2015-10-05T17:54:06-05:00 2014-12-31 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 945834346 990 2014-01-01 936021113 UNITED ASSOC LOC NO 290 PLUMBER STEAMFITTER & SHIPFITTER IND H & W PLAN UNIT 5034543800 7600 SW MOHAWK STREET TUALATIN OR 97062 ED GORMLEY CO-CHAIRMAN 5034543800 2015-10-05 1 LORI L SCOTT P01452038 9252779100 2014 2016-03-07 17:11:31Z ED GORMLEY POBOX 117 1715 LAFAYETTE MCMINNVILLE OR 97128 70977357 0 X WWW.UA290BENEFITS.ORG X 1957 OR PROVIDE HEALTH AND WELFARE BENEFITS. 8 0 184 0 0 0 0 0 48945116 49293594 1923371 1787768 638288 673751 51506775 51755113 0 0 49801036 52808820 0 0 0 0 0 1497129 1897733 51298165 54706553 208610 -2951440 78636891 78172696 37307062 39375242 41329829 38797454 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS. 0 0 PROVIDED HEALTH, DENTAL, VISION, TIME LOSS, LIFE INSURANCE AND AD & D BENEFITS FOR ELIGIBLE PARTICIPANTS. 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 2068 0 1 184 1 0 0 0 0 0 0 X 8 0 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X ASSOCIATED THIRD PARTY ADMINISTRATORS 5034543800 7600 SW MOHAWK STREET TUALATIN OR 97062 X ED GORMLEY CO-CHAIRMAN 1.00 X 0 0 0 FRANK WALL TRUSTEE 1.00 X 0 0 0 DAN SMITH TRUSTEE 1.00 X 0 0 0 BILL MEHRENS TRUSTEE 1.00 X 0 0 0 BILL MOORE TRUSTEE 1.00 X 0 0 0 JON BERRY TRUSTEE 1.00 X 0 0 0 AL SHROPSHIRE CO-CHAIRMAN 1.00 X 0 0 0 RUSS HILL TRUSTEE 1.00 X 0 0 0 SEE SCHEDULE O FOR COMPENSATION PAID BY RELAT 1.00 X 0 1 0 0 1 0 0 0 0 0 ASSOCIATED THIRD PARTY ADMINISTRATORS 7600 SW MOHAWK STREET TUALATIN OR 97062 CONTRACT ADMINISTRATOR 909637 MULTIPLAN VIANT 115 FIFTH AVENUE NEW YORK NY 10003 PPO PROVIDER 220339 INNOVATIVE CARE MANAGEMENT INC 12300 SE MALLARD WAY SUITE 265 MILWAUKIE OR 97222 MEDICAL MANAGEMENT 127329 3 EMPLOYER CONTRIBUTIONS 900099 42729737 42729737 SUBSIDY FROM OTHER PLAN 900099 3475504 3475504 PARTICIPANT CONTRIBUTIONS 900099 2825295 2825295 MEDICARE-RETIREE DRUG SUBSIDY 900099 263058 263058 49293594 2337254 2337254 18672758 19222244 -549486 -549486 -549486 PRESCRIPTION REBATES 900099 629389 629389 MISCELLANEOUS INCOME 900099 42770 42770 CCL DISTRIBUTION 900099 1592 1592 673751 51755113 49967345 0 1787768 52808820 909637 40122 36751 30054 361391 227650 18354 29642 ACA REINSURANCE FEE 237615 MISCELLANEOUS 5383 UA RECIPROCITY FEES 1134 54706553 363495 3756369 14511732 8795923 5493233 5078716 9020 9694 58259411 60531994 78636891 78172696 1492029 528468 259033 241774 35556000 38605000 37307062 39375242 X 0 0 0 0 41329829 38797454 41329829 38797454 78636891 78172696 -2951440 419065 0 X X 0 1 X 1 0 0 ACCUMULATED ELIGIBILITY CREDITS 32698000 CLAIMS PAYABLE AND INCURRED BUT NOT REPORTED 5907000 38605000 X 52144124 419065 419065 51725059 30054 30054 51755113 51627499 0 51627499 30054 3049000 3079054 54706553 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 TO 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 DECEMBER 31, 2014, 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 2011. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION A, LINE 3 THE PLAN HAS CONTRACTED WITH ASSOCIATED THIRD PARTY ADMINISTRATORS TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE ORGANIZATION'S FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE GOVERNING BODY OF THE ORGANIZATION PRIOR TO ITS FILING WITH THE IRS. ALSO, THE ORGANIZATION'S ATTORNEY AND THE CHAIRMAN OF THE BOARD OF TRUSTEES READ THE FORM 990 FOR COMPLETENESS AND ACCURACY, PRIOR TO FILING THE FORM WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ADOPTED THEIR CONFLICT OF INTEREST POLICY DURING MARCH 2009. THE POLICY COVERS ALL TRUSTEES AND SERVICE PROVIDERS. THE POLICY PROVIDES FOR AN ANNUAL REVIEW OF PARTY-IN-INTEREST TRANSACTIONS; THE ADMINISTRATOR AND LEGAL COUNSEL ARE TO DISTRIBUTE PARTY-IN-INTEREST INQUIRIES AND REVIEW RESPONSES TO THE INQUIRIES. 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 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, ASSOCIATED THIRD PARTY ADMINISTRATORS. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSIGHT OF THE ANNUAL AUDIT AND FOR SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. UA LOCAL 290 401K PLAN 7600 SW MOHAWK ST TUALATIN OR 97062 931143757 TO PROVIDE RETIREMENT BENEFITS. OR 501A N/A N/A 0 UA LOCAL 290 PENSION PLAN 7600 SW MOHAWK ST TUALATIN OR 97062 936021114 TO PROVIDE PENSION BENEFITS. OR 501A N/A N/A 0 UA LOCAL 290 RETIREE HEALTH 7600 SW MOHAWK ST TUALATIN OR 97062 931143759 TO PROVIDE HEALTH AND WELFARE BENEFITS. OR 501(C)(9) N/A N/A 0 UA LOCAL 290 EDUCATION REIMBSCHOLORSHIP & VACATION PLAN 7600 SW MOHAWK ST TUALATIN OR 97062 931255764 TO PROVIDE VACATION, SCHOLARSHIP AND EDUCATIONAL REIMBURSEMENT BENEFITS. OR 501(C)(9) N/A N/A 0 UNITED ASSOCIATION OF JOURNEYMEN & LOCAL 290 20210 SW TETON AVE TUALATIN OR 97062 930895184 LABOR ORGANIZATION OR 501(C)(5) N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 UNITED ASSOC UNION LOC #290 PLUMBER STEAMFITTER & SHIPFITTER IND RET HEAL S 3475504 ACTUAL AMOUNT RECEIVED SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS: EXPLANATION: 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, 2014, THERE ARE APPROXIMATELY 177 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 ADMINISTRATIVE 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. A & A DRILLING A.P.C.C.O. ACCURATE CONCRETE CUTTING, INC. ADVANCED TECHNOLOGY GROUP INC AIR PRIDE INC. AIRTRONIX ALBINA PIPE BENDING CO INC ALLIANT SYSTEMS, LLC ALLSTARS PLUMBING AND ROOTER ALPINE BUILDING SERVICES INC AM TECHNICAL SOLUTIONS, INC APOLLO MECHANICAL CONTRACTORS ARCTIC SHEET METAL, INC AUBURN MECHANICAL INC BASELINE INDUSTRIAL CONSTRUCTION, INC BAY CITIES FABRICATORS BEAVER CONCRETE CUTTING BEDROCK CONCRETE CUTTING INC BEND WELDING & TRUCK, LLC BILL BAILEY PLUMBING INC BLUE WATER PLUMBING & WATER TREATMENT, LLC BMWC CONSTRUCTORS, INC BOHEMIA PLUMBING AND CONST BOILER & COMBUSTION SERVICE INC BROTHERS PLUMBING, LLC BRYAN MEARS PLUMBING, LLC BUILDING ENERGY LLC.COM C.J. 