $177,246 FOR SERVICES PROVIDED TO VARIOUS AUTOMOTIVE INDUSTRIES TRUST FUNDS, INCLUDING AUTOMOTIVE INDUSTRIES WELFARE FUND. THE COMPENSATION ALLOCATED TO THE AUTOMOTIVE INDUSTRIES WELFARE FUND OF $106,862 IS REPORTED ON PART XI STATEMENT OF FUNCTIONAL EXPENSES. AUTOMOTIVE INDUSTRIES PENSION PLAN 4160 DUBLIN BOULEVARD NO 400 DUBLIN CA 945687756 941133245 TO PROVIDE PENSION BENEFITS CA 501(A) N/A N/A 0 CMTA-IAM JOINT RETIREE HEALTH & WELFARE TRUST 4160 DUBLIN BOULEVARD NO 400 DUBLIN CA 945687756 946130509 TO PROVIDE HEALTH BENEFITS CA 501(C)(9) 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, IDENTIFICATION OF 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 DECEMBER 31, 2020, THERE ARE APPROXIMATELY 166 EMPLOYERS AND VARIOUS SPONSORING ORGANIZATIONS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS AND VARIOUS SPONSORING ORGANIZATIONS, 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 AND VARIOUS SPONSORING ORGANIZATION IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT, THE NAMES OF THE CONTRIBUTING EMPLOYERS AND VARIOUS SPONSORING ORGANIZATIONS ARE LISTED ON PART VII BELOW AND NOT ON PARTS II THROUGH IV BY FEDERAL TAX CLASSIFICATION. A & B DIE CASTING A & H TRUCK REPAIR A TEICHERT & SON INC AB & I FOUNDRY AB CAR RENTAL SERVICES, INC. ACE TRUCK REPAIR AFSCME DISTRICT COUNCIL #57 AKIMA LOGISTICS SERVICES LL ALAMEDA COUNTY INDUSTRIES ALBANY FORD SUBARU ALLISON BMW ANTIOCH AUTO CENTER ARAMARK UNIFORM SERVICES, I ASHLOCK CO ATLAS PACIFIC ENGINEERING CO AUDI OF STEVENS CREEK AUTO METAL SERVICE AUTOMOTIVE APPRENTICE TRUST BABBITT BEARING COMPANY BAY LINE CONCRETE CUTTING & CORING BENNER AUTO REPAIR, INC. BERKELEY FARMS BILL BRANDT FORD - DISABILITY PLAN BOB MOTTERS BODY SHOP, INC. C H BULL CO CAIETTIS TRUCK REPAIR CAL BODY STEEL FORMING CALIFORNIA CONFERENCE OF MACHINISTS CALIFORNIA TANK LINES, INC CALIFORNIA WASTE SOLUTIONS CAPITAL MACHINE CORPORATION CARGILL SALT CEMEX CENTRAL CONCRETE SUPPLY CO, INC CENTRAL CONTRA COSTA TRANSIT CHUCK'S BRAKE AND WHEEL CLUTCH & BRAKE XCHANGE, INC COAST COUNTIES TRUCK & EQUIP COCA COLA BOTTLING CO COLE EUROPEAN (ALL OTHER HIRE>7/1/98) COMMERCIAL SPEEDOMETER SERVICE COMMERCIAL TRUCK CO CON GLOBAL INDUSTRIES (CGI) CORNELY CO CUMMINS PACIFIC, LLC CUSTOM ALIGNMENT D W NICHOLSON CORP DARLING INTERNATIONAL, INC. DIAMOND MFG CORP DIEGO TRUCK REPAIR, INC. DONAL MACHINE INC DRILL TECH DRILLING & SHORING, INC EARTHGRAINS EAST BAY CLARKLIFT - ALL JOURNEYMAN EURO-AM AUTO SERVICE FIRST STUDENT INC FRED'S BODY