SEIU HEALTHCARE NW HEALTH BENEFITS TRUST: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- SEIU HEALTHCARE NW HEALTH BENEFITS TRUST (EIN 20-1842198)
- Tax period
- 2013-08-01 to 2014-07-31
- Filed
- 2015-06-10
- IRS object ID
- 201521619349300822
- Schema version
- 2013v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-06-10T16:24:44-05:00 | ReturnTs |
| Tax Period End | 2014-07-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910614823 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCHOEDEL & SCHOEDEL CPAS PLLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 422 W RIVERSIDE AVE STE 1420 | AddressLine1 |
| City | SPOKANE | City |
| State | WA | State |
| ZIP Code | 992010395 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-08-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201842198 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SEIU Healthcare NW Health Benefits Trust | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SEIU | BusinessNameControlTxt |
| Phone | 4257717359 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 6 | AddressLine1 |
| City | Mukilteo | City |
| State | WA | State |
| ZIP Code | 98275 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Charissa Raynor | PersonNm |
| Person Title | Executive Director | PersonTitleTxt |
| Phone | 2538153728 | PhoneNum |
| Signature | 2015-06-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SCOTT OPPERUD CPA | PreparerPersonNm |
| PTIN | P00542597 | PTIN |
| Phone | 5097472158 | PhoneNum |
| Preparation | 2015-06-08 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | David Rolf | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 6 | AddressLine1 |
| City | Mukilteo | City |
| State | WA | State |
| ZIP Code | 98275 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $149,889,337 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | www.myseiubenefits.org | WebsiteAddressTxt |
| Type Of Organization Trust | Yes (X) | TypeOfOrganizationTrustInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | The Trust was established as a result of collective bargaining between the Service Employees International Union, Local 775 (SEIU 775) and various employers or employer representatives signatory thereto to provide health, vision and dental benefits covering qualified employees reported under the collective bargaining agreements. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $125,854,067 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $149,881,817 | CYProgramServiceRevenueAmt |
| PY Investment Income | $21,078 | PYInvestmentIncomeAmt |
| CY Investment Income | $7,520 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $125,875,145 | PYTotalRevenueAmt |
| CY Total Revenue | $149,889,337 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $129,225,279 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $145,671,055 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,722,813 | PYOtherExpensesAmt |
| CY Other Expenses | $4,072,234 | CYOtherExpensesAmt |
| PY Total Expenses | $131,948,092 | PYTotalExpensesAmt |
| CY Total Expenses | $149,743,289 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$6,072,947 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $146,048 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $28,254,268 | TotalAssetsBOYAmt |
| Total Assets EOY | $29,820,194 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,932,243 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,352,121 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $26,322,025 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $26,468,073 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The Trust provides health and welfare benefits pursuant to collective bargaining agreements between various employers and the Trust. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Desc | The Trust was established as a result of collective bargaining between SEIU 775 and various employers or employer representatives signatory thereto to provide health, vision and dental benefits covering qualified employees reported under the collective bargaining agreements. | Desc |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 8 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Benefit Solutions Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4257717359 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12121 Harbour Reach Drive Ste 105 | AddressLine1 |
| City | Mukilteo | City |
| State | WA | State |
| ZIP Code | 98275 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| David Rolf | ||||||
| Chairman / Labor Trustee | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Sterling Harders | ||||||
| Labor Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Misha Werschkul | ||||||
| Labor Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Seth Hemond | ||||||
| Labor Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Eric Erickson | ||||||
