2020-05-11T18:34:27-05:00 2019-06-30 208149084 ANASTASI MOORE & MARTIN PLLC 9 S WASHINGTON ST STE 600 SPOKANE WA 99201 990 2018-07-01 916068079 NORTHWEST IRONWORKERS HEALTH AND SECURITY PLAN NORT 2064417574 P O BOX 34203 SEATTLE WA 98124 JEFF ILENSTINE CHAIRMAN 2064417574 2020-05-11 1 PAUL J ANASTASI CPA P00395796 5093230272 2020-05-11 209.210.95.36 2020-05-11 14:00:54 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 ABDBB1FB2412B365B21685C41D82161133A37AFF 2018 2020-11-19 02:30:22Z P O BOX 34203 SEATTLE WA 98124 142316912 0 X N/A X 1966 WA HEALTH BENEFITS FOR PARTICIPANTS. 16 16 51 16 0 0 0 0 44594796 52333293 1683945 741593 6602 32564 46285343 53107450 0 0 50781660 42201211 0 0 0 0 0 3247908 3504824 54029568 45706035 -7744225 7401415 46999375 49284881 44094238 33214786 2905137 16070095 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS OF THE PLAN. 0 0 45706035 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS OF THE PLAN. 45706035 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 1 1 0 1 1516 0 1 51 1 0 0 0 0 0 0 0 0 0 0 X 16 16 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X WELFARE & PENSION ADMINISTRATION SERVICE INC 2064417574 7525 SOUTHEAST 24TH STREET SUITE MERCER ISLAND WA 98040 X JEFF ILENSTINE CHAIRMAN 1.00 0.00 X X 0 0 0 STEVE PENDERGRASS SECRETARY 1.00 0.00 X X 0 0 0 KEN CARR TRUSTEE 1.00 0.00 X 0 0 0 ROBERT DECKER TRUSTEE 1.00 0.00 X 0 0 0 DICK DEVRIES TRUSTEE 1.00 0.00 X 0 0 0 ALLAN HARDING TRUSTEE 1.00 0.00 X 0 0 0 DAVE HARRISON TRUSTEE 1.00 0.00 X 0 0 0 KEVIN PATTERSON TRUSTEE 1.00 0.00 X 0 0 0 JOE BOWERS TRUSTEE 1.00 0.00 X 0 0 0 GREG GALES TRUSTEE 1.00 0.00 X 0 0 0 ROBERT KORTH TRUSTEE 1.00 0.00 X 0 0 0 ANTHONY LADD TRUSTEE 1.00 0.00 X 0 0 0 CHIS MCCLAIN TRUSTEE 1.00 0.00 X 0 0 0 JOHN MORSE TRUSTEE 1.00 0.00 X 0 0 0 SHANE NEHLS TRUSTEE 1.00 0.00 X 0 0 0 0 0 0 0 0 0 0 WELFARE & PENSION ADMINISTRATION SERVICE 7525 SOUTHEAST 24TH STREET SUITE 2 MERCER ISLAND WA 98040 THIRD PARTY ADMIN 1240722 PREMERA BLUECROSS 7001 220ST SOUTHWEST BUILDING 1 MOUNTLAKE TERRACE WA 98043 CLAIMS PROCESSING 938546 INNOVATIVE CARE MANAGEMENT INC 15 82ND DRIVE SUITE 180 GLADSTONE OR 97027 MEDICAL MANAGEMENT 276049 ENVISION PHARMACEUTICAL SERVICES 2181 EAST AURORA ROAD TWINSBURG OH 44087 CLAIMS PROCESSING 171791 RAEL & LETSON 999 3RD AVENUE SUITE 1530 SEATTLE WA 98104 ACTUARY 163820 6 EMPLOYER CONTRIBUTIONS 525100 47735689 47735689 PARTICIPANT CONTRIBUTIONS 525100 4448476 4448476 DRUG TEST REIMBURSEMENTS 525100 149128 149128 52333293 944716 944716 89006339 89209462 -203123 -203123 -203123 INCOME FROM DORMANT ACCOUNTS 900099 18068 18068 LIQUIDATED DAMAGES 900099 14496 14496 32564 53107450 52162734 0 944716 42201211 42201211 447120 447120 40088 40088 38695 38695 100678 100678 2318474 2318474 80911 80911 21095 21095 18879 18879 25690 25690 DRUG TEST PROGRAM 217005 217005 POSTAGE 88663 88663 EMPLOYEE ASSISTANCE PRO 72934 72934 PCORI FEES 15474 15474 19118 19118 45706035 45706035 0 0 1828517 1538332 4993466 6579076 4980930 5154166 23118 22534 33641307 35990773 1532037 46999375 49284881 1396709 1513260 42697529 31701526 44094238 33214786 X 0 0 0 0 2905137 16070095 2905137 16070095 46999375 49284881 X 7401415 1318990 4444553 X 0 1 X 0 0 0 AMOUNTS DUE INSURANCE COMPANIES 569067 HEALTH REIMBURSEMENT ACCOUNTS (HRA) LIABILITY 864012 CLAIMS INCURRED BUT NOT REPORTE4D 8205000 LAG MONTHS ELIGIBILITY COVERAGE 7904447 ACCUMULATED ELIGIBIILITY CREDITS 14159000 31701526 X 54325762 1318990 1318990 53006772 100678 100678 53107450 50035055 0 50035055 100678 -4429698 -4329020 45706035 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS QUALIFIED PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE (IRC), AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE PLAN HAS OBTAINED A DETERMINATION LETTER IN WHICH THE INTERNAL REVENUE SERVICE (IRS) STATED THAT THE PLAN, AS DESIGNED, WAS IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC. THE PLAN HAS BEEN AMENDED SINCE RECEIVING THE DETERMINATION LETTER. HOWEVER, THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS DESIGNED AND IS CURRENTLY BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT 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 ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF JUNE 30, 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 AMOUNTS DUE INSURANCE COMPANIES 105,290. CHANGE IN CLAIMS INCURRED BUT NOT REPORTED -5,399,000. CHANGE IN HRA LIABILITY 864,012. FORM 990, PART VI, SECTION A, LINE 3 THE DAY TO DAY OPERATIONS OF THE TRUST ARE CONTRACTED OUT TO A PROFESSIONAL ADMINISTRATION COMPANY, BUT THE BOARD OF TRUSTEES RETAIN ULTIMATE RESPONSIBILITY FOR THE OPERATIONS OF THE TRUST. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PROVIDED TO THE CHAIRMAN AND THIRD PARTY ADMINISTRATOR BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE PLAN'S THIRD PARTY ADMINISTRATOR SENDS AN ANNUAL QUESTIONNAIRE TO EACH TRUSTEE REGARDING CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION C, LINE 18 PARTICIPANTS OF THE PLAN MAY REQUEST INFORMATION FROM THE PLAN'S THIRD PARTY ADMINISTRATOR, HOWEVER, NO DOCUMENTS ARE AVAILABLE TO THE PUBLIC. FORM 990, PART VI, SECTION C, LINE 19 PARTICIPANTS OF THE PLAN MAY REQUEST INFORMATION FROM THE PLAN'S THIRD PARTY ADMINISTRATOR, HOWEVER, NO DOCUMENTS ARE AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CHANGE IN LAG MONTHS ELIGIBILITY COVERAGE 1,492,553. CHANGE IN ACCUMULATED ELIGIBILITY CREDITS 2,952,000. 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