2018-09-27T14:09:24-05:00 2017-12-31 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2017-01-01 946078226 AUTOMOTIVE INDUSTRIES WELFARE FUND AUTO 8006353105 4160 DUBLIN BOULEVARD NO 400 DUBLIN CA 945687756 JIM BENO SECRETARY 8006353105 2018-09-27 1 JESSICA R ROSTER P01317380 9252779100 66.7.226.66 2018-09-27 12:08:58 PD P D85FB602DC4FA66F28A631CB81EF53DF59ECABFA D85FB602DC4FA66F28A631CB81EF53DF59ECABFA 2017 2018-06-14 16:35:46Z JIM BENO 4160 DUBLIN BOULEVARD NO 400 DUBLIN CA 945687756 78060907 0 X N/A X 1956 CA TO PROVIDE HEALTH AND WELFARE BENEFITS. 10 0 157 0 0 0 0 0 58789345 55006185 808987 1169688 0 0 59598332 56175873 0 0 53451757 51686959 0 0 0 0 0 2915537 2424356 56367294 54111315 3231038 2064558 34424088 36240888 6036171 4875210 28387917 31365678 TO PROVIDE HEALTH AND WELFARE BENEFITS. 0 0 PROVIDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER COLLECTIVE BARGAINING AGREEMENTS. 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 1 113 0 1 157 1 0 0 0 0 0 0 X 10 0 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X HEALTH SERVICES & BENEFITS ADMINISTRATORS INC 8006353105 4160 DUBLIN BOULEVARD 400 DUBLIN CA 945687756 X DON CROSATTO TRUSTEE 1.00 X 0 0 0 STEPHEN MACK TRUSTEE 1.00 X 0 0 0 JOHN DIBERNARDO TRUSTEE 1.00 X 0 0 0 RICH MORALES TRUSTEE 1.00 X 0 0 0 DOUG CORNFORD TRUSTEE 1.00 X 0 0 0 JIM BENO SECRETARY 2.00 X 0 0 0 TOM DILLON CHAIRMAN 2.00 X 0 0 0 RYAN THIBODEAU TRUSTEE 1.00 X 0 0 0 THOMAS BRANDON TRUSTEE 1.00 X 0 0 0 JIM SCHWANTZ TRUSTEE 1.00 X 0 0 0 SCOTT PAGTER PAST 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 HEALTH SERVICES & BENEFIT ADMINISTRATORS 4160 DUBLIN BLVD SUITE 400 DUBLIN CA 94568 ADMINISTRATION 1088789 ANTHEM BLUE CROSS 11050 OLSON DR SUITE 110 RANCHO CORDOVA CA 95670 CLAIMS PROCESSING 237188 LINDQUIST LLP 5000 EXECUTIVE PKWY SUITE 400 SAN RAMON CA 94583 AUDIT 224668 DELTA DENTAL OF CALIFORNIA 100 FIRST STREET SAN FRANCISCO CA 94105 CLAIMS PROCESSING 191270 SEGAL CONSULTING 120 MONTGOMERY STREET SAN FRANCISCO CA 94104 CONSULTING 152190 6 EMPLOYER CONTRIBUTIONS 900099 52767318 52767318 STOP LOSS REIMBURSMENT 900099 1798724 1798724 PARTICIPANT CONTRIBUTIONS 900099 265943 265943 PRESCRIPTION REBATES 900099 156030 156030 LIQUIDATED DAMAGES 900099 18170 18170 55006185 793432 793432 22261290 21885034 376256 376256 376256 56175873 55006185 0 1169688 51686959 1014959 81342 224669 57485 723093 239880 7810 75118 54111315 5625158 9652235 1966057 714838 59721 24957 26773152 25848858 34424088 36240888 643877 1900043 5392294 2975167 6036171 4875210 X 0 0 0 0 28387917 31365678 28387917 31365678 34424088 36240888 2064558 913203 0 X X 0 1 X 1 0 0 ACCUMULATED ELIGIBILITY CREDITS 640167 BENEFIT CLAIMS PAYABLE AND IBNR 2335000 2975167 X 57031591 913203 913203 56118388 57485 57485 56175873 55196296 0 55196296 57485 -1142466 -1084981 54111315 PART X, LINE 2: THE PLAN'S ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF DECEMBER 31, 2017, 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'S ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL YEARS PRIOR TO 2014. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION A, LINE 3 THE TRUST HAS CONTRACTED WITH HEALTH SERVICES AND BENEFIT ADMINISTRATORS TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 WAS PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE, OFFICER AND MANAGEMENT EMPLOYEE WITH DELEGATED POWERS WHO CAN INFLUENCE THE ACTIONS OF AUTOMOTIVE INDUSTRIES WELFARE FUND IS COVERED UNDER THE CONFLICT-OF-INTEREST POLICY. IF A CONFLICTING INTEREST EXISTS, THE PERSON WITH THE CONFLICT IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT-OF-INTEREST POLICY AND FINANCIAL INFORMATION AVAILABLE TO THE PUBLIC AND THE ORGANIZATION'S MEMBERS UPON REQUEST. 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, HEALTH SERVICES & BENEFIT ADMINISTRATORS. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT AUDITOR. THERE HAS BEEN NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. AUTOMOTIVE INDUSTRIES PENSION PLAN 4160 DUBLIN BOULEVARD NO 400 DUBLIN CA 945687756 941133245 TO PROVIDE PENSION BENEFITS CA 501(A) N/A N/A 0 CMTA-IAM JOINT RETIREE HEALTH & WELFARE TRUST 4160 DUBLIN BOULEVARD NO 400 DUBLIN CA 945687756 946130509 TO PROVIDE HEALTH BENEFITS CA 501(C)(9) N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE R, 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, 2017, THERE ARE APPROXIMATELY 211 EMPLOYERS AND VARIOUS SPONSORING ORGANIZATIONS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS AND VARIOUS SPONSORING ORGANIZATIONS, 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 AND VARIOUS SPONSORING ORGANIZATION IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT, THE NAMES OF THE CONTRIBUTING EMPLOYERS AND VARIOUS SPONSORING ORGANIZATIONS ARE LISTED ON PART VII BELOW AND NOT ON PARTS II THROUGH IV BY FEDERAL TAX CLASSIFICATION. A & B DIE CASTING A & H TRUCK REPAIR A TEICHERT & SON INC AB CAR RENTAL SERVICES, INC. ACE TRUCK REPAIR ACURA OF PLEASANTON AFSCME DISTRICT COUNCIL #57 AKIMA LOGISTICS SERVICES LLC ALAMEDA COUNTY INDUSTRIES ALBANY FORD SUBARU ALLIED INDUSTRIAL FORKLIFT SVC ALLISON BMW ANTIOCH AUTO CENTER ARAMARK UNIFORM SERVICES, INC. ASHLOCK CO ATLAS PACIFIC ENGINEERING CO AUTO METAL SERVICE AUTO WEST HONDA AUTOMOTIVE APPRENTICE TRUST BABBITT BEARING COMPANY BAY LINE CONCRETE CUTTING & CORING BENNER AUTO REPAIR, INC. BERKELEY FARMS BERKELEY HONDA AUTO CENTER BILL BRANDT FORD BOB GALLI'S AUTO REPAIR, INC. BOB MOTTERS BODY SHOP, INC. C H BULL CO CAIETTIS TRUCK REPAIR CAL BODY STEEL FORMING CALAVERAS MATERIAL, INC. CALIFORNIA CONFERENCE OF MACHINISTS CALIFORNIA TANK LINES, INC CALIFORNIA WASTE SOLUTIONS CAPITAL MACHINE CORPORATION CARGILL SALT CEMEX CENTRAL CONCRETE SUPPLY CO, INC CENTRAL CONTRA COSTA TRANSIT CHUCK'S BRAKE AND WHEEL CLUTCH & BRAKE XCHANGE, INC COAST COUNTIES TRUCK & EQUIP COCA COLA BOTTLING CO COLE EUROPEAN, INC. COMMERCIAL SPEEDOMETER SERVICE CON GLOBAL INDUSTRIES (CGI) CON GLOBAL INDUSTRIES/RCS CORNELY CO CUMMINS PACIFIC, LLC D W NICHOLSON CORP DALY CITY AUTO REPAIRS DARLING INTERNATIONAL, INC. DE SOTO CAB CO DIAMOND MFG CORP DIEGO TRUCK REPAIR, INC. DONAL MACHINE INC DRILL TECH DRILLING & SHORING, INC EARTHGRAINS EARTHGRAINS, C/O BIMBO BAK. EAST BAY CLARKLIFT ELM FORD, INC. EURO-AM AUTO SERVICE FABCO AUTOMOTIVE CORPORATION FIRST STUDENT INC FIRST VEHICLE SERVICES FRANCISCAN MOTORS