2018-05-10T14:28:00-05:00 2017-06-30 952648289 VAVRINEK TRINE DAY & CO LLP 1900 S NORFOLK STREET SUITE 225 SAN MATEO CA 94403 990 2016-07-01 916034674 ALASKA TEAMSTER EMPLOYER WELFARE TRUST ALAS 9075658310 520 EAST 34TH AVENUE NO 107 ANCHORAGE AK 99503 TRUSTEE TRUSTEE TRUSTEE 9075658310 2018-05-10 1 P00739466 9094664410 2016 2022-09-23 18:48:47Z 520 EAST 34TH AVENUE NO 107 ANCHORAGE AK 99503 41387044 0 X N/A X 1964 AK SEE PART III(A) 8 8 24 0 0 0 0 0 33094902 35387567 382980 312596 1396262 1638487 34874144 37338650 0 0 34024846 31161954 0 0 0 0 0 2651482 2609364 36676328 33771318 -1802184 3567332 11684452 13003795 17147236 14722797 -5462784 -1719002 NONE 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE UNION AND THE EMPLOYERS 0 0 0 0 0 0 0 0 0 0 0 0 1 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 0 0 0 1 14 0 24 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X ALASKA TEAMSTER EMPLOYER SERVICE CO 9077519700 520 E 34TH AVE ANCHORAGE AK 99503 X WILLIAM PIERCE TRUSTEE 5.00 X 0 0 0 RICK BOYLES TRUSTEE 5.00 X 0 0 0 DEREK MUSTO TRUSTEE 5.00 X 0 0 0 MARION DAVIS TRUSTEE 5.00 X 0 0 0 SCOTT DEPAEPE TRUSTEE 5.00 X 0 0 0 TODD HENDERSON TRUSTEE 5.00 X 0 0 0 BARBARA HUFF-TUCKNESS TRUSTEE 5.00 X 0 0 0 FRANK MONFREY TRUSTEE 5.00 X 0 0 0 0 0 0 0 0 0 0 ALASKA TEAMSTERS EMPLOYER SERVICE CORPOR 520 E 34TH STREET SUITE 107 ANCHORAGE AK 99503 THIRD PARTY ADMINISTRATOR 575349 BENESYS 1220 SW MORRISON AVE SUITE 300 PORTLAND OR 97205 ADMINSTRATOR 556729 AETNA 151 FARMINGTON AVE 107 HARTFORD CT 06156 CLAIMS ADMINISTRATION 486479 PARKER SMITH FEEK 2233 112TH AVE BELLEVUE WA 98004 PLAN CONSULTANT 179746 BRIDGEHEALTH MEDICAL 6000 E EVANS AVE SUITE 2-400 DENVER CO 80222 CLAIMS ADMINISTRATION 148083 6 EMPLOYER CONTRIBUTIONS 900099 31963368 31963368 PARTICIPANT 900099 3424199 3424199 35387567 125478 125478 4235512 4048394 187118 187118 187118 EXPERIENCE REFUNDS 900099 1570195 1570195 MISCELLANEOUS 900099 68292 68292 1638487 37338650 37213172 0 125478 31161954 1617666 52326 90042 27523 31984 12931 21895 MEDICAL NETWORK 486479 CONSULTANT 212746 ACA TRANSITIONAL REINSU 45293 PATIENT CARE OUTCOME RE 7311 3168 33771318 1393715 1384196 347 212358 2453378 2780096 236003 428795 6591732 6896289 1009277 1302061 11684452 13003795 167946 165918 16979290 14556879 17147236 14722797 X 0 0 0 0 -5462784 -1719002 -5462784 -1719002 11684452 13003795 3567332 176450 0 X X 0 1 X 1 0 0 PRESCRIPTION REBATE 265423 ULLICO DIVIDEND RECEIVABLE 64497 STOP LOSS RECEIVABLE 972141 1302061 CONTRIBUTIONS ADVANCED BY RETIREES 13078 GROUP INSURANCE PREMIUMS 243801 SELF-FUNDED BENEFIT CLAIMS 8539199 DOLLAR BANK RESERVE 5760000 DUE TO AFFILIATES 801 14556879 X 37515100 176450 176450 37338650 0 37338650 33771318 0 33771318 0 33771318 PART X, LINE 2: THE TRUST HAS ADOPTED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD. THE PLAN MANAGEMENT BELIEVES THAT THE TRUST HAS NOT TAKEN UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS AS A TAX LIABILITY. THE PLAN MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR FISCAL YEARS PRIOR TO JUNE 30, 2014. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS DELEGATED CONTROL OVER MANAGEMENT DUTIES CUSTOMARILY PERFORMED BY OR UNDER THE DIRECT SUPERVISION OF OFFICERS, DIRECTORS, TRUSTEES, OR KEY EMPLOYEES TO A CONTRACT ADMINISTRATOR. FORM 990, PART VI, SECTION B, LINE 11B THE TRUSTEES DESIGNATE THE ADMINISTRATOR TO REVIEW THE FORM 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY THE TRUSTEES SIGNING A FORM ANNUALLY. FORM 990, PART VI, SECTION C, LINE 18 THE ENTITY IS NOT A 501(C)(3) PLAN, AND IS THEREFORE NOT REQUIRED TO MAKE ITS FORM 990 AVAILABLE TO THE PUBLIC. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES IT'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON WRITTEN REQUEST. FORM 990, PART XII, LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE PLAN'S FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT AUDITOR. FORM 990, PART IV, LINE 34 SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS: THE FILING ENTITY IS A 501(C)(9) VEBA WHO MUST LIST CONTRIBUTING EMPLOYERS ON SCHEDULE R. THE ADMINISTRATIVE OFFICE MAINTAINES A LIST OF CONTRIBUTING EMPLOYERS, HOWEVER, THAT LIST DOES NOT INCLUDE FEDERAL TAX CLASSIFICATION. THEREFORE, THE LIST OF CONTRIBUTING EMPLOYERS IS REPORTED ON PART VII, SUPPLEMENTAL INFORMATION. A.I.C. 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