2019-03-15T12:57:31-05:00 2018-05-31 MILLER KAPLAN ARASE LLP 600 STEWART ST STE 618 SEATTLE WA 981011261 990 2017-06-01 930478837 THE BLEDSOE HEALTH TRUST % GARTH FISHER BLED 2063294900 2323 EASTLAKE AVE EAST SEATTLE WA 98102 RODGER GLOSS CHAIRMAN 2063294900 2019-03-14 true Catalina Kirby P02018896 2065963930 12.244.147.122 95416620190745000017 2019-03-15 P 91E1D72868A0580E1577584470F1D7E6516499F8 1D553F0CC161CAB4950D5232994D4871B352D586 2017 2019-02-21 02:37:17Z ROGER M GLOS 2323 Eastlake Ave E Seattle WA 98102 56935080 false X N/A X 1959 OR SEE SCHEDULE O 10 0 0 0 0 0 0 0 48068249 52522351 3373038 3446129 1514808 0 52956095 55968480 0 0 55864744 52273613 0 0 0 0 0 1172894 1216411 57037638 53490024 -4081543 2478456 111831975 112963632 13667697 12123588 98164278 100840044 THE ORGANIZATIONS'S MISSION IS TO PROVIDE HEALTH BENEFITS TO ELIGIBLE ACTIVE PARTICIPANTS AND THEIR COVERED DEPENDENTS. THE PLAN ALSO PROVIDES HEALTH BENEFITS TO SELF PAY PARTICIPANTS AND RETIREES FOR WHICH A CONTRIBUTION IS RECEIVED. false false THE ORGANIZATION'S MISSION IS TO PROVIDE HEALTH BENEFITS TO ELIGIBLE ACTIVE PARTICIPANTS AND THEIR COVERED DEPENDENTS. THE PLAN ALSO PROVIDES HEALTH BENEFITS TO SELF-PAY PARTICIPANTS AND RETIREES FOR WHICH A CONTRIBUTION IS RECEIVED. false false false false false false false false false true false false true true true false false false false false false false false false false false false false false false false false false false false false false false false true false false true 3 0 true 0 false false false false false false X 10 0 false false false false false false false true false false false false true true true true true false X GARTH FISHER 2063294900 2323 EASTLAKE AVE E SEATTLE WA 98102 X RODGER M GLOS TRUSTEE 1.0 0.0 X 0 0 0 KEVIN PETERSON TRUSTEE 1.0 0.0 X 0 0 0 JOHN SAHLBERG TRUSTEE 1.0 0.0 X 0 0 0 KELLYE T WISE TRUSTEE 1.0 0.0 X 0 0 0 TONY HADLEY TRUSTEE 1.0 0.0 X 0 0 0 PAUL MARKS ALTERNATE TRUSTEE 1.0 0.0 X 0 0 0 CAL WELBORN SR TRUSTEE 1.0 0.0 X 0 0 0 JERRY KING TRUSTEE 1.0 0.0 X 0 0 0 TODD GORHAM TRUSTEE 1.0 0.0 X 0 0 0 RAY CALICA ALTERNATE TRUSTEE 1.0 0.0 X 0 0 0 0 0 0 0 false false false REGENCE BLUECROSS BLUESHIELD OF ORE PO Box 1271 PORTLAND OR 97207 ADMIN SERVICE ORG 6006517 NORTHWEST ADMINISTRATORS INC 2323 EASTLAKE AVE E SEATTLE WA 98102 Administrative Fees 535532 TRUCKER HUSS ONE EMBARCADERO CtR 12th FLOOR SAN FRANCISCO CA 94111 LEGAL FEES 135717 3 0 EMPLOYER CONTRIBUTIONS 900099 46648363 46648363 SELF-PAY CONTRIBUTIONS 900099 5873988 5873988 52522351 3412729 3412729 0 0 0 0 0 1000000 966600 33400 33400 33400 0 0 0 0 0 0 0 0 0 0 55968480 52522351 3446129 0 0 0 52273613 0 0 0 0 0 0 535532 139800 60636 0 0 35229 177596 0 148386 0 0 0 0 0 12209 0 0 0 39286 ACA REINSURANCE FEE 36671 ACA PCORI FEE 31066 53490024 796 -29799 2511916 1060896 0 0 3794873 4135255 0 0 0 0 0 0 0 0 1025296 1023211 0 0 92978978 94428431 11520116 12345638 0 0 0 0 0 0 111831975 112963632 81541 90509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13586156 12033079 13667697 12123588 X 0 0 0 0 98164278 100840044 98164278 100840044 111831975 112963632 2478456 197310 X false true X true GROSVENOR INSTITUTIONAL PARTNE 12345638 F 12345638 0 BENEFIT OBLIGATIONS 12033079 12033079 X 56165790 197310 197310 55968480 55968480 55042945 55042945 -1552921 -1552921 53490024 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN A TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY A TAX AUTHORITY. 