2016-04-11T13:41:58-05:00 2015-05-31 300702322 HEMMING MORSE CPA'S AND CONSULTANTS 155 BOVET ROAD SUITE 600 SAN MATEO CA 94402 990 2014-06-01 941235152 LABORERS HEALTH & WELFARE TRUST FUND FOR NORTHERN CALIFORNIA LABO 7078642800 220 CAMPUS LANE FAIRFIELD CA 945341498 ED SMITH SECRETARY 7078642800 2016-04-11 1 P01781096 4158364000 2014 2016-08-17 19:52:53Z ED SMITH 220 CAMPUS LANE FAIRFIELD CA 945341498 301012889 0 X N/A X 1953 CA SEE PART III LINE 4A 10 10 0 0 0 0 0 0 203664923 225351623 7048644 3999300 2552439 4251900 213266006 233602823 0 0 219858016 219519633 0 0 0 0 0 14226236 16398077 234084252 235917710 -20818246 -2314887 205954696 215328372 120763006 130017287 85191690 85311085 NONE 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS ACCORDING TO THE TERMS OF THE COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE EMPLOYERS AND THE UNION 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 63 0 0 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 0 0 1 1 0 0 0 X EDWARD SMITH SECRETARY 7078642800 220 CAMPUS LANE FAIRFIELD CA 94534 X BILL KOPONEN TRUSTEE 5.00 X 0 0 0 BYRON LONEY TRUSTEE 5.00 X 0 0 0 MANUEL DE SANTIAGO TRUSTEE 5.00 X 0 0 0 ROBERT CHRISP TRUSTEE 5.00 X 0 0 0 JERRY OVERAA TRUSTEE 5.00 X 0 0 0 RAMON HERNANDEZ TRUSTEE 5.00 X 0 0 0 OSCAR DE LA TORRE TRUSTEE 5.00 X 0 0 0 FERNANDO ESTRADA TRUSTEE 5.00 X 0 0 0 DOYLE RADFORD TRUSTEE 5.00 X 0 0 0 DAVID GORGAS TRUSTEE 5.00 X 0 0 0 0 0 0 0 0 0 0 LABORERS FUND ADMINISTRATIVE OFFICE OF N 220 CAMPUS LANE FAIRFIELD CA 94534 ADMINISTRATOR 8322895 BLUE CROSS OF CALIFORNIA PO BOX 70000 VAN NUYS CA 914700001 CLAIMS ADMINISTRATION 2695449 HEALTHWAYS 21281 BURBANK BLVD WOODLAND HILLS CA 91367 CLAIMS ADMINISTRATION 1399447 DELTA DENTAL 100 FIRST STREET SAN FRANCISCO CA 94105 CLAIMS ADMINISTRATION 1052965 HEALTH AND SAFETY FUND 905 16TH STREET NW WASHINGTON DC 20006 MEDICAL CONSULTING 587761 5 EMPLOYER CONTRIBUTIONS 900099 209978165 209978165 PARTICIPANT CONTRIBS 900099 14805217 14805217 COBRA CONTRIBUTIONS 900099 568241 568241 225351623 4298784 4298784 67110582 67410066 -299484 -299484 -299484 REBATES AND SUBSIDIES 900099 4130405 4130405 SETTLEMENT INCOME 900099 121495 121495 4251900 233602823 229304039 0 4298784 219519633 8322895 420388 50665 347143 1058461 7415 12976 CLAIMS ADMIN 6170274 POSTAGE AND PRINTING 7860 235917710 6610671 10606805 1342608 6546310 18753714 20593615 33307 31491 123788240 115901967 51621713 55871529 3804443 5776655 205954696 215328372 1430649 1201279 119332357 128816008 120763006 130017287 X 0 0 0 0 85191690 85311085 85191690 85311085 205954696 215328372 -2314887 2434282 0 X X 0 1 X 0 0 0 COMMON COLLECTIVE FUNDS 55871529 F 55871529 DUE TO LABORERS FUNDS ADMINISTRATIVE OFFICES OF NORTHERN CALIFORNIA, INC. 997981 GROUP INSURANCE PEMIUMS PAYABLE 11513440 SELF-FUNDED BENEFIT CLAIMS PAYABLE 34085009 IBNR 12094000 BANK OF HOURS 70108000 DUE TO BROKER 17578 128816008 X 236037105 2434282 2434282 233602823 0 233602823 235917710 0 235917710 0 235917710 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. THE TRUST ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR FISCAL YEARS PRIOR TO MAY 31, 2012. 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 OR TRUSTEES, OR KEY EMPLOYEES TO THE ADMINISTRATIVE OFFICE. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY SUB-COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE TRUSTEES HAVE DESIGNATED THE ADMINISTRATOR TO REVIEW THE FORM PRIOR TO FILING OF THE FORM 990. 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 XI, LINE 2C THE BOARD OF TRUSTEES OF THE ORGANIZATION ASSUME'S RESPONSIBILITY FOR THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND THE SELECTION OF THE INDEPENDENT AUDITOR. LABORERS PENSION TRUST FUND FOR NORTHERN 220 CAMPUS LANE FAIRFIELD CA 94534 946277608 TO PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS CA 401B 0 LABORERS PENSION TRUST FUND FOR NORTHERN CALIFORNIA - ANNUITY PLAN 220 CAMPUS LANE FAIRFIELD CA 94534 946277608 TO PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS CA 401B 0 LABORERS VACATION-HOLIDAY TRUST FUND FOR NORTHERN CALIFORNIA 220 CAMPUS LANE FAIRFIELD CA 94534 946092198 TO PROVIDE VACATION AND HOLIDAY BENEFITS TO ELIGIBLE PARTICIPANTS CA 501(C)(9) 0 LABORERS TRAINING AND RETRAINING TRUST FUND FOR NORTHERN CALIFORNIA 220 CAMPUS LANE FAIRFIELD CA 94534 941688279 TO PROVIDE TRAINING SERVICES TO ELIGIBLE PARTICIPANTS CA 501(C)(3) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0