2015-10-09T13:02:35-05:00 2014-12-31 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2014-01-01 936024141 OREGON LABORERS - EMPLOYERS HEALTH & WELFARE TR FUND OREG 5032825581 3140 NE BROADWAY STREET PORTLAND OR 97232 GREG HELD TRUSTEE 5032825581 2015-10-09 1 KATHLEEN D HAAB P01068129 9252779100 2014 2016-02-25 16:41:14Z GREG HELD 17230 NE SACRAMENTO ST 201 PORTLAND OR 97230 51114039 0 X N/A X 1954 OR PROVIDE HEALTH AND WELFARE BENEFITS 6 1 39 0 0 0 0 0 20467509 20424705 408830 825991 5342 349689 20881681 21600385 0 0 21663019 21255139 0 0 0 0 0 2009807 2069932 23672826 23325071 -2791145 -1724686 27115350 24487027 10543526 10467837 16571824 14019190 PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 PROVIDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 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 6 0 1 39 1 0 0 0 0 0 0 X 6 1 0 1 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 X WC EARHART CO 5032825581 3140 NE BROADWAY ST PORTLAND OR 97232 X GREG HELD TRUSTEE 0.50 X 0 0 0 DAVE TISCHER TRUSTEE 0.50 X 0 0 0 ERIC SNELLING TRUSTEE 0.50 X 0 0 0 MIKE SCHIESS TRUSTEE 0.50 X 0 0 0 JAMES R WATTS TRUSTEE 0.50 X 0 0 0 JEFF HOLLIDAY TRUSTEE - PAST 0.50 X 0 0 0 KELLY DIXON TRUSTEE 0.50 X 0 0 0 SEE SCHEDULE O FOR COMPENSATION PAID BY RELATED ORGANIZATION 0.00 X 0 1 0 0 1 0 0 0 0 0 REGENCE BLUE CROSS BLUE SHIELD 100 SW MARKET STREET PORTLAND OR 972015702 CLAIMS ADMINISTRATION 907143 WILLIAM C EARHART CO INC PO BOX 4148 PORTLAND OR 97208 THIRD PARTY ADMINISTRATIVE FEES 239342 OREGON LABORERS-EMPLOYERS ADMIN LLC 3140 NE BROADWAY ST PORTLAND OR 97232 COORDINATOR EXPENSE 121088 MILLIMAN 1301 5TH AVENUE SUITE 1900 SEATTLE WA 98101 CONSULTING SERVICES 106649 4 EMPLOYER CONTRIBUTIONS 900099 18054090 18054090 EMPLOYEE CONTRIBUTIONS 900099 1914495 1914495 PRESCRIPTION REBATES 900099 188306 188306 MEDICARE PART D SUBSIDY 900099 181624 181624 STOP-LOSS INCOME 900099 81290 81290 4900 4900 20424705 287097 287097 30052548 29513654 538894 538894 538894 PERFORMANCE GUARANTEES 900099 349689 349689 349689 21600385 20774394 0 825991 21255139 235431 127362 57200 173093 1134880 37451 23766 45451 TRANSITIONAL REINSURANC 163288 NAT'L HEALTH AND SAFETY 67401 OTHER EXPENSES 4609 23325071 474197 486906 2138485 1883636 10930 0 3372809 7688309 21118929 14428176 27115350 24487027 346526 431659 10197000 10036178 10543526 10467837 X 0 0 0 0 16571824 14019190 16571824 14019190 27115350 24487027 -1724686 -827948 0 X X 0 1 X 1 0 0 COMMON/COLLECTIVE TRUST FUNDS 14428176 F 14428176 ACCUMULATED ELIGIBILITY CREDITS 8461000 CLAIMS PAYABLE AND IBNR 1538000 PREMIUMS PAYABLE 37178 10036178 X 20599344 -827948 -827948 21427292 173093 173093 21600385 23312800 0 23312800 173093 -160822 12271 23325071 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 TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN 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 FISCAL YEARS PRIOR TO 2011. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGES IN BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION A, LINE 3 THE PLAN HAS CONTRACTED WITH WILLIAM C. EARHART CO., INC. TO PROVIDE DAY-TO-DAY ADMINISTRATIVE SERVICES TO THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 8B THE BOARD OF TRUSTEES DOES NOT HAVE COMMITTEES THAT ACT ON ITS BEHALF. FORM 990, PART VI, SECTION B, LINE 11 ALL MEMBERS OF THE BOARD OF TRUSTEES REVIEWED THE FORM 990 PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. 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, WILLIAM C. EARHART CO. FORM 990, SCHEDULE D, 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. OREGON LABORERS - EMPLOYERS PENSION PLAN 3140 NE BROADWAY ST PORTLAND OR 97232 936075363 TO PROVIDE PENSION BENFITS OR 501(A) N/A N/A 0 OREGON LABORERS-EMPLOYERS DEFINED CONTRIBUTION AND 401(K) PLAN 3140 NE BROADWAY ST PORTLAND OR 97232 276434385 TO PROVIDE PENSION BENFITS OR 501(A) N/A N/A 0 OREGON AND SOUTHERN IDAHO LABORERS - EMPLOYERS TRAINING TRUST 3140 NE BROADWAY ST PORTLAND OR 97232 204626312 TO PROVIDE TRAINING BENEFITS OR 501(C)3 N/A N/A 0 IDAHO SIGNATORY EMPLOYERS LABORERS PENSION PLAN 3140 NE BROADWAY ST PORTLAND OR 97232 916145041 TO PROVIDE PENSION BENFITS OR 501(A) N/A N/A 0 OREGON AND SOUTHERN IDAHO DISTRICT COUNCIL OF LABORERS 17230 NE SACRAMENTO ST 201 PORTLAND OR 97230 930144236 LABOR ORGANIZATION OR 501(C)5 N/A N/A 0 LABORERS INTERNATIONAL UNION LOCAL 483 1125 SE MADISON ST SUITE 206 PORTLAND OR 97214 930169132 LABOR ORGANIZATION OR 501(C)5 N/A N/A 0 LABORERS LOCAL NO 320 PO BOX 16790 PORTLAND OR 97292 930173215 LABOR ORGANIZATION OR 501(C)5 N/A N/A 0 LABORERS INTERNATIONAL UNION NO 296 4545 NE 102ND AVE PORTLAND OR 97220 930188805 LABOR ORGANIZATION OR 501(C)5 N/A N/A 0 LABORERS UNION LOCAL 155 465 W 17TH ST IDAHO FALLS ID 83402 820411490 LABOR ORGANIZATION ID 501(C)5 N/A N/A 0 LABORERS INTERNATIONAL UNION OF NORTH AMERICA 121 265 SE SCOTT ST BEND OR 97702 930958230 LABOR ORGANIZATION OR 501(C)5 N/A N/A 0 OREGON LABORERS ADMINISTRATIVE LLC 3140 NE BROADWAY ST PORTLAND OR 97232 830431313 ADMINISTRATIVE SERVICES OR NA - THERE ARE 3 EQUAL PARTNERS RELATED 99846 26468 0 0 0.33330 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 OREGON LABORERS ADMINISTRATIVE LLC M 121088 OBTAINED FROM THE PLAN'S RECORDS. SCHEDULE R, PART II THROUGH IV (CONTINUED): VERAZ CONST DBA BENGE IND VIGOR MARINE VOITH HYDRO INC WACO SCAFFOLD & EQUIP WALKER SPECIALITY CONST WALLTEK CONSTRUCTION LLC WARD HENSHAW CONST CO INC WASHINGTON GROUP INTERNAT WEBCOR BUILDERS WEITMAN EXCAVATION WESTERN PARTITIONS INC WESTERN WATERPROOFING CO WFJ JANITORIAL SERVICES WHITAKER/ELLIS BUILDERS WIBERG JANITORIAL SERVICE WILCOX CONSTRUCTION INC WILDISH BUILDING CO WILDISH CONSTRUCTION CO WILDISH STANDARD PAVING C WILLAMETTE FENCE CO INC WILLAMETTE GRAYSTONE INC ZAVALA CORPORATION INCE SCHEDULE R, PART II THROUGH IV IDENTIFICATION OF RELATED ORGANIZATIONS: 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 310 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. 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