2016-11-07T18:50:34-06:00 2015-12-31 410746749 CLIFTONLARSONALLEN LLP 3000 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2015-01-01 930864012 INLANDBOATMEN'S UNION OF THE PACIFIC NATIONAL HEALTH BENEFIT TRUST INLA 5032240048 1200 WESTLAKE AVE N NO 1006 SEATTLE WA 98109 ALAN COTE CO-CHAIRMAN 5032240048 2016-11-02 1 KAREN THOMAS CPA P00106450 4252506100 2015 2017-02-10 21:41:12Z ALAN COTE 1200 WESTLAKE AVE N NO 1006 SEATTLE WA 98109 38581252 0 X WWW.IBU.AIBPA.COM/HEALTH X 1984 WA TO PROVIDE HEALTH AND WELFARE BENEFITS TO QUALIFIED PARTICIPANTS 12 12 28 12 0 0 0 0 26332905 27866670 1156309 1037402 13335 64272 27502549 28968344 0 0 24606859 23908970 0 0 0 0 0 1840090 1836356 26446949 25745326 1055600 3223018 29847984 31890042 10997899 10805499 18850085 21084543 TO PROVIDE HEALTH AND WELFARE BENEFITS TO QUALIFIED PARTICIPANTS. 0 0 DISBURSEMENTS NEEDED TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AS SPECIFIED IN THE PLAN. 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 7 0 1 28 1 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X LEE CENTRONE 5032240048 1220 SW MORRISON SUITE 300 PORTLAND OR 97205 X X ALAN COTE CO-CHAIRMAN 0.50 X X 0 0 0 DONOVAN DUNCAN TRUSTEE 0.50 X 0 0 0 MARINA SECCHITANO TRUSTEE 0.50 X 0 0 0 LEE EGLAND CO-CHAIRMAN 0.50 X X 0 0 0 DEAN KAPOI TRUSTEE 0.50 X 0 0 0 JOHN SKOW TRUSTEE 0.50 X 0 0 0 MATT HAINLEY TRUSTEE 0.50 X 0 0 0 MIKE O'CONNOR TRUSTEE 0.50 X 0 0 0 BRIAN DODGE TRUSTEE 0.50 X 0 0 0 CAROLYN HORGAN TRUSTEE 0.50 X 0 0 0 PETER HART TRUSTEE 0.50 X 0 0 0 DENNIS CONKLIN TRUSTEE 0.50 X 0 0 0 0 0 0 0 0 0 0 A&I BENEFIT PLAN ADMINISTRATORS 1220 SW MORRISON ST SUITE 300 PORTLAND OR 97205 ADMINISTRATION 408067 PREMERA BLUE CROSS 7001 220TH ST SW BUILDING 1 MOUNTLAKE TERRACE WA 98043 CLAIMS PAYER 402843 BENESYS INC 1220 SW MORRISON ST SUITE 300 PORTLAND OR 97205 ADMINISTRATION 349854 3 EMPLOYER CONTRIBUTIONS 900099 27632615 27632615 SELF PAY CONTRIBUTIONS 900099 234055 234055 27866670 791854 791854 9858456 9612908 245548 245548 245548 OTHER INCOME 900099 64272 64272 64272 28968344 27930942 0 1037402 23908970 1310417 21776 33248 83900 117767 58319 35346 35805 REINSURANCE 132050 ACA TAXES 7728 25745326 1578499 2161928 3597222 4105653 24672263 25622461 29847984 31890042 256051 234195 10741848 10571304 10997899 10805499 X 0 0 0 0 18850085 21084543 18850085 21084543 29847984 31890042 3223018 -988560 0 X X 0 1 X 1 0 0 AMOUNTS DUE INSURANCE COMPANIES 691304 LAG MONTHS ELIGILIBILITY COVERAGE 3500000 CLAIMS PAYABLE AND INCURRED BUT NOT REPORTED 3300000 PARTICIPANTS INDIVIDUAL ACCOUNTS 2400000 PARTICIPANTS SUPPLEMENTAL ACCOUNTS 680000 10571304 X 27895884 -988560 -988560 28884444 83900 83900 28968344 25831970 0 25831970 83900 -170544 -86644 25745326 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN'S BOARD OF TRUSTEES TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XII, LINE 4B - OTHER ADJUSTMENTS: DECREASE IN BENEFIT OBLIGATIONS -170,544. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF TRUSTEES REVIEWS A DRAFT OF THE FORM 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12 THE TRUSTEES ARE REQUIRED TO PROVIDE AN ANNUAL WRITTEN STATEMENT CONCERNING ANY CONFLICTS THEY ARE AWARE OF. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN DOCUMENT, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PARTICPANTS AND PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 6: TRUSTEES ARE NOT COMPENSATED BY THE TRUST. COMPENSATION PAID TO TRUSTEES EMPLOYED BY OTHER RELATED TAX-EXEMPT ORGANIZATIONS IS REPORTED ON FORM 990 FILED WITH THE IRS BY RELATED TAX-EXEMPT ORGANIZATION. IF YOU WOULD LIKE ADDITIONAL INFORMATION, PLEASE CONTACT THE PLAN ADMINISTRATOR. FORM 990, PART XII LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM PRIOR YEARS. INLANDBOATMEN'S UNION OF THE PACIFIC NATIONAL PENSION PLAN INLANDBOATMEN'S UNION OF THE PACIFIC NATIONAL 401(K) PLAN INLANDBOATMEN'S UNION MLK JR CNTY LABOR COUNCIL ALASKA LONGSHORE HEALTH AND WELFARE ACT ITF-ILWU NATIONAL OFFICE ALASKA NAUTICAL SVCS LLC BLUE AND GOLD FLEET BRIX MARITIME CORP (FOSS) BRUSCO TUG & BARGE INC CDX FERRY CONCESSIONS INC CONNOLLY-PACIFIC CO CROWLEY MARINE SERVICES FOSS MARITIME COMPANY GEORGIA PACIFIC GOLDEN GATE BRIDGE & HWY BLACK BALL TRANSPORT MANSON-SW MARINE PENSION NORTHLAND SERVICES PACIFIC TERMINAL SERVICES RED & WHITE FLEET SADDLE MOUNTAIN SAUSE BROS INC TIDEWATER BARGE LINES WESTOIL MARINE SERVICES DUNLAP TOWING CO P&M MARINE SERVICES LLC PACIFIC COAST MARITIME IN PUGET SOUND PILOTS YOUNG BROTHERS 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0