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HARDER MECHANICAL CONTRACTORS INC. HARVEY & PRICE COMPANY HEINZ BUILDING AUTOMATION, INC HEINZ MECHANICAL INC. HEINZ MECHANICAL SERVICE, INC HILL CONSTRUCTION HOFFMAN MECHANICAL HOOD RIVER PLUMBING & HEATING INC. HOODLAND PLUMBING, INC HYBRID TECH IDEAL PLUMBING CO INDUCCO, INC INNER CITY PLUMBING, INC J H KELLY J P PLUMBING CO INC JAY JAY'S PLUMBING INC JOHN BURGER HEATING AND AC JOHNSON CONTROLS JONES PLUMBING & HEATING INC. JR MERIT, INC K2 MECHANICAL, INC KAUFMANN PLUMBING AND MECHANICAL LLC KENNY PLUMBING CO KEY MECHANICAL CO OF WASHINGTON KINETIC SYSTEMS, INC KIRK ERECTORS, INC. LITCH PLUMBING, INC. LIVESAY PLUMBING & MECH, INC. LOY CLARK PIPELINE LYNCH MECHANICAL CONST CO LLC M P P PIPING INC MACDONALD-MILLER FACILITY SOLUTIONS, INC MACKIN & LITTLE, INC MAPLESERVICE INC MCKINSTRY CO LLC MEDFORD MECHANICAL INC MEI SPECIALTY MACHINERY MOVING, LLC METRO MECHANICAL METRO MECHANICAL SYSTEMS, LLC MICHELS CORPORATION MILWAUKIE HEATING & COOLING MISSION PLUMBING SERVICE MORGAN MILLWRIGHT & MECHANICAL SERVICES MORGAN MILLWRIGHT & MECHANICAL SERVICES, INC MUNSON PUMP SERVICES MURRAY COMPANY NESS & CAMPBELL CRANE, INC. NORTHWEST CONTROL COMPANY INC NORTHWEST METAL FAB & PIPE INC NW INDUSTRIAL MECHANICS, INC NW MECHANICAL CONTRACTORS LLC NW MECHANICAL GROUP, LLC OCEAN PARK MECHANICAL INC OCEAN PARK MECHANICAL, INC. OREGON AIR REPS DBA ENVIRONMENTAL CONTROL CORP OREGON EQUIPMENT SERVICE CORP OTTO PIPE CONSTRUCTION LLC PARAZOO PLUMBING, LLC PATTERSON PLUMBING CO PELICAN BAY STATE PRISON PENHALL COMPANY PENINSULA PLUMBING CO PERFORMANCE CONTRACTING SERVICES PERFORMANCE CONTRACTING, INC PERMACOLD ENGINEERING, INC PHILLIPS REFRIGERATION CO PLATINUM INDUSTRIAL, INC. PLUMBING & MECHANICAL CONTRACTORS ASSN PONDER BURNER CO. PORT OF VANCOUVER USA PORTLAND MECHANICAL CONSTRUCTION, INC PORTLAND SERVICE PLUMBING POWER PLUMBING CO PROCESS PIPING FABRICATION, LLC PROFESSIONAL MECHANICAL INC PURE COMMERCIAL PLUMBING RESOURCE MANAGEMENT RICHARD GIFFORD DBA: EAGLE LAKE PLUMBING RM MECHANICAL, INC. RMS ENTERPRISES LLC DBA CROWN PLUMBING ROB'S SUPERIOR PLUMBING, INC ROCKY'S MECHANICAL SERVICE ROSENDIN ELECTRIC, INC S F S, INC DBA SPECIALTY FIRESTOPING SYSTEMS S-2 INDUSTRIAL SANDPIPER PLUMBING SHERRELL PLUMBING & CONSTRUCTION LLC SIEMENS INDUSTRIES INC SKYLINE PLUMBING, LLC SNELSON COMPANIES, INC STEVE'S PLUMBING STIRRETT-JOHNSEN, INC. SWISSLOG TRANSLOGIC CORP TC PLUMBING & MECHANICAL TEMP-CONTROL MECH SERVICE CORP TEMP-CONTROL MECHANCAL CORP THERMOPOWER INDUSTRIES INC TI TECH LLC TIMBER VALLEY PLUMBING TITTEL ENTERPRISES, INC. TOTAL FACILITY SOLUTIONS, INC. TOTAL MECHANICAL INC TRANE OREGON TUTOR-SOLIBA CORP TWIN RIVERS PLUMBING U A LOCAL 290 U A LOCAL 290 TRAINING CTR UNIVERSITY MECHANICAL CONT. USA MECHANICAL, INC VAN ROW MECH, LLC VIGOR MARINE, LLC WATSON PLUMBING CO WAYNE MAPLES PLUMBING & HEATING WEST COAST MECHANICAL CONTRACTORS YMC, INC.