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: CHANGE IN BENEFIT OBLIGATIONS. PART I, LINE 1 AND PART III, LINES 1 AND 4A - ORGANIZATION'S MISSION: TO PROVIDE HEALTH BENEFITS TO ELIGIBLE ACTIVE PARTICIPANTS AND THEIR COVERED DEPENDENTS. THE PLAN ALSO PROVIDES HEALTH BENEFITS TO SELF-PAY PARTICIPANTS AND RETIREES FOR WHICH A CONTRIBUTION IS RECEIVED. PART VI, LINE 11B: FORM 990 IS REVIEWED BY THE ADMINISTRATIVE OFFICE PRIOR TO BEING FILED. THE ADMINISTRATIVE OFFICE NOTIFIES THE BOARD OF TRUSTEES OF UNUSUAL OR SIGNIFICANT ITEMS, IF NOTED. PART VI, LINE 12C: TRUSTEES ARE REQUIRED TO NOTIFY THE PLAN OF ANY CHANGES IN INTERESTS THAT COULD GIVE RISE TO CONFLICTS. PART VI, LINE 19: THE PLAN'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MAINTAINED AT THE ADMINISTRATIVE OFFICE AND ARE AVAILABLE UPON REQUEST. PART VII - SECTION A: MEMBERS OF THE BOARD OF TRUSTEES SERVE FOR NO COMPENSATION. COMPENSATION PAID TO TRUSTEES BY THEIR EMPLOYERS IS REPORTED ON THE EMPLOYERS' ANNUAL TAX FILINGS. THIS INFORMATION IS UNKOWN TO THE PLAN ADMINISTRATOR. CIC-TOC PENSION PLAN 2323 EASTLAKE AVE E SEATTLE WA 98102 456909074 PENSION BEN. WA 1.401-1(B)3 NA false LUMBER INDUSTRY PENSION PLAN 2323 EASTLAKE AVE E SEATTLE WA 98102 456909074 PENSION BEN. WA 1.401-1(B)3 NA false CIC DEFINED CONTRIBUTION RETIREMENT PLAN 2323 EASTLAKE AVE E SEATTLE WA 98102 456909074 PENSION BEN. WA 1.401-1(B)3 NA false CARPENTERS INDUSTRIAL COUNCIL 12788 SE STARK ST PORTLAND OR 97233 421693707 LABOR ORG. OR 501(C)5 NA false see supplemental information na see supplemental information na false false false false false false false false false false false false false false false false false false true PARTS II, III AND IV - IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS: A CONTRIBUTING EMPLOYER IS A RELATED ORGANIZATION SOLELY TO THE EXTENT THAT THE EMPLOYER IS SIGNATORY TO A COLLECTIVE BARGAINING AGREEMENT OR PARTICIPATION AGREEMENT REQUIRING CONTRIBUTIONS TO THE TRUST. THE PLAN ADMINISTRATOR DOES NOT MAINTAIN INFORMATION CONCERNING THE ENTITY TYPE OF EACH OF THE TRUST'S CONTRIBUTING EMPLOYERS. THE PLAN CONTRACTS WITH VIGILANT SERVICES, INC. FOR ONE OF ITS MEMBERS TO SERVE AS AN EMPLOYER TRUSTEE AND CHAIRMAN OF THE BOARD OF TRUSTEES OF THE PLAN, REPRESENTING CONTRIBUTING EMPLOYERS THAT ARE NOT REPRESENTED BY ANOTHER TRUSTEE. A MONTHLY FEE IS PAID BY THE PLAN TO VIGILANT SERVICES, INC. UNDER THE TERMS OF THE AGREEMENT. FOR THE PLAN YEAR ENDED MAY 31, 2018, THE MONTHLY FEE WAS $3,750 FROM JUNE 2017 THROUGH DECEMBER 2017, AND $4,750 FROM JANUARY 2018 THROUGH MAY 2018.