DBA ACURA OF SERRA FRESNO TRUCK CENTER FRITZ & PETERS G & H DIESEL SERVICE, INC. G & M AUTOBODY, INC. GEIGER MFG, INC GENERAL GRINDING INC GENUINE MOTORS LLC GEORGE M MARTIN CO GEORGE MC GILLS BODY SHOP GILLIG CORPORATION GLENCORE RECYCLING INC GOLDEN GATE TRANSIT GOLDEN GATE TRUCK CENTER G-P CORPORATION, INC. GRANITE ROCK CO #17072 GREYHOUND LINES-DALLAS, TX GREYHOUND LINES-REDDING/RENO/SACTO H W MC KEVITT CO INC HAIGHT STREET GARAGE HALLOWELL CHEVROLET HAYWARD FORD, INC HECO-PACIFIC MFG INC HEDRICK'S COLLISION CENTER HERTZ CORPORATION HONDA OF EL CERRITO HONDA OF OAKLAND HONDA OF STEVENS CREEK HOWER AUTO REPAIR HUBBARD MACHINE SHOP HWM AUTO CORP I A OF M LOCAL 1101 I A OF M LOCAL 1173 I A OF M LOCAL 1584 I A OF M LOCAL 653 I A OF M LODGE 1546 I A OF M LODGE 190 I A OF M LODGE 2182 I A OF M LODGE 725 IAM & AW LOCAL LODGE 93 INDUSTRIAL MACHINE SHOP INSIDE GARAGE INC. JACOBS TECHNOLOGY, INC. JENSEN'S TIRE SERVICE, INC JOE GOMES TRUCKING, INC. KINGS TOWING KNOPP INC KOEHLER AUTO BODY WORKS L A SMITH & SONS L P MCNEAR BRICK CO LEE'S FORKLIFT SERVICE LEHIGH SOUTHWEST CEMENT CO LEHMER'S LEXUS OF PLEASANTON LIBERTY FLEET CARE LIVERMORE SANITATION, INC. MACY AUTOMOTIVE, INC. MAGNUSSEN TOYOTA OF PALO ALTO MARTINEZ AUTO BODY SHOP MIKE FULLER MOTOR SPORTS MIKE HARVEY ACURA MILL VALLEY REFUSE SERVICE, INC MORTON SALT CO MV TRANSPORTATION INC NATIONAL AEROSPACE SOLUTIONS NELSON BODY SHOP NIELLO INFINITI NOEL MILLER INC NOVATO AUTO CENTER OAKLAND MACHINE WORKS PACIFIC AUTO REPAIR INC PALM AVENUE MOTORS PAR 3 MOTORS INC PARAMEDICS PLUS PARKER ROBB CHEVROLET PARKING INDUSTRY FUND PBA MAINTENANCE PENINSULA AUTO MACHINISTS #1414 PENSKE TRUCK LEASING PETALUMA ACQUISITIONS, LLC PETER PAN MOTORS PETKARRIS, INC PLEASANTON TRUCK & EQUIPMENT REPAIR PRECISION STRIPPING & COATING PROFESSIONAL AUTO CARE PUMP REPAIR SERVICE CO RAIL TERMINAL SERVICES RALPH PANELLA LEASING RECTOR MOTOR CAR REGALIA'S AUTO BODY REINEGGER FRAME REPUBLIC SERVICES RIVERVIEW INTERNATIONAL TRUCKS INC ROBERT CHRISP COMPANY RODNEY DUTRA SERVICE ROLLIN J LOBAUGH INC RUAN TRANSPORT CORP RUTTER ARMEY INC. RYDER TRUCK RENTAL INC SAFEWAY STORES INC. SAN FRANCISCO HONDA SAN JOSE DIE CASTING CORP. SAN LEANDRO AUTO SAN MATEO COUNTY CENTRAL LBR COUCIL SAN PABLO AUTOMOTIVE SUPPLY SANTA CLARA CO AUTO APPRENT TRUST SARDEE INDUSTRIES INC SAVE MART SUPERMARKETS SERRAMONTE FORD INC SFO SHUTTLE BUS CO SHAMROCK MATERIALS INC SHEEDY DRAYAGE SIERRA LOBO CORP SILGAN CONTAINER CORP SIMS RECYCLING SOLUTIONS SOSCOL AUTO BODY SOUTH BAY AFL-CIO LABOR COUNCIL SPECIALTY DISTRIBUTORS SSA TERMINALS ST CLAIRE CADILLAC ST FRANCIS ELECTRIC STEVENS CREEK BMW STEWART CHEVROLET SVENHARDS SWEDISH BAKERY, INC SYAR INDUSTRIES INC. TELFER PAVEMENT TECHNOLOGIES THERMA SERVICES LLC TOBYS TRUCKING INC TOYOTA MATERIAL HANDLING TOYOTA OF VALLEJO TOYOTA OF WALNUT CREEK UNITED PARCEL SERVICE VALLEY RESTORATION VAN BEBBER BROS VERIFLO CORP VIEIRA'S VALLEY EQUIPMENT CO VINCENT WHITNEY WALSH STATION AUTO SERVICE WASTE MANAGEMENT OF ALAMEDA COUNTY WENZEL ENGINEERING WEST COUNTY RESOURCE RECOVERY INC WESTERN GRINDING SERVICE INC WINTER CHEVROLET WORKING PARTNERSHIP USA YANG ENTERPRISES, INC. YELLOW CAB COOPERATIVE, INC.