SHOP, INC. FRESNO TRUCK CENTER FRITZ & PETERS G & H DIESEL SERVICE, INC. G & M AUTOBODY, INC. GEIGER MFG, INC GENUINE MOTORS LLC GEORGE MC GILLS BODY SHOP-NONCONTRACT GLENCORE RECYCLING INC GOLDEN GATE TRANSIT GOLDEN GATE TRUCK CENTER G-P CORPORATION, INC. GRANITE ROCK CO #17072 GREYHOUND LINES-HOUSTON, TX H W MC KEVITT CO INC HALLOWELL CHEVROLET HAYWARD FORD,INC-INSTRLS,STCKRM,ETC HECO-PACIFIC MFG INC HEDRICK'S COLLISION CENTER HONDA OF EL CERRITO HONDA OF OAKLAND HUBBARD MACHINE SHOP I A OF M LOCAL 1101 I A OF M LOCAL 1173 I A OF M LOCAL 1584 I A OF M LOCAL 653 I A OF M LODGE 1546 I A OF M LODGE 190 I A OF M LODGE 2182 I A OF M LODGE 725 IAM & AW LOCAL LODGE 93 INDUSTRIAL MACHINE SHOP JACOBS TECHNOLOGY INC KOEHLER AUTO BODY WORKS L P MCNEAR BRICK CO LEE'S FORKLIFT SERVICE LEHIGH SOUTHWEST CEMENT CO LEHMER'S LESTER G LAWRENCE & SON VOLVO LIBERTY FLEET CARE LIVERMORE SANITATION, INC. MAGNUSSEN TOYOTA OF PALO ALTO MARTINEZ AUTO BODY SHOP MERITOR INC MILL VALLEY REFUSE SERVICE, INC MV TRANSPORTATION INC NATIONAL AEROSPACE SOLUTIONS NELSON BODY SHOP - JOURNEYMAN NOEL MILLER INC - NON CONTRACT NOVATO AUTO CENTER OAKLAND MACHINE WORKS PACIFIC AUTO REPAIR INC PACIFIC POWER GROUP PALM AVENUE MOTORS PAR 3 MOTORS INC PARKER ROBB CHEVROLET PBA MAINTENANCE PENINSULA AUTO MACHINISTS #1414 PENINSULA FORD OF SUNNYVALE PENSKE TRUCK LEASING PETALUMA ACQUISITIONS, LLC PETER PAN MOTORS PETKARRIS, INC PLEASANTON TRUCK & EQUIPMENT REPAIR PRECISION STRIPPING & COATING PROFESSIONAL AUTO CARE PUMP REPAIR SERVICE CO RAIL TERMINAL SERVICES RALPH PANELLA LEASING RECTOR MOTOR CAR REPUBLIC SERVICES RODNEY DUTRA SERVICE RUAN TRANSPORT CORP RYDER TRUCK RENTAL INC SAFEWAY STORES INC. SAN FRANCISCO HONDA SAN JOSE DIE CASTING & MACHINING SAN LEANDRO AUTO SAN PABLO AUTOMOTIVE SUPPLY SANTA CLARA CO AUTO APPRENT TRUST SARDEE INDUSTRIES INC SERRAMONTE FORD INC SFO SHUTTLE BUS CO SHAMROCK MATERIALS INC SIERRA LOBO CORP SILGAN CONTAINER CORP-MODESTO SIMS RECYCLING SOLUTIONS SOUTH BAY AFL-CIO LABOR COUNCIL SPECIALTY DISTRIBUTORS SSA TERMINALS-OAKLAND ONLY ST FRANCIS ELECTRIC STEVENS CREEK BMW STEWART CHEVROLET SYAR INDUSTRIES INC. THERMA SERVICES LLC TOYOTA MATERIAL HANDLING TOYOTA OF VALLEJO TRI CITY BODY & PAINT UNITED PARCEL SERVIC- LOCAL 0801 VALLEY RESTORATION VAN BEBBER BROS VERIFLO CORP VIEIRA'S VALLEY EQUIPMENT CO VINCENT WHITNEY WALSH STATION AUTO SERVICE WASTE MANAGEMENT OF ALAMEDA COUNTY WESTERN GRINDING SERVICE INC WINTER CHEVROLET WORKING PARTNERSHIP USA YANG ENTERPRISES, INC.