2017-01-11T17:07:08-06:00 2016-03-31 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2015-04-01 916028570 LOCALS 302 & 612 INTL UNION OF OP ENG CONST IND HEALTH AND SECURITY PLAN LOCA 2064417574 PO BOX 34203 SEATTLE WA 981241203 DAREN KONOPASKI CHAIRMAN 2064417574 2017-01-11 1 TODD M STOKES P01451940 9252779100 2015 2021-01-29 14:40:06Z DAREN KONOPASKI PO BOX 34203 SEATTLE WA 981241203 411968825 0 X WWW.ENGINEERSTRUST.COM X 1953 WA PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS. 10 0 82 0 0 0 0 0 121530704 131561343 5923325 4534030 157986 147100 127612015 136242473 0 0 126412103 124589577 0 0 0 0 0 5661010 6753819 132073113 131343396 -4461098 4899077 238563823 219340602 104757172 80864562 133806651 138476040 PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS, THEIR DEPENDENTS, AND RETIREES. 0 0 PROVIDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS, THEIR DEPENDENTS, AND RETIREES. 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 4863 0 1 82 1 0 0 0 0 0 0 X 10 0 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 1 0 0 0 X WELFARE & PENSION ADMINISTRATION SE 2064417574 2815 SECOND AVENUE SUITE 300 SEATTLE WA 98121 X BRETT FERULLO TRUSTEE 1.00 X 0 0 0 MIKE TUCCI TRUSTEE 1.00 X 0 0 0 DOUG PETERSON TRUSTEE/SECRETARY 1.00 X 0 0 0 MIKE MILLER TRUSTEE 1.00 X 0 0 0 ERNEST EVANS TRUSTEE 1.00 X 0 0 0 DAREN KONOPASKI TRUSTEE/CHAIRMAN 1.00 X 0 0 0 ROBERT PETERSON TRUSTEE - PAST 1.00 X 0 0 0 SEAN JEFFRIES TRUSTEE 1.00 X 0 0 0 KYLE BREES TRUSTEE - PAST 1.00 X 0 0 0 MIKE LEE TRUSTEE 1.00 X 0 0 0 JASON ALWARD TRUSTEE 1.00 X 0 0 0 SEE SCHEDULE O FOR COMPENSATION PAID BY RELATED ORGANIZATI 0.00 X 0 1 0 0 1 0 0 0 0 0 WELFARE & PENSION ADMINISTRATION SERVICE PO BOX 34203 SEATTLE WA 98124 ADMINISTRATION 2653337 PREMERA 7001 220TH ST SW BUILDING 1 MOUNTLAKE TERRACE WA 98043 BENEFIT ADMINISTRATION 888980 FIRST CHOICE HEALTH 600 UNIVERSITY STREET SUITE 1400 SEATTLE WA 98101 PPO NETWORK PROVIDER 508681 EMDEON 13209 CORPORATE EXCHANGE DRIVE BRIDGETON MO 63044 CLAIM PAYMENT MANAGEMENT 219734 RAINIER INVESTMENT MANAGEMENT 601 UNION STREET SUITE 2801 SEATTLE WA 98101 INVESTMENT MANAGER 207390 8 EMPLOYER CONTRIBUTIONS 900099 107370132 107370132 PARTICIPANT CONTRIBUTIONS 900099 14980132 14980132 FORMULARY & OTHER REBATES 900099 6625571 6625571 EGWP SUBSIDY 900099 1944984 1944984 EXP RATING REF - UNITED OF OMAHA 900099 640524 640524 131561343 5168641 5168641 275091741 275726352 -634611 -634611 -634611 LEGAL FEES COLLECTED 900099 67414 67414 SECURITIES LENDING INCOME 900099 64736 64736 INCOME LITIGATION 900099 14950 14950 147100 136242473 131628757 0 4613716 124589577 946120 261949 123950 196906 3734666 625354 9495 21916 22403 ACA REINSURANCE FEE 609704 ALASKA VACCINE ASSESSME 160784 PCORI FEE 40572 131343396 3319376 5919447 3090651 3363865 12636497 21731971 6200 6400 187057492 162718737 21654642 32453607 3945540 238563823 219340602 586878 431854 104170294 80432708 104757172 80864562 X 0 0 0 0 133806651 138476040 133806651 138476040 238563823 219340602 4899077 -229688 0 X X 0 1 X 1 0 0 LIMITED PARTNERSHIP 21654642 F 21654642 ACCUMULATED ELIGIBILITY CREDITS 51365000 OBLIGATIONS UNDER SECURITIES LENDING AGREEMENT 4426330 CLAIMS PAYABLE AND IBNR 24641378 80432708 X 135815879 -229688 -229688 136045567 196906 196906 136242473 126382629 0 126382629 196906 4763861 4960767 131343396 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 RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF MARCH 31, 2016, 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 YEARS PRIOR TO 2013. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION A, LINE 3 THE PLAN HAS CONTRACTED WITH WELFARE & PENSION ADMINISTRATION SERVICE, INC. TO PROVIDE DAY TO DAY ADMINISTRATIVE SERVICES TO THE PLAN. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 WILL BE REVIEWED BY THE TRUST CHAIRMAN FOR ACCURACY AND COMPLETENESS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, 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 THE OTHER RELATED ORGANIZATIONS IS REPORTED ON THE FROM 990 FILED WITH THE INTERNAL REVENUE SERVICE BY THE RELATED TAX-EXEMPT ORGANIZATION. IF YOU WOULD LIKE ADDITIONAL INFORMATION, PLEASE CONTACT THE THIRD-PARTY ADMINISTRATION, WELFARE & PENSION ADMINISTRATION SERVICE, INC. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS A BOARD OF TRUSTEES THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED. FORM 990, PART V, LINE 2A THE PLAN PROVIDES TAXABLE DISABILITY BENEFIT PAYMENTS TO ELIGIBLE PARTICIPANTS AND REPORTS THOSE BENEFITS ON FORM W-2. THESE BENEFITS ARE INCLUDED ON FORM 990 PART IX LINE 4. WESTERN WA OPERATING ENGINEERS - EMPLOYERS TRAINING TRUST 16921 VANTAGE HIGHWAY ELLENSBURG WA 98926 916134083 TO PROVIDE TRAINING BENEFITS WA 501(C)3 9 N/A 0 LOCALS 302 & 612 OF THE IUOE RETIREMENT PLAN PO BOX 34203 SEATTLE WA 981241203 916028571 TO PROVIDE PENSION BENEFITS WA 501(A) N/A N/A 0 INTL UNION OF OPERATING ENGINEERS LOCAL 302 18701 120TH AVENUE NE BOTHELL WA 980119514 910257483 LABOR UNION WA 501(C)5 N/A N/A 0 INTL UNION OF OPERATING ENGINEERS LOCAL 612 1555 SOUTH FAWCETT AVENUE TACOMA WA 98401 910268531 LABOR UNION WA 501(C)5 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, 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 MARCH 31, 2016, THERE ARE APPROXIMATELY 519 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 ADMINISTATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT THE NAMES OF THE CONTRIBUTING EMPLOYERS ARE LISTED ON PART VII BELOW AND NOT ON PARTS II THROUGH IV BY FEDERAL TAX CLASSIFICATION 1 ALLIANCE GEOMATICS 3 KINGS ENVIRONMENTAL 800 5TH AVE PARTNERS A & L CONSTRUCTION A MILLICAN CRANE SERV A-1 LANDSCAPING/CONST ABERCROMBIE PIPELINE ABLE ENGINEERING SVCS ABM FACILITY SERVICES ACCURATE ENTERPRISES ACME CONCRETE PAVING ACTIVE CONST INC ADMIRALTY CONSTRUCTION ADP CONSTRUCTION SERV ADVANCED BLASTING ADVANCED GEOSOLUTIONS ADVANTAGE DIRT AGGREGATE CONSTRUCTION AGOSTINO CONSTRUCTION AHTNA CONST & PRIMARY AIR PLACED CONCRETE AK FRONTIER AK INTERSTATE CONST AK OPER ENG TRNG FUND ALASKA CONCRETE SVCS ALASKA CRANE SERVICE ALASKA FRONTIER ALASKA INDUSTRIAL LLC ALASKA JUNEAU CONST. 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