2019-10-24T18:20:30-05:00 2018-12-31 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2018-01-01 936024141 OREGON LABORERS - EMPLOYERS HEALTH & WELFARE TR FUND OREG 5032825581 12029 NE GLENN WIDING DR PORTLAND OR 97220 JAMES WATTS TRUSTEE 5032825581 2019-10-24 1 JAMES N BROWNING P01451906 9252779100 66.7.226.66 2019-10-24 16:20:23 PD P D85FB602DC4FA66F28A631CB81EF53DF59ECABFA D85FB602DC4FA66F28A631CB81EF53DF59ECABFA 2018 2019-02-21 02:37:17Z JAMES WATTS 17230 NE SACRAMENTO ST 201 PORTLAND OR 97230 61168913 0 X N/A X 1954 OR PROVIDE HEALTH AND WELFARE BENEFITS 6 1 40 0 0 0 0 0 25543868 32175796 361553 537737 78837 0 25984258 32713533 0 0 25803201 31655303 0 0 0 0 0 1878594 2237661 27681795 33892964 -1697537 -1179431 25682195 28144787 12209032 17046334 13473163 11098453 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 1 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 5 0 1 40 1 0 0 0 0 0 0 0 0 X 6 1 0 1 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 X WC EARHART CO 5032825581 12029 NE GLENN WIDING DR PORTLAND OR 97220 X GREG HELD TRUSTEE 0.50 X 0 0 0 ERIC SNELLING TRUSTEE 0.50 X 0 0 0 ZACK CULVER TRUSTEE 0.50 X 0 0 0 JAMES R WATTS TRUSTEE 0.50 X 0 0 0 GARY MOORE TRUSTEE 0.50 X 0 0 0 KELLY DIXON TRUSTEE 0.50 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 REGENCE BLUE CROSS BLUE SHIELD 100 SW MARKET STREET PORTLAND OR 972015702 CLAIMS ADMINISTRATION 1136505 WILLIAM C EARHART CO INC PO BOX 4148 PORTLAND OR 97208 THIRD PARTY ADMINISTRATIVE FEES 292102 OREGON LABORERS-EMPLOYERS ADMIN LLC 12029 NE GLENN WIDING DR PORTLAND OR 97220 COORDINATOR EXPENSE 159490 MILLIMAN INC 1455 SW BROADWAY ST STE 1600 PORTLAND OR 97201 CONSULTING 138942 4 EMPLOYER CONTRIBUTIONS 900099 29480980 29480980 PARTICIPANT CONTRIBUTIONS 900099 1858471 1858471 PRESCRIPTION REBATES 900099 504899 504899 STOP-LOSS INCOME 900099 247733 247733 MEDICARE PART D SUBSIDY 900099 83713 83713 32175796 384558 384558 28608559 28455380 153179 153179 153179 32713533 32175796 0 537737 31655303 288067 113486 55000 135048 1434937 56186 10949 46786 NAT'L HEALTH AND SAFETY 91247 OTHER EXPENSES 5955 33892964 146626 409775 2921956 3109603 8026931 10549772 14586682 14075637 25682195 28144787 245032 381334 11964000 16665000 12209032 17046334 X 0 0 0 0 13473163 11098453 13473163 11098453 25682195 28144787 -1179431 -1195279 0 X X 0 1 X 1 0 0 COMMON/COLLECTIVE TRUST FUNDS 14075637 F 14075637 ACCUMULATED ELIGIBILITY CREDITS 14233000 CLAIMS PAYABLE AND IBNR 2432000 16665000 X 31383206 -1195279 -1195279 32578485 135048 135048 32713533 29056916 0 29056916 135048 4701000 4836048 33892964 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 TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF DECEMBER 31,2018, 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 2015. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION A, LINE 3 THE PLAN HAS CONTRACTED WITH WILLIAM C. EARHART CO., INC. TO PROVIDE DAY-TO-DAY ADMINISTRATIVE SERVICES TO THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 8B THE BOARD OF TRUSTEES DOES NOT HAVE COMMITTEES THAT ACT ON ITS BEHALF. FORM 990, PART VI, SECTION B, LINE 11B ALL MEMBERS OF THE BOARD OF TRUSTEES REVIEWED THE FORM 990 PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1A: TRUSTEES ARE NOT COMPENSATED BY THE TRUST. COMPENSATION PAID TO TRUSTEES EMPLOYED BY 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, WILLIAM C. EARHART CO. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSIGHT OF THE ANNUAL AUDIT AND FOR SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. OREGON LABORERS - EMPLOYERS PENSION PLAN 12029 NE GLENN WIDING DR PORTLAND OR 97220 936075363 TO PROVIDE PENSION BENEFITS OR 501(A) N/A N/A 0 OREGON LABORERS-EMPLOYERS DEFINED CONTRIBUTION AND 401(K) PLAN 12029 NE GLENN WIDING DR PORTLAND OR 97220 276434385 TO PROVIDE PENSION BENEFITS OR 501(A) N/A N/A 0 OREGON AND SOUTHERN IDAHO LABORERS - EMPLOYERS TRAINING TRUST 12029 NE GLENN WIDING DR PORTLAND OR 97220 204626312 TO PROVIDE TRAINING BENEFITS OR 501(C)3 N/A N/A 0 OREGON AND SOUTHERN IDAHO DISTRICT COUNCIL OF LABORERS 17230 NE SACRAMENTO ST 201 PORTLAND OR 97230 930144236 LABOR ORGANIZATION OR 501(C)5 N/A N/A 0 LABORERS INTERNATIONAL UNION LOCAL 483 1125 SE MADISON ST SUITE 206 PORTLAND OR 97214 930169132 LABOR ORGANIZATION OR 501(C)5 N/A N/A 0 LABORERS LOCAL 737 17230 NE SACRAMENTO ST 201 PORTLAND OR 97230 474408911 LABOR ORGANIZATION OR 501(C)5 N/A N/A 0 LABORERS UNION LOCAL 155 465 W 17TH ST IDAHO FALLS ID 83402 820411490 LABOR ORGANIZATION ID 501(C)5 N/A N/A 0 OREGON LABORERS ADMINISTRATIVE LLC 12029 NE GLENN WIDING DR PORTLAND OR 97220 830431313 ADMINISTRATIVE SERVICES OR NA - THERE ARE 3 EQUAL PARTNERS RELATED 140152 0 0 0.33330 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 OREGON LABORERS ADMINISTRATIVE LLC M 159490 OBTAINED FROM THE PLAN'S RECORDS. SCHEUDLE R, PARET II THROUGH IV - IDENTIFICATION OF RELATED ORGANIZATIONS: THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF DECEMBER 31, 2018, THERE ARE APPROXIMATELY 277 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. THE FEDERAL TAX CLASSIFICATION (DISREGARDED ENTITY, TAX-EXEMPT ORGANIZATION, PARTNERSHIP, TAXABLE CORPORATION OR TRUST) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. 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