2020-02-14T17:51:20-06:00 2019-03-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2018-04-01 911106482 CEMENT MASONS AND PLASTERERS HEALTH AND WELFARE TRUST CEME 2064417574 PO BOX 34203 SEATTLE WA 98124 ERIC COFFELT CHAIRMAN 2064419386 2020-02-04 1 MICHAEL MEAD CPA P00006300 4252506100 2020-02-04 67.137.57.251 2020-02-04 17:09:19 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 6DFCD1967819CE616E4FF511662B8C57821E54A4 2018 2020-11-06 18:47:13Z ERIC COFFELT 6362 6TH AVE S SEATTLE WA 98108 34453311 0 X N/A X 1980 WA TO PROVIDE HEALTH AND WELFARE BENEFITS TO QUALIFIED PARTICIPANTS 10 10 14 10 0 0 0 0 16579951 2655481 299205 368762 297791 299867 17176947 3324110 0 0 15813880 17617399 0 0 0 0 0 1052026 1288338 16865906 18905737 311041 -15581627 20753774 22778001 11632847 12533539 9120927 10244462 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 1 461 0 1 14 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X ADAM KECK-WELFARE & PENSION ADMINISTRATION 2064417574 7525 SE 24TH ST 200 MERCER ISLAND WA 98040 X X FRANK BENISH TRUSTEE 1.00 X 0 0 0 JOHN SALINAS TRUSTEE 1.00 X 0 0 0 ERIC COFFELT CHAIR/TRUSTEE 1.00 X X 0 0 0 JOSEPH HANNAN TRUSTEE (FORMER) 0.50 X 0 0 0 GARRETT CONDEL SECRETARY/TRUSTEE 1.00 X X 0 0 0 ANDREW LEDBETTER 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 JOHN KEARNS TRUSTEE (FORMER) 0.50 X 0 0 0 0 0 0 0 0 0 0 WPAS INC PO BOX 34203 SEATTLE WA 98124 ADMINISTRATION SERVICES 679652 AETNA INC 151 FARMINGTON AVENUE HARTFORD CT 06156 CLAIMS PROCESSING 255081 2 EMPLOYEE CONTRIBUTIONS 900099 1213237 1213237 RETIREE CONTRIBUTIONS 900099 1213237 1213237 EMPLOYER CONTRIBUTIONS 900099 229007 229007 2655481 411476 411476 31086487 31129201 -42714 -42714 -42714 FORMULARY REBATES 900099 283767 283767 LIQUIDATED DAMAGES 900099 16100 16100 299867 3324110 2955348 0 368762 17617399 962549 105406 35439 31396 64470 47043 7306 809 1976 9245 DUES, REGISTRATIONS AND 10658 BANK FEES 9885 LOST WAGES 2156 18905737 139034 111183 841568 949332 2388736 2402274 3492 2786 17380944 19312426 20753774 22778001 273847 354039 11359000 12179500 11632847 12533539 X 0 0 0 0 9120927 10244462 9120927 10244462 20753774 22778001 -15581627 216759 0 X X 0 1 X 1 0 0 LAG MONTH ELIGIBILITY COVERAGE 2416000 ACCUMULATED ELIGIBILITY CREDITS 6906000 CLAIMS INCURRED BUT NOT REPORTED 2857500 12179500 X 19987991 216759 216759 19771232 41281 41281 19812513 18030990 0 18030990 41281 833466 874747 18905737 PART X, LINE 2: THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF MARCH 31, 2019, 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 441000. CHANGE IN ACCUMULATED ELIGIBILITY CREDITS 1084000. CHANGE IN INCURRED BUT NOT REPORTED CLAIMS -704500. CHANGE IN PREMIUMS PAYABLE 12966. 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 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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