| Employer Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Adam Glickman-Flora | ||||||
| Labor Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Diane Lutz | ||||||
| Employer Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MaryAnne Lindenblad | ||||||
| Employer Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Monique Taylor Swan | ||||||
| Labor Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Bill Moss | ||||||
| Employer Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Mark Robinson | ||||||
| Employer Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Charissa Raynor | ||||||
| Executive Director | 10.00 | Yes (X) | $0 | $142,320 | $38,316 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $142,320 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $38,316 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SEIU Healthcare NW Training Partnership | |||||
| 215 Columbia Street | Seattle | WA | 98104 | Plan administration | $1,565,043 |
| Benefit Solutions Inc | |||||
| 12121 Harbour Reach Drive Suite 10 | Mukilteo | WA | 98275 | Contract administrator | $696,403 |
| Delta Dental of Washington | |||||
| 9706 Fourth Avenue NE | Seattle | WA | 981152157 | Dental claims administrator | $315,624 |
| Sara Willgress Consulting LLC | |||||
| 15113 21st Dr SE | Mill Creek | WA | 98012 | Consulting | $290,175 |
| Weber Shandwick | |||||
| 818 Stewart St Suite 1300 | Seattle | WA | 98101 | Communications Consutling | $254,696 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Employer contributions | 525100 | $145,380,567 | $145,380,567 |
| Participant contributions | 525100 | $4,496,306 | $4,496,306 |
| Employer late charges | 525100 | $4,944 | $4,944 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $149,881,817 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,520 | TotalRevenueColumnAmt |
| Exclusion | $7,520 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $149,889,337 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $149,881,817 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $7,520 | ExclusionAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $145,671,055 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,917,117 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,802 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,831 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,156,781 | TotalAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,910 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,650 | TotalAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $510,981 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $145,853 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,237 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,315 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,387 | TotalAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Dues | Desc |
| Total | $29,370 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,743,289 | TotalAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,084,490 | BOYAmt |
| EOY | $13,327,188 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,155,764 | BOYAmt |
| EOY | $16,479,389 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,230 | BOYAmt |
| EOY | $12,627 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,784 | BOYAmt |
| EOY | $990 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,254,268 | BOYAmt |
| EOY | $29,820,194 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $146,743 | BOYAmt |
| EOY | $532,121 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,785,500 | BOYAmt |
| EOY | $2,820,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,932,243 | BOYAmt |
| EOY | $3,352,121 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,322,025 | BOYAmt |
| EOY | $26,468,073 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,322,025 | BOYAmt |
| EOY | $26,468,073 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,254,268 | BOYAmt |
| EOY | $29,820,194 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $146,048 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Dental claims payable | $48,000 |
| Premiums due to insurers | $2,660,000 |
| Dental claims incurred but not reported | $112,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,820,000 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $149,889,337 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $149,889,337 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $149,889,337 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $149,743,289 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $149,743,289 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $149,743,289 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | The Trust is subject to audit or examination by various regulatory jurisdictions. As of May 11, 2015, there were no audits or examinations in progress. With few exceptions, as of July 31, 2014, the Trust was no longer open to audit or examination for fiscal years ended prior to July 31, 2011. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Charissa Raynor | PersonNm |
