2021-11-02T13:06:07-05:00 2020-12-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2020-01-01 930864012 INLANDBOATMEN'S UNION OF THE PACIFIC NATIONAL HEALTH BENEFIT TRUST INLA 5032240048 5608 17TH AVE NW NO 131 SEATTLE WA 98107 LEE EGLAND CO-CHAIRMAN 5032240048 2021-11-02 1 LEE EGLAND 999009999 MICHAEL T MEAD CPA P01893207 4252506100 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z LEE EGLAND 5608 17TH AVE NW NO 131 SEATTLE WA 98107 47470538 0 X OURBENEFITOFFICE.COM/IBU/BENEFITS/HEALTHCARE.ASPX X 1984 WA TO PROVIDE HEALTH AND WELFARE BENEFITS TO QUALIFIED PARTICIPANTS 10 10 45 12 0 0 0 0 30436151 30315353 910216 1136245 15560 24388 31361927 31475986 0 0 25356254 25863307 0 0 0 0 0 1602559 1612255 26958813 27475562 4403114 4000424 41361374 47935844 10624123 13241035 30737251 34694809 TO PROVIDE HEALTH AND WELFARE BENEFITS TO QUALIFIED PARTICIPANTS. 0 0 DISBURSEMENTS NEEDED TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AS SPECIFIED IN 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 4 0 1 45 1 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 X LEE CENTRONE 5032240048 5331 S MACADAM AVE 220 PORTLAND OR 97239 X X LEE EGLAND CO-CHAIR 0.50 X X 0 0 0 JAY UBELHART CO-CHAIR 0.50 X X 0 0 0 MICHAEL ANDERSON TRUSTEE 0.50 X 0 0 0 JOHN SKOW TRUSTEE 0.50 X 0 0 0 MATT HAINLEY TRUSTEE 0.50 X 0 0 0 BRIAN DODGE TRUSTEE 0.50 X 0 0 0 MIKE O'CONNOR TRUSTEE 0.50 X 0 0 0 PETER HART TRUSTEE 0.50 X 0 0 0 PATRICK MURPHY TRUSTEE 0.50 X 0 0 0 ROBERT ESTRADA TRUSTEE 0.50 X 0 0 0 MARINA SECCHITANO CO-CHAIR - FORMER 0.50 X 0 0 0 DONOVAN DUNCAN TRUSTEE - FORMER 0.50 X 0 0 0 0 0 0 0 0 0 0 BENESYS INC 5331 S MACADAM AVE 220 PORTLAND OR 97205 ADMINISTRATION 742050 PREMERA BLUE CROSS 7001 220TH ST SW BUILDING 1 MOUNTLAKE TERRACE WA 98043 CLAIMS PAYER 370160 2 EMPLOYER CONTRIBUTIONS 900099 29887313 29887313 SELF PAY CONTRIBUTIONS 900099 428040 428040 30315353 808794 808794 16322003 15994552 327451 327451 327451 OTHER INCOME 900099 24388 24388 24388 31475986 30339741 0 1136245 25863307 1244135 14668 39673 108004 84875 28689 5069 38796 BANK FEES 48346 27475562 7177578 6373049 3890651 4202873 32325 63179 30260820 37296743 41361374 47935844 307088 279687 10317035 12961348 10624123 13241035 X 0 0 0 0 30737251 34694809 30737251 34694809 41361374 47935844 4000424 2041699 -2084565 0 X X 0 1 X 1 0 0 AMOUNTS DUE INSURANCE COMPANIES 1240996 LAG MONTHS ELIGILIBILITY COVERAGE 3131031 CLAIMS PAYABLE AND INCURRED BUT NOT REPORTED 4106749 PARTICIPANTS INDIVIDUAL ACCOUNTS 3770406 PARTICIPANTS SUPPLEMENTAL ACCOUNTS 712166 12961348 X 33409681 2041699 2041699 31367982 108004 108004 31475986 26436462 0 26436462 108004 931096 1039100 27475562 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN'S BOARD OF TRUSTEES 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 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: INCREASE IN BENEFIT OBLIGATIONS 559,748. EXPENSES FROM HRA PLAN 371,348. FORM 990, PART VI, SECTION A, LINE 8B THE GOVERNING BODY DID NOT DELEGATE AUTHORITY TO A COMMITTEE TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF TRUSTEES REVIEWS A DRAFT OF THE FORM 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE TRUSTEES ARE REQUIRED TO PROVIDE AN ANNUAL WRITTEN STATEMENT CONCERNING ANY CONFLICTS THEY ARE AWARE OF. FORM 990, PART VI, SECTION B, LINE 15 THE TRUST DOES NOT HAVE A COMPENSATED CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL. THE TRUST DOES REGULARLY REVIEW THE COMPENSATION TO ITS SERVICE PROVIDERS DURING THEIR BOARD MEETINGS. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN DOCUMENT, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PARTICPANTS AND PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1A, COLUMN (E): 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 ORGANIZATION. IF YOU WOULD LIKE ADDITIONAL INFORMATION, PLEASE CONTACT THE PLAN ADMINISTRATOR. FORM 990, PART XII LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM PRIOR YEARS. 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