2015-01-12T10:26:41-06:00 2014-06-30 910189318 MOSS ADAMS LLP 805 SW BROADWAY STE 1200 PORTLAND OR 97205 990 2013-07-01 942329720 RETA TRUST CO GALLAGHER BENEFIT SERVICES OF CA RETA 4155368428 1255 BATTERY STREET SUITE 450 SAN FRANCISCO CA 94111 JOHN STEIN EXECUTIVE DIRECTOR 4155368428 2014-12-11 1 WENDY CAMPOS P00448102 5032421447 2013 2016-02-25 16:41:14Z JOHN STEIN 1255 BATTERY STREET SUITE 450 SAN FRANCISCO CA 94111 266298876 0 X N/A X 1976 CA THE RETA TRUST WAS FORMED UNDER A RELIGIOUS TRUST AGREEMENT ENTERED INTO BY TWO ROMAN CATHOLIC ARCHDIOCESES, SEVERAL DIOCESES AND SEVERAL RELIGIOUS ORDERS OF THE ROMAN CATHOLIC CHURCH AS A MEANS WHEREIN TO PROVIDE COST EFFECTIVE MEDICAL BENEFITS TO CLERGY, WOMEN RELIGIOUS, AND THEIR LAY EMPLOYEES AND THEIR DEPENDENTS. 10 10 0 10 0 0 0 0 179761489 200439202 2983205 3489036 1825002 2080940 184569696 206009178 0 0 133054226 159229939 0 0 0 0 0 60752653 31492189 193806879 190722128 -9237183 15287050 92552575 110923990 30073230 27224557 62479345 83699433 X THE RETA TRUST WAS FORMED UNDER A RELIGIOUS TRUST AGREEMENT ENTERED INTO BY TWO ROMAN CATHOLIC ARCHDIOCESES, SEVERAL DIOCESES AND SEVERAL RELIGIOUS ORDERS OF THE ROMAN CATHOLIC CHURCH AS A MEANS WHEREIN TO PROVIDE COST EFFECTIVE MEDICAL BENEFITS TO CLERGY, WOMEN RELIGIOUS, AND THEIR LAY EMPLOYEES AND THEIR DEPENDENTS. 0 0 THE RETA TRUST PROVIDES MEDICAL BENEFITS TO CLERGY, WOMEN RELIGIOUS, AND LAY EMPLOYEES AND THEIR DEPENDENTS OF ROMAN CATHOLIC ORGANIZATIONS. 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 1 0 0 0 0 0 0 0 1 0 0 1 24 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 1 1 1 1 1 0 0 1 1 1 0 0 1 1 0 0 CA X GALLAGHER BENEFIT SERVICES OF CA 4155368428 1255 BATTERY STREET SUITE 450 SAN FRANCISCO CA 94111 X X ROBERT SERVENTI CHAIR 2.50 X 0 0 0 CLAIRE BLOHM SECRETARY 1.50 X X 0 0 0 SR MARY JO ANDERSON TRUSTEE 1.00 X 0 0 0 TOM ARNOLD TRUSTEE 1.50 X 0 0 0 MIKE BROWN TRUSTEE 1.50 X 0 0 0 MICHAEL CANIZZARO TRUSTEE 1.00 X 0 0 0 REV GERALD COLEMAN TRUSTEE 1.50 X 0 0 0 STEVE SALLOT TRUSTEE 1.00 X 0 0 0 TOM SCHADLE TRUSTEE 1.50 X 0 0 0 PHILIP J RIES TRUSTEE 1.00 X X 0 0 0 SR MARY ELIZABETH GALT TRUSTEE 1.00 X 0 0 0 RANDY STEINER TRUSTEE 1.00 X 0 0 0 JOHN STEIN EXECUTIVE DIRECTOR 40.00 X 0 0 0 0 0 0 0 0 0 0 BENEFIT ALLOCATION SYSTEMS 132 IVY LANE KING OF PRUSSIA PA 19406 CONSULTING SERVICES 2332661 GALLAGHER BENEFIT SERVICES 1255 BATTERY STREET SUITE 450 SAN FRANCISCO CA 94111 CONSULTING SERVICES 2081380 WEBMD 12186 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 CONSULTING SERVICES 795865 ARMANINO LLP 12657 ALCOSTA BLVD SUITE 500 SAN RAMON CA 94583 ACCOUNTING SERVICES 315586 AXENE HEALTH PARTNERS 38975 SKY CANYON DRIVE SUITE 105 MURRIETA CA 92563 CONSULTING, WELLNESS PROGRAM 282597 10 TRUSTOR CONTRIBUTIONS 525100 200439202 200439202 200439202 1245764 1245764 62532970 60289698 2243272 2243272 2243272 PRESCRIPT DRUG REBATE 525100 2080940 2080940 2080940 206009178 202520142 0 3489036 159229939 2087013 164755 453216 316727 670462 199785 196836 3837 31691 CLAIMS ADMINISTRATION 15333455 REINSURANCE PREMIUMS 6439876 THIRD PARTY ADMINISTRAT 2403400 HMO PREMIUMS/REFUNDS -10707 3201843 190722128 10223431 11813854 1099641 1159967 2636963 1996072 78592540 95954097 92552575 110923990 623788 3731156 4875000 4513446 