| Title | Executive Director | TitleTxt |
| Base Compensation Filing Org | $0 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $142,320 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $38,316 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $0 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $180,636 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | SEIU Healthcare 775NW and the SEIU Healthcare NW Training Partnership are service providers to this trust as well as participating employers. David Rolf is the Chairman of this trust, the President of SEIU Healthcare 775NW, and the Chairman of the SEIU Healthcare NW Training Partnership. Misha Werschkul is a trustee of this trust and an employee of SEIU Healthcare 775NW. Mark Robinson is a trustee of this trust and an employee of Addus Healthcare, Inc., an employer of record participating in this trust. Seth Hemond is a trustee of this trust, an employee of SEIU Healthcare 775NW, and a trustee of the SEIU Healthcare NW Training Partnership. MaryAnne Lindeblad is a trustee of this trust, and an employee of State of WA, an employer of record participating in this trust. Sterling Harders is a trustee of this trust, the Vice President of SEIU Healthcare 775NW, and a trustee of the SEIU Healthcare NW Training Partnership. Adam Glickman-Flora is a trustee of this trust, an employee and the Secretary-Treasurer of SEIU Healthcare 775NW. Eric Erickson is a trustee of this trust and an employee of CDM Services, a participating employer of this trust. Diane Lutz is a trustee of this trust and an employee of the State of Washington, an employer of record participating in this trust. Bill Moss is a trustee of this trust, a trustee of SEIU Healthcare NW Training Partnership, and an employee of State of Washington an employer of record participating in this trust. Monique Taylor Swan is a trustee of this trust and an executive board member of SEIU Healthcare 775NW. Charissa Raynor is the Executive Director of this trust and the Executive Director of the SEIU Healthcare NW Training Partnership. |
| Form 990, Part VI, Section A, line 3 | The Trust has contracted with various organizations (Benefit Solutions, Inc., Delta Dental of Washington, SEIU Healthcare NW Training Partnership, and SEIU Healthcare 775NW) to provide administrative, bookkeping, claims processing, member communications, and record keeping services. |
| Form 990, Part VI, Section A, line 7a | There are four voting Labor Trustees and four voting Employer Trustees. Any vacancies of Employer Trustees are filled by appointment of the remaining Employer Trustees. The appointment of an Employer Trustee may be terminated, at any time, by the remaining Employer Trustees by such method as is satisfactory to them. Any vacancies of the Labor Trustees are filled by appointment of the president of SEIU Healthcare 775NW according to SEIU Healthcare 775NW's internal rules, procedures, policies or bylaws. The appointment of a Labor Trustee may be terminated, at any time, by the president of SEIU Healthcare 775NW according to SEIU Healthcare 775NW's internal rules, procedures, policies or bylaws. |
| Form 990, Part VI, Section B, line 11 | The Form 990 was prepared by the independent accounting firm SCHOEDEL & SCHOEDEL, Certified Public Accountants, PLLC from information provided by the third-party administrator and other consultants and advisors. Draft copies of the Trust's financial statements and Form 990 were first provided to the Trust's consultants and advisors, who reviewed the Form 990 for accuracy and completeness. Any questions, concerns or issues raised by the consultants and advisors were addressed and any necessary revisions were made to the Form 990. The revised Form 990 was then provided to the Board of Trustees for its review and approval. Any additional questions, concerns or issues raised by the Board of Trustees were addressed and any necessary revisions were made to the Form 990. The final version of the Form 990 was reviewed, approved and filed by the Board of Trustees. |
| Form 990, Part VI, Section B, line 12c | A copy of the Trust's Conflict of Interest Policy has been distributed to each Trustee and other fiduciaries. At least annually, a fiduciary is obligated to disclose or update to the Board of Trustees a list of relatives as defined in the policy involved in any transaction, as well as the fiduciary's business or other interests in any transaction impacting Trust assets (except for the receipt of benefits under the terms of the trust and plan). Further, any fiduciary who has knowledge of any transaction that may arguably be restricted pursuant to the policy, and that has not been specifically permitted by ERISA Section 408 or Department of Labor administrative exemptions, is obligated to disclose such information to the Board of Trustees. The Board of Trustees will investigate any actual or potential conflicts of interest. If the Board of Trustees determines that a conflict exists with respect to a fiduciary, it will prohibit the fiduciary from discussions, votes, or attempts to influence the issue or decision that is impacted. |
