2020-12-08T09:41:38-06:00 2020-01-31 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2019-02-01 956035137 PRINTING SPECIALTIES AND PAPER PRODUCTS JOINT EMPLOYER AND UNION H&W FUND PRIN 2063294900 2323 EASTLAKE AVENUE EAST SEATTLE WA 98102 GAYLE SPARAPANI TRUSTEE 2063294900 2020-12-08 1 JAMES N BROWNING P01451906 9252779100 66.7.226.66 2020-12-08 07:41:22 PS P D85FB602DC4FA66F28A631CB81EF53DF59ECABFA 92C7F91AD246760067C653CBF66B8BF12B4D5FD1 2019 2021-04-22 16:20:28Z GAYLE SPARAPANI 2323 EASTLAKE AVENUE E SEATTLE WA 98102 336625268 0 X N/A X 1952 CA PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. 5 2 0 0 0 0 0 0 63395956 62512460 1641150 2902098 0 0 65037106 65414558 0 0 57946975 54916297 0 0 0 0 0 2218731 2045703 60165706 56962000 4871400 8452558 93751822 105708865 14443890 16086560 79307932 89622305 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 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 2135 0 1 0 0 0 0 0 0 0 0 0 X 5 2 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X NORTHWEST ADMINISTRATORS INC 2063294900 2323 EASTLAKE AVE EAST SEATTLE WA 981023305 X CLARK RITCHEY TRUSTEE 1.00 X 0 0 0 GAYLE SPARAPANI TRUSTEE & CHAIR 1.00 X 0 0 0 THOMAS SARNECKI TRUSTEE 1.00 X 0 0 0 DAN CABADA TRUSTEE & SECRETARY 1.00 X 0 0 0 AMANDA JORDAN TRUSTEE 1.00 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 NORTHWEST ADMINISTRATORS INC 2323 EASTLAKE AVE EAST SEATTLE WA 981023305 CONTRACT ADMINISTRATOR 714721 BLUE SHIELD OF CALIFORNIA 2175 N CALIFORNIA AVE STE 250 WALNUT CREEK CA 94596 CLAIMS ADMINISTRATOR 236174 INVESCO 1555 PEACHTREE ST NE ATLANTA GA 30309 INVESTMENT MANAGEMENT 205567 KRAW LAW GROUP 1017 EAST GRAND AVENUE ESCONDIDO CA 92025 ATTORNEY 203161 MILLIMAN INC 650 CALIFORNIA ST NO 17 SAN FRANCISCO CA 94108 CONSULTING 188132 6 EMPLOYER CONTRIBUTIONS 900099 60260121 60260121 PRESCRIPTION REBATES 900099 1108503 1108503 STOP LOSS REIMBURSEMENTS 900099 1102458 1102458 SELF-PAY CONTRIBUTIONS 900099 40682 40682 OTHER INCOME 900099 696 696 62512460 2273252 2273252 271839556 271210710 628846 628846 628846 65414558 62512460 0 2902098 54916297 729927 198136 139364 271452 497164 115355 45923 42132 ACA-PCORI FEES 6250 56962000 10051035 7820340 6745760 8328203 39256 34756 76915771 89525566 93751822 105708865 1225690 3057860 13218200 13028700 14443890 16086560 X 0 0 0 0 79307932 89622305 79307932 89622305 93751822 105708865 8452558 1861815 0 X X 0 1 X 1 0 0 ACCUMULATED ELIGIBILITY CREDITS 9253000 CLAIMS PAYABLE AND IBNR 3775700 13028700 X 67004921 1861815 1861815 65143106 271452 271452 65414558 56880048 0 56880048 271452 -189500 81952 56962000 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 POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF JANUARY 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 ORGANIZATION HAS CONTRACTED WITH NORTHWEST ADMINISTRATORS, INC. TO PROVIDE DAY-TO-DAY ADMINISTRATIVE SERVICES TO THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE ADMINISTRATIVE OFFICE REVIEWS THE FORM 990 AND WILL NOTIFY THE BOARD OF TRUSTEES IF ANY UNUSUAL OR SIGNIFICANT ITEMS ARE NOTED. THE TRUST CHAIRMAN AND SECRETARY REVIEW THE FORM 990 PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF TRUSTEES ARE COVERED BY THE CONFLICT-OF-INTEREST POLICY. IF AND WHEN A POTENTIAL CONFLICT OF INTEREST IS DISCLOSED, THE BOARD OF TRUSTEES WILL INVOLVE THE TRUST'S ATTORNEY TO EVALUATE IF THE MATTER WOULD LIKELY PREVENT AN UNBIASED OR OBJECTIVE DECISION BY A TRUSTEE. AS APPROPRIATE, DISCIPLINARY OR CORRECTIVE ACTION WILL BE TAKEN. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MAINTAINED BY THE ADMINISTRATIVE OFFICE AND ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1A: TRUSTEES ARE NOT COMPENSATED BY THE TRUST. COMPENSATION PAID TO TRUSTEES EMPLOYED BY THE 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, NORTHWEST ADMINISTRATORS,INC. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES HAVE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED. ALLIED PRINTING CO CA TEAMSTERS DISTRICT COUNCIL NO 2 710 E COMMONWEALTH AVENUE FULLERTON CA 92831 951296250 LABOR ORGANIZATION CA 501(C)5 N/A N/A 0 AABCO PRINTING CORRU-KRAFT II INTERNATIONAL PAPER (BEAVERTON CORRUG) INTERNATIONAL PAPER (BUENA PARK) KP CORPORATION (SEATTLE) KAPSTONE (IDAHO) MISSION CORRUGATED PACKAGING CORP OF AMERICA SUBURBAN PRESS PACKAGING CORP OF AMERICA - SAN LORENZO EMPLOYEES US INK - A DIVISION OF SUN CHEMICALS NORTHGATE TERRACE - GCIU INC GEORGIA PACIFIC-OLYMPIA GEORGIA PACIFIC-SAN LEANDRO HOLLYWOOD IMPRESS CHIMES PRINTING DAILY JOURNAL OF COMMERCE IRWIN-HODSON RUBBER STAMP MOREL COMMUNICATIONS GEORGIA PACIFIC-BUENA PARK GEORGIA PACIFIC-MODESTO INTERNATIONAL PAPER (BEAVERTONBAG) INTERNATIONAL PAPER (COMPTON) INTERNATIONAL PAPER (SALINAS) INTERNATIONAL PAPER (MOSES LAKE) INTERNATIONAL PAPER (OLYMPIA) INTERNATIONAL PAPER (ELK GROVE SACRAM) IRWIN-HODSON GROUP LLC PACKAGING CORP OF AMERICA - COLORADO EMPLOYEES INTERNATIONAL PAPER (RIVERSIDE) INTERNATIONAL PAPER (SANTA FE SPRINGS) INTERNATIONAL PAPER (YAKIMA) INTERNATIONAL PAPER (CROCKETT CONTAINER CORP) CORRU-KRAFT IV HOUSE OF PRINTING INC LA PAPER BOX & BOARD MERCURY CONTAINER PACIFIC PRINTING (BU & NBU) RAPID DISPLAYS ROTARY OFFSET PRESS ROYAL PAPER BOX SERVICE PRESS INC HOLLY PRESS INTERNATIONAL PAPER (CAMARILLO) INTERNATIONAL PAPER - TRACY CARUSTAR CUSTOM PKG MANUFACTURED PACKAGING WESTROCK (CORONA) WESTROCK (MILPITAS) WESTROCK (PORTLAND) WESTROCK (SALINAS) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0