24574442 18979955 30073230 27224557 X 62479345 83699433 0 0 0 0 62479345 83699433 92552575 110923990 15287050 5933038 0 X 0 1 X 1 0 0 CLAIMS INCURRED BUT NOT REPORTED 16496602 PRESCRIPTION CLAIMS PAYABLE 2483353 18979955 X 211625489 5933038 5933038 205692451 316727 316727 206009178 190405401 0 190405401 316727 316727 190722128 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT 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 ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF JUNE 30, 2014 AND 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET), OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2010 (JUNE 30, 2011). PART IV, LINE 11F: THE RETA TRUST, AS ESTABLISHED TO HOLD THE PLAN'S NET ASSETS, IS QUALIFIED UNDER SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE AND BY THE CALIFORNIA FRANCHISE TAX BOARD UNDER SECTION 23701(I). ACCORDINGLY, THE RETA TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE RETA TRUST OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE EFFECTIVE AS OF AUGUST 5, 1977. THE TRUST HAS BEEN AMENDED SINCE RECEIPT OF THAT DETERMINATION LETTER. HOWEVER, THE TRUST ADMINISTRATOR AND THE TRUST'S TAX COUNSEL BELIEVE THAT THE TRUST IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. JOHN STEIN SEE PART V BELOW 287664 JOHN STEIN IS THE EXECUTIVE DIRECTOR OF THE TRUST BY CONTRACT WITH A THIRD-PARTY MANAGEMENT COMPANY AND IS AN EMPLOYEE OF THAT MANAGEMENT COMPANY; THE MANAGEMENT COMPANY PROVIDES VARIOUS SERVICES TO THE TRUST, WHICH INCLUDE THE EXECUTIVE DIRECTOR POSITION. THE TRANSACTION AMOUNT IS THE AMOUNT THE TRUST PAID THE MANAGEMENT COMPANY FOR HIS SERVICES. 0 PART IV TRUST EXECUTIVE DIRECTOR/EMPLOYEE OF MANAGEMENT COMPANY PROVIDING SERVICES TO THE TRUST. FORM 990, PART VI, SECTION A, LINE 3 JOHN STEIN IS THE EXECUTIVE DIRECTOR OF THE RETA TRUST BY CONTRACT WITH A THIRD-PARTY MANAGEMENT COMPANY, GALLAGHER BENEFIT SERVICES, AND IS AN EMPLOYEE OF THAT COMPANY. GALLAGHER PROVIDES VARIOUS CONSULTING SERVICES TO THE RETA TRUST, WHICH INCLUDES THE EXECUTIVE DIRECTOR POSITION. THE RETA TRUST PAID $287,664 TO GALLAGHER FOR JOHN STEIN'S SERVICES, AS DISCLOSED IN SCHEDULE L. IN TOTAL, THE RETA TRUST PAID $2,081,380 TO GALLAGHER FOR THEIR SERVICES, AS DISCLOSED IN PART VII, SECTION B. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE TRUST ARE THE TRUSTOR ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 7A THE TRUSTOR MEMBERS VOTE TO ELECT THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY SUBJECT TO APPROVAL BY MEMBERS ARE ELECTION OF TRUSTEES, INDEMNIFICATION OF ANY PERSON WHO CLAIMS HIS OR HER ACTIONS WERE TAKEN ON BEHALF OF THE TRUST, AND INDEMNIFICATION AND REMOVAL OF A MEMBER. FORM 990, PART VI, SECTION B, LINE 11 THE EXECUTIVE DIRECTOR AND GENERAL COUNSEL REVIEW THE FORM 990 WITH THE AUDITORS AND KEY MEMBERS OF THE GOVERNING BODY CONCURRENT WITH THE FILING OF THE FORM. FORM 990, PART VI, SECTION B, LINE 15A EXECUTIVE DIRECTOR COMPENSATION IS DETERMINED THROUGH USE OF A COMPENSATION STUDY, WITH APPROVAL BY THE GOVERNANCE COMMITTEE AND THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A: THE ORGANIZATION MADE A REASONABLE EFFORT TO COLLECT THE DATA TO COMPLETE PART VII BY REQUESTING FROM EACH TRUSTEE COMPENSATION AND BENEFITS PAID BY THE RELATED ORGANIZATION TO EACH TRUSTEE OF THE FILING ORGANIZATION, HOWEVER, NO ONE PROVIDED THE REQUESTED DATA. ARCHDIOCESE OF ANCHORAGE 225 CORDOVA STREET ANCHORAGE AK 99501 920019215 ARCHDIOCESE AK 501(C)(3) 170(B)(1) (A)(I) 0 ARCHDIOCESE OF LOS ANGELES 3424 WILSHIRE BLVD LOS ANGELES CA 90010 951642382 ARCHDIOCESE CA 501(C)(3) 170(B)(1) (A)(I) 0 ARCHDIOCESE OF SAN FRANCISCO ONE PETER YORK WAY SAN FRANCISCO CA 94109 941156707 ARCHDIOCESE CA 501(C)(3) 170(B)(1) (A)(I) 0 BISHOP GARCIA DIEGO HIGH SCHOOL 4000 LA COLINA RD SANTA MARIA CA 931101412 952056632 CATHOLIC SCHOOL CA 501(C)(3) 170(B)(1) (A)(II) 0 CARMELITE SISTERS 920 E ALHAMBRA ROAD ALHAMBRA CA 91801 952564138 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 CATHOLIC CHARITIES DIOCESE OF SAN DIEGO 349 CEDAR STREET SAN DIEGO CA 92101 237334012 SOCIAL SERVICES CA 501(C)(3) 170(B)(1) (A)(I) 0 CATHOLIC CHARITIES OF GALVESTON-HOUSTON 2900 LOUISANA STREET HOUSTON TX 77006 741109733 SOCIAL SERVICES TX 501(C)(3) 170(B)(1) (A)(I) 0 CATHOLIC CHARITIES OF ORANGE COUNTY 1820 E 16TH STREET SANTA ANA CA 92701 953031389 SOCIAL SERVICES CA 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF BELLEVILLE 222 S THIRD STREET BELLEVILLE IL 62220 370673467 DIOCESE IL 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF FAIRBANKS 225 CORDOVA STREET ANCHORAGE AK 99501 920019215 DIOCESE AK 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF JUNEAU 225 CORDOVA STREET ANCHORAGE AK 99501 920019215 DIOCESE AK 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF LAS CRUCES 1280 MED PARK DRIVE LAS CRUCES NM 88005 850303816 DIOCESE NM 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF LAS VEGAS 336 CATHEDRAL WAY LAS VEGAS NV 89109 880059349 DIOCESE NV 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF MONTEREY 631 ABREGO STREET MONTEREY CA 93940 941658203 DIOCESE CA 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF NORWICH 201 BROADWAY NORWICH CT 06360 060687373 DIOCESE CT 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF OAKLAND 2121 HARRISON STREET OAKLAND CA 94612 941527086 DIOCESE CA 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF ORANGE 13280 CHAPMAN AVENUE ORANGE CA 92840 953018918 DIOCESE CA 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF SAN BERNARDINO 1201 EAST HIGHLAND AVE SAN BERNARDINO CA 92404 530196617 DIOCESE CA 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF SAN JOSE 1150 N FIRST STREET 100 SAN JOSE CA 95112 942734503 DIOCESE CA 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF TULSA PO BOX 690240 TULSA OK 74169 730942657 DIOCESE OK 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF TUSCON 111 S CHURCH AVE TUSCON AZ 85701 860133391 DIOCESE AZ 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF VICTORIA 1505 E MESQUITE LANE VICTORIA TX 77901 752231873 DIOCESE TX 501(C)(3) 170(B)(1) (A)(I) 0 DISCALCED CARMELITE FRIARS PO BOX 2178 REDLANDS CA 923730701 911635570 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 DOMINICAN SISTERS OF MISSION SAN JOSE 43326 MISSION BLVD FREMONT CA 94539 941449873 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 FATHER JOE'S VILLAGES 3350 E STREET SAN DIEGO CA 92102 330492304 SOCIAL SERVICES CA 501(C)(3) 509(A)(1) 0 HOSPITALLER BROTHERS HEALTHCARE INC 2468 S ST ANDREWS PLACE LOS ANGELES CA 90018 954334552 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 IMMACULATE HEART HIGH SCHOOL 5515 FRANKLIN AVE LOS ANGELES CA 900285999 951643329 CATHOLIC SCHOOL CA 501(C)(3) 170(B)(1) (A)(II) 0 LITTLE SISTERS OF THE POOR 2100 SOUTH WESTERN AVE SAN PEDRO CA 907324389 951972847 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 MARIANIST PROVINCE OF THE UNITED STATES 4425 W PINE BLVD ST LOUIS MO 63108 030415363 RELIGIOUS ORDER MO 501(C)(3) 170(B)(1) (A)(I) 0 MERCY HIGH SCHOOL BURLINGAME 2750 ADELINE DRIVE BURLINGAME CA 94010 941230999 CATHOLIC SCHOOL CA 501(C)(3) 170(B)(1) (A)(II) 0 NOTRE DAME ELEMENTARY SCHOOL 1200 NOTRE DAME AVENUE BELMONT CA 940021846 912072682 CATHOLIC SCHOOL CA 501(C)(3) 170(B)(1) (A)(II) 0 PAULINE BOOKS AND MEDIA 50 ST PAULS AVENUE BOSTON MA 02130 042966563 CATHOLIC BOOKSTORE MA 501(C)(3) 170(B)(1) (A)(I) 0 RANCHO SAN ANTONIO BOY'S HOME INC 21000 PLUMMER STREET CHATSWORTH CA 91311 951642382 FAMILY SERVICES CA 501(C)(3) 509(A)(3), TYPE III 0 RELIGIOUS SISTERS OF CHARITY 10668 ST JAMES DRIVE CULVER CITY CA 90230 953085555 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 SALESIANS OF ST JOHN BOSCO 1100 FRANKLIN ST SAN FRANCISCO CA 94109 941642297 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 SANTA CATALINA SCHOOL 1500 MARK THOMAS DR MONTEREY CA 93940 911156652 CATHOLIC SCHOOL CA 501(C)(3) 170(B)(1) (A)(II) 0 SISTERS OF MERCY WEST MIDWEST COMMUNITY INC 7262 MERCY ROAD OMAHA NE 68124 946071848 RELIGIOUS ORDER NE 501(C)(3) 170(B)(1) (A)(I) 0 SISTERS OF NOTRE DAME DE NAMUR 1500 RALSTON AVE BELMONT CA 94002 941347084 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 SISTERS OF ST FRANCIS - MT ALVERNO 1520 RALSTON AVENUE BELMONT CA 94002 237290790 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 SISTERS OF THE COMPANY OF MARY 16791 E MAIN STREET TUSTIN CA 92780 952462907 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 SISTERS OF THE HOLY NAMES OF JESUS AND MARY US ONTARIO PR 17410 HOLY NAMES DRIVE LAKE OSWEGO OR 97034 204366910 RELIGIOUS ORDER OR 501(C)(3) 170(B)(1) (A)(I) 0 SISTERS OF THE SOCIETY DEVOTED TO THE SACRED HEART 10480 1/2 WINNETKA AVE CHATSWORTH CA 913111821 954201880 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 SMALL RELIGIOUS COMMUNITIES 3424 WILSHIRE BLVD LOS ANGELES CA 90005 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 SOCIETY OF THE SACRED HEART UNITED STATES PROVINCE PO BOX 56607 ST LOUIS MO 63156 431272049 RELIGIOUS ORDER MO 501(C)(3) 170(B)(1) (A)(I) 0 STMICHAELS ABBEY 19292 EL TORO ROAD SILVERADO CA 92676 952380993 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 THOMAS AQUINAS COLLEGE 10000 N OJAI ROAD SANTA PAULA CA 93060 941698615 CATHOLIC SCHOOL CA 501(C)(3) 170(B)(1) (A)(II) 0 CATHOLIC CHARITIES CYO OF SAN FRANCISCO 180 HOWARD STREET STE 100 SAN FRANCISCO CA 94105 941498472 SOCIAL SERVICES CA 501(C)(3) 170(B)(1) (A)(IV) 0 DIOCESE OF CHEYENNE PO BOX 1468 CHEYENNE WY 82003 836004905 DIOCESE WY 501(C)(3) 170(B)(1) (A)(I) 0 ROMAN CATHOLIC BISHOP OF PORTLAND (DIOCESE OF PORTLAND) 510 OCEAN AVENUE PORTLAND ME 041034936 010212546 DIOCESE ME 501(C)(3) 170(B)(1) (A)(I) 0 SISTERS OF THE PRESENTATION 281 MASONIC AVENUE SAN FRANCISCO CA 94118 942209052 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1