| Form 990, Part VI, Section B, line 15 | There are no compensated management officials, officers or key employees of the organization. If the organization had such compensated individuals, policies and procedures would be developed to determine compensation. |
| Form 990, Part VI, Section C, line 19 | The Trust's governing documents, conflict of interest policy, financial statements, and Form 990 are available to the general public upon written request sent to Benefit Solutions, Inc. at P.O. Box 6, Mukilteo, WA 98275. |
| Form 990, Part VII, Section A, Line 1A: | None of the Trustees are compensated by the organization. The Board of Trustees is comprised of eleven individuals, five of whom are representatives of the employers and six of whom are respresentatives of the union. In their roles as Trustees, all are fiduciaries and understand their obligations under the Trust Agreement and the Trust's policies and procedures, which include a conflict of interest policy. The Trust does not readily have access to information related to compensation paid by other entities to the Trustees. Additionally, the amount of time spent on activities related to being a Trustee is less than 300 hours per year per Trustee. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | EINEIN |
|---|---|---|---|---|---|---|---|---|---|---|
| Coastal CAP | ||||||||||
| 117 East Third | Aberdeen | WA | 98520 | Home care services | WA | 501(c)(3) | Line 7 | N/A | 0 | |
| Concerned Citizens | ||||||||||
| PO Box 1787 | Forks | WA | 98331 | Home care services | WA | 501(c)(3) | Line 7 | N/A | 0 | 911156809 |
| Korean Women's Association | ||||||||||
| 123 E 96th Street | Tacoma | WA | 98445 | Home care services | WA | 501(c)(3) | Line 9 | N/A | 0 | |
| SEIU Healthcare NW Training Partnership | ||||||||||
| 635 Andover Park West Suite 200 | Tukwila | WA | 98188 | To provide comprehensive training, support, and career development benefits. | WA | 501(c)(3) | Line 2 | N/A | 0 | |
| SEIU Healthcare 775NW | ||||||||||
| 33615 First Way S Suite A | Federal Way | WA | 98003 | Local union representing home care and nursing home workers. | WA | 501(c)(5) | N/A | 0 | ||
| SEIU 925 Multiemployer Health Benefits Trust | ||||||||||
| PO Box 6 | Mukilteo | WA | 98275 | To provide health benefits for participants | WA | 501(c)(9) | N/A | 0 | ||
| State of Washington - Department of Social and Health Services | ||||||||||
| PO Box 45842 | Olympia | WA | 98504 | To improve safety and health of individuals, families, and communities. | WA | N/A | 0 | |||
| Visiting Nurse HomeCare | ||||||||||
| 600 Birchwood Avenue Suite 100 | Bellingham | WA | 98225 | Home care services | WA | 501(c)(3) | Line 9 | N/A | 0 | |
| CDM Caregiving Services | ||||||||||
| 2409 Broadway | Vancouver | WA | 98663 | Home care services | WA | 501(c)(3) | Line 7 | N/A | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|
| AAA Residential Services | ||||||||
| 16256 Military Rd S Suite 209 | SeaTac | WA | 98188 | Home care services | WA | N/A | C | 0 |
| Addus Health Care | ||||||||
| 1121 N Argonne Road | Spokane | WA | 99212 | Home care services | WA | N/A | C | 0 |
| Amicable Healthcare Inc | ||||||||
| 15220-B 32nd Avenue South | SeaTac | WA | 99188 | Home care services | WA | N/A | S | 0 |
| Capital Opportunities | ||||||||
| PO Box 877 | Bozeman | MT | 59771 | Home care services | MT | N/A | C | 0 |
| Catholic Community Services | ||||||||
| 100 23rd Ave S | Seattle | WA | 98144 | Home care services | WA | N/A | S | 0 |
| Chesterfield Services Inc | ||||||||
| 703 Columbia Street Suite 200 | Seattle | WA | 98104 | Home care services | WA | N/A | C | 0 |
| Lower Columbia Community Action Council | ||||||||
| 1526 Commerce Avenue | Longview | WA | 98632 | Home care services | WA | N/A | C | 0 |
| Olympic Community Action Programs | ||||||||
| 803 West Park Avenue | Port Townsend | WA | 98368 | Home care services | WA | N/A | C | 0 |
| ResCare of WA | ||||||||
| 747 St Helens Avenue Suite 200 | Tacoma | WA | 98402 | Home care services | WA | N/A | C | 0 |
| Senior Life Resources Northwest | ||||||||
| 8656 West Gage Blvd Suite 301 | Kennewick | WA | 99336 | Home care services | WA | N/A | C | 0 |
| Whatcom Counseling and Psychiatric Clinic | ||||||||
| 3645 E McLeod Road | Bellingham | WA | 98226 | Home care services | WA | N/A | S | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |