2018-11-14T18:30:41-06:00 2017-12-31 952648289 VAVRINEK TRINE DAY & CO LLP 1900 S NORFOLK STREET SUITE 225 SAN MATEO CA 94403 990 2017-01-01 946401544 U A LOCAL 393 HEALTH & WELFARE TR UALO 4084368210 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 TRUSTEE TRUSTEE TRUSTEE 4084368210 2018-11-14 1 MELISSA EVJENTH P01781096 9094664410 65.60.100.226 2018-11-14 16:30:16 PS P C8485762D0A103083B9EABF22E0AFFE603142D80 A8923EACCE2D6A4F1290DCBC04922AB836540ED7 2017 2019-02-21 02:37:17Z 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 88544921 0 X N/A X 1952 CA TO PROVIDE ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS WITH HEALTH & WELFARE BENEFITS. 10 10 1 0 0 0 0 0 59688170 58382918 1086716 1853376 335510 815382 61110396 61051676 0 0 47664540 55169719 86565 92362 0 0 0 1928957 2083325 49680062 57345406 11430334 3706270 115025939 128032078 49630718 55588524 65395221 72443554 NONE 0 0 TO PROVIDE ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS WITH HEALTH & WELFARE BENEFITS ACCORDING TO COLLECTIVE BARGAINING AGREEMENTS BETWEEN EMPLOYERS AND THE UNION. 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 1 208 0 1 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X BENESYS ADMINISTRATORS 4084368210 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 X ALEX HALL TRUSTEE 5.00 X 0 0 0 STEVE FLORES TRUSTEE 5.00 X 0 0 0 MICHAEL J VLAMING TRUSTEE 5.00 X 0 0 0 LARRY GATES TRUSTEE 5.00 X 0 0 0 WAYD LA PEARLE TRUSTEE 5.00 X 0 0 0 EDWARD NICHOLS CHAIRMAN 5.00 X 0 0 0 GARY GLENN TRUSTEE 5.00 X 0 0 0 GREGORY GONZALES TRUSTEE 5.00 X 0 0 0 DAVE MCLAUGHLIN TRUSTEE 5.00 X 0 0 0 LEROY GINN TRUSTEE 5.00 X 0 0 0 0 0 0 0 0 0 0 BENESYS ADMINISTRATORS 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 CONTRACT ADMIN 620849 DELTA DENTAL 100 FIRST ST SAN FRANCISCO CA 94105 BENEFIT ADMIN EXPENSE 324700 BLUE CROSS OF CALIFORNIA 21555 OXNARD STREET WOODLAND HILLS CA 91367 BENEFIT ADMIN EXPENSE 188365 RXEDO INC PO BOX 678586 DALLAS TX 75267 BENEFIT ADMIN EXPENSE 146672 NWQ INVESTMENTS 2049 CENTURY PARK EAST 16TH FL LOS ANGELES CA 90067 INVESTMENT MANAGER 119553 5 EMPLOYER CONTRIBUTIONS 900099 52327137 52327137 ERA CONTRIBUTIONS 900099 5964041 5964041 COBRA CONTRIBUTIONS 900099 91740 91740 58382918 1912594 1912594 27434027 27493245 -59218 -59218 -59218 OTHER INCOME 900099 520207 520207 MEDICARE D SUBSIDY 900099 289425 289425 LIQUIDATED DAMAGES 900099 5750 5750 815382 61051676 59139082 0 1912594 55169719 92362 620849 50737 96663 184847 27179 5525 DELTA DENTAL ADMIN FEE 324700 BLUE CROSS ADMIN FEE 188365 RXEDO 146672 BENEFIT CONSULTING 113218 324570 57345406 2194619 2530721 16814264 8774975 6195562 5208895 650 693 89616809 110971205 204035 545589 115025939 128032078 2427820 451672 47202898 55136852 49630718 55588524 X 0 0 0 0 65395221 72443554 65395221 72443554 115025939 128032078 3706270 3342063 0 X X 0 1 X 1 0 0 SELF FUNDED BENEFITS PAYABLE 3740651 GROUP INSURANCE PREMIUMS PAYABLE 3259687 BANK OF HRS LIABILITY FOR EXT. COVERAGE 16295000 PARTICIPANT RESERVE ACCOUNT 29389956 CLAIMS INCURRED BUT NOT REPORTED 1611400 DUE TO OTHER FUNDS 840158 55136852 X 64393739 3342063 3342063 61051676 0 61051676 57345406 0 57345406 0 57345406 PART X, LINE 2: THE TRUST HAS ADOPTED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD. THE TRUST ADMINISTRATOR BELIEVES THAT THE TRUST HAS NOT TAKEN UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS AS A TAX LIABILITY. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES CONTROL OVER MANAGEMENT DUTIES CUSTOMARILY PERFORMED BY OR UNDER THE DIRECT SUPERVISION OF OFFICERS, DIRECTORS, TRUSTEES OR KEY EMPLOYEES TO THE CONTRACT ADMINISTRATOR. FORM 990, PART VI, SECTION A, LINE 8B THE PLAN DOES NOT HAVE ANY COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE TRUSTEES DESIGNATE THE ADMINISTRATOR TO REVIEW THE FORM. FORM 990, PART VI, SECTION B, LINE 12C REVIEW WITH BOARD OF TRUSTEES ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST TO ALL PLAN PARTICIPANTS. FORM 990, PART XI, LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSEEING THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND FOR SELECTING THE INDEPENDENT AUDITOR. U A LOCAL 393 PENSION TRUST FUND 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 946359772 TO PROVIDE PENSION AND DEATH BENEFITS TO ELIGIBLE PARTICIPANTS CA 401(A) N/A 0 U A LOCAL 393 TRUST FUND DEFINED CONTRIBUTION 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 946075617 TO PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS COVERED BY CBA CA 401(B) N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PARTS II, III, AND IV - IDENTIFICATION OF RELATED TAX ORGANIZATIONS IN A MULTIEMPLOYER PLAN, A CONTRIBUTING EMPLOYER IS CONSIDERED A RELATED ORGANIZATION BECAUSE THEY ARE OBLIGATED TO CONTRIBUTE TO THE PLAN PURSUANT TO THE TERMS IN THE COLLECTIVE BARGAINING OR PARTICIPATION AGREEMENT. THE ADMINISTRATIVE OFFICE ONLY MAINTAINS THE DATA NECESSARY TO FULFILL THE OBLIGATION TO CONTRIBUTE, IT DOES NOT MAINTAIN SPECIFIC BUSINESS DATA REGARDING THE EMPLOYERS, SUCH AS ENTITY TYPE OR TAX INFORMATION.