2021-11-09T18:51:53-06:00 2020-12-31 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2020-01-01 936024141 OREGON LABORERS - EMPLOYERS HEALTH & WELFARE TR FUND OREG 5032825581 12029 NE GLENN WIDING DR PORTLAND OR 97220 JAMES WATTS TRUSTEE 5032825581 2021-11-09 1 JAMES WATTS 999009999 JAMES N BROWNING P01451906 9252779100 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z JAMES WATTS 17230 NE SACRAMENTO ST 201 PORTLAND OR 97230 76611490 0 X N/A X 1954 OR PROVIDE HEALTH AND WELFARE BENEFITS 6 2 0 0 0 0 0 0 38768794 41087555 1933507 326829 0 0 40702301 41414384 0 0 34356689 29120585 0 0 0 0 0 2399076 2532715 36755765 31653300 3946536 9761084 32197514 41505382 17067243 15364011 15130271 26141371 PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 PROVIDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 1 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 5 0 1 0 0 0 0 0 0 0 0 0 X 6 2 0 1 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 X WC EARHART CO 5032825581 12029 NE GLENN WIDING DR PORTLAND OR 97220 X JEFF GRITZ TRUSTEE 0.50 X 0 0 0 ZACK CULVER TRUSTEE 0.50 X 0 0 0 JAMES R WATTS TRUSTEE 0.50 X 0 0 0 KELLY DIXON TRUSTEE 0.50 X 0 0 0 BOB TIMMONS TRUSTEE 0.50 X 0 0 0 BEN NELSON TRUSTEE 0.50 X 0 0 0 SEE SCHEDULE O FOR COMPENSATION PAID BY RELATED ORGANIZATIONS 0.00 X 0 1 0 0 1 0 0 0 0 0 REGENCE BLUE CROSS BLUE SHIELD 100 SW MARKET STREET PORTLAND OR 972015702 CLAIMS ADMINISTRATION 1376972 WILLIAM C EARHART CO INC PO BOX 4148 PORTLAND OR 97208 THIRD PARTY ADMINISTRATIVE FEES 362559 OREGON LABORERS-EMPLOYERS ADMIN LLC 12029 NE GLENN WIDING DR PORTLAND OR 97220 COORDINATOR EXPENSE 166904 MILLIMAN INC 1455 SW BROADWAY ST STE 1600 PORTLAND OR 97201 CONSULTING 144215 4 EMPLOYER CONTRIBUTIONS 900099 38246761 38246761 PARTICIPANT CONTRIBUTIONS 900099 1701104 1701104 PRESCRIPTION REBATES 900099 1035016 1035016 MEDICARE PART D SUBSIDY 900099 104674 104674 41087555 319677 319677 35204258 35197106 7152 7152 7152 41414384 41087555 0 326829 29120585 338436 112080 55400 109247 1688091 96215 853 20135 NAT'L HEALTH AND SAFETY 104965 OTHER EXPENSES 7293 31653300 356221 501534 3471263 3501089 875 17873788 26134009 10496242 11367875 32197514 41505382 357243 392011 16710000 14972000 17067243 15364011 X 0 0 0 0 15130271 26141371 15130271 26141371 32197514 41505382 9761084 1250016 0 X X 0 1 X 1 0 0 COMMON/COLLECTIVE TRUST FUNDS 11367875 F 11367875 ACCUMULATED ELIGIBILITY CREDITS 13134000 CLAIMS PAYABLE AND IBNR 1838000 14972000 X 42555153 1250016 1250016 41305137 109247 109247 41414384 33282053 0 33282053 109247 -1738000 -1628753 31653300 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE THE TAX POSITIONS TAKEN BY THE PLAN AND TO RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN 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 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 FORM 990, PART VI, SECTION A, LINE 3 THE PLAN HAS CONTRACTED WITH WILLIAM C. EARHART CO., INC. TO PROVIDE DAY-TO-DAY ADMINISTRATIVE SERVICES TO THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 8B THE BOARD OF TRUSTEES DOES NOT HAVE COMMITTEES THAT ACT ON ITS BEHALF. FORM 990, PART VI, SECTION B, LINE 11B ALL MEMBERS OF THE BOARD OF TRUSTEES REVIEWED THE FORM 990 PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, 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 INTERAL REVENUE SERVICE BY THE RELATED TAX-EXEMPT ORGANIZATION. IF YOU WOULD LIKE ADDITONAL INFORMATION, PLEASE CONTACT THE THIRD-PARTY ADMINISTRATOR, WILLIAM C. EARHART. CO. FORM 990, PART XII , LINE 2C: THE BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSIGHT OF THE ANNUAL AUDIT AND FOR SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. OREGON LABORERS - EMPLOYERS PENSION PLAN 12029 NE GLENN WIDING DR PORTLAND OR 97220 936075363 TO PROVIDE PENSION BENEFITS OR 501(A) N/A N/A 0 OREGON LABORERS-EMPLOYERS DEFINED CONTRIBUTION AND 401(K) PLAN 12029 NE GLENN WIDING DR PORTLAND OR 97220 276434385 TO PROVIDE PENSION BENEFITS OR 501(A) N/A N/A 0 OREGON AND SOUTHERN IDAHO LABORERS - EMPLOYERS TRAINING TRUST 12029 NE GLENN WIDING DR PORTLAND OR 97220 204626312 TO PROVIDE TRAINING BENEFITS OR 501(C)3 N/A N/A 0 OREGON AND SOUTHERN IDAHO DISTRICT COUNCIL OF LABORERS 17230 NE SACRAMENTO ST 201 PORTLAND OR 97230 930144236 LABOR ORGANIZATION OR 501(C)5 N/A N/A 0 LABORERS INTERNATIONAL UNION LOCAL 483 1125 SE MADISON ST SUITE 206 PORTLAND OR 97214 930169132 LABOR ORGANIZATION OR 501(C)5 N/A N/A 0 LABORERS LOCAL 737 17230 NE SACRAMENTO ST 201 PORTLAND OR 97230 474408911 LABOR ORGANIZATION OR 501(C)5 N/A N/A 0 LABORERS UNION LOCAL 155 465 W 17TH ST IDAHO FALLS ID 83402 820411490 LABOR ORGANIZATION ID 501(C)5 N/A N/A 0 OREGON LABORERS ADMINISTRATIVE LLC 12029 NE GLENN WIDING DR PORTLAND OR 97220 830431313 ADMINISTRATIVE SERVICES OR NA - THERE ARE 3 EQUAL PARTNERS RELATED 139944 0 0 0.33330 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 OREGON LABORERS ADMINISTRATIVE LLC M 166904 OBTAINED FROM THE PLAN'S RECORDS. SCHEUDLE 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 272 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS, 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 IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. 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