BLEDSOE HEALTH TR: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- BLEDSOE HEALTH TR (EIN 93-0478837)
- Tax period
- 2012-06-01 to 2013-05-31
- Filed
- 2014-02-13
- IRS object ID
- 201410449349302086
- Schema version
- 2012v2.3
- 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) |
|---|---|---|
| Timestamp | 2014-02-13T18:13:11-06:00 | Timestamp |
| Tax Period End Date | 2013-05-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MILLER KAPLAN ARASE LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 7TH AVE STE 2100 | AddressLine1 |
| City | SEATTLE | City |
| State | WA | State |
| ZIP Code | 981011360 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-06-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930478837 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE BLEDSOE HEALTH TRUST | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % GARTH FISHER | InCareOfName |
| Name Control | BLED | NameControl |
| Phone | 2063294900 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2323 EASTLAKE AVE E | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | SEATTLE | City |
| State | WA | State |
| ZIP Code | 98102 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RODGER GLOS | Name |
| Title | TRUSTEE | Title |
| Phone | 2063294900 | Phone |
| Date Signed | 2014-02-13 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MILLER KAPLAN ARASE LLP | Name |
| Phone | 2068267180 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | GARTH FISHER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2323 Eastlake Ave E | AddressLine1 |
| City | Seattle | City |
| State | WA | State |
| ZIP Code | 98102 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 156385103 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | N/A | WebSite |
| Type Of Organization Trust | X | TypeOfOrganizationTrust |
| Year Formation | 1959 | YearFormation |
| State Legal Domicile | OR | StateLegalDomicile |
| Activity Or Mission Description | SEE SCHEDULE O | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 281 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 48485388 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 46178654 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2002488 | InvestmentIncomePriorYear |
| Investment Income Current Year | 7012994 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 11439 | OtherRevenuePriorYear |
| Other Revenue Current Year | 197 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 50499315 | TotalRevenuePriorYear |
| Total Revenue Current Year | 53191845 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 58495273 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 51392982 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1128655 | OtherExpensePriorYear |
| Other Expenses Current Year | 1140592 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 59623928 | TotalExpensesPriorYear |
| Total Expenses Current Year | 52533574 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -9124613 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 658271 | RevenuesLessExpensesCY |
| Total Assets BOY | 129430779 | TotalAssetsBOY |
| Total Assets EOY | 134965520 | TotalAssetsEOY |
| Total Liabilities BOY | 16809077 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 15577738 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 112621702 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 119387782 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SEE SCHEDULE O | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Description | SEE SCHEDULE O | Description |
| Described In501 C3 | false | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | false | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | false | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 2 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 281 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | GARTH FISHER | NamePerson |
| Telephone Number | 2063294900 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2323 EASTLAKE AVE E | AddressLine1 |
| City | SEATTLE | City |
| State | WA | State |
| ZIP Code | 98102 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (12 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector |
|---|---|---|
| RODGER M GLOS | ||
| TRUSTEE | 1.0 | X |
| WES ANDERSON | ||
| TRUSTEE | 1.0 | X |
| DEREK GLOS | ||
| TRUSTEE | 1.0 | X |
| CAL WELBORN SR | ||
| Trustee (ALTERNATE) | 1.0 | X |
| JOHN SAHLBERG | ||
| TRUSTEE | 1.0 | X |
| HANK SNOW | ||
| TRUSTEE | 1.0 | X |
| JIM LAUGHTON | ||
| TRUSTEE | 1.0 | X |
| PAUL MARKS | ||
| TRUSTEE | 1.0 | X |
| SHERRY SCOTT | ||
| TRUSTEE | 1.0 | X |
| MICHAEL PIETI | ||
| TRUSTEE | 1.0 | X |
| RANDY FOUTS | ||
| TRUSTEE | 1.0 | X |
| KELLYE T WISE | ||
| TRUSTEE | 1.0 | X |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| REGENCE BLUECROSS BLUESHIELD OF ORE | |||||
| PO Box 1271 | PORTLAND | OR | 972071271 | ADMIN SERVICE ORG | 3317288 |
| NORTHWEST ADMINISTRATORS INC | |||||
| 2323 EASTLAKE AVE E | SEATTLE | WA | 981023305 | Administrative Fees | 532591 |
| PLATTE RIVER CAPITAL | |||||
| 15 SW COLORADO STE 200 | BEND | OR | 977021635 | INVESTMENT MGMT FEES | 106567 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| EMPLOYER CONTRIBUTIONS | 900099 | 36393257 | 36393257 |
| EMPLOYEE CONTRIBUTIONS | 900099 | 9785397 | 9785397 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 46178654 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4245345 | TotalRevenueColumn |
| Exclusion | $4,245,345 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 105960907 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 103193258 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2767649 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2767649 | TotalRevenueColumn |
| Exclusion | $2,767,649 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 197 | TotalRevenueColumn |
| Related Or Exempt Function Income | 197 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 197 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 53191845 | TotalRevenueColumn |
| Related Or Exempt Function Income | 46178851 | RelatedOrExemptFunctionIncome |
| Exclusion | $7,012,994 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51392982 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 532591 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40905 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 93410 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 186036 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 141457 | Total |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24052 | Total |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7701 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39667 | Total |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal |
|---|---|
| NEWSLETTER EXPENSES | 33669 |
| BANK FEES | 30831 |
| ADMIN. - MEDCO | 10273 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52533574 | Total |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8243357 | BOY |
| EOY | 7630872 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4391466 | BOY |
| EOY | 4380948 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1000000 | BOY |
| EOY | 1000000 | EOY |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 115795956 | BOY |
| EOY | 121953700 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 129430779 | BOY |
| EOY | 134965520 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 129510 | BOY |
| EOY | 165371 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16679567 | BOY |
| EOY | 15412367 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16809077 | BOY |
| EOY | 15577738 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 112621702 | BOY |
| EOY | 119387782 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 112621702 | BOY |
| EOY | 119387782 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 129430779 | BOY |
| EOY | 134965520 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 658271 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 6107809 | ReconciliationUnrealizedInvest |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Current Year Minus4 Years | CurrentYearMinus4Years | |
| Land | Land | |
| Buildings | Buildings | |
| Leasehold Improvements | LeaseholdImprovements | |
| Equipment | Equipment | |
| Other Land Buildings | OtherLandBuildings | |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | BENEFIT OBLIGATIONS | Description |
| Amount | $15,412,367 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 15412367 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 59299654 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 6107809 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 6107809 | RevenueNotRptdF990 |
| Revenue Subtotal | 53191845 | RevenueSubtotal |
| Total Revenue Per Form990 | 53191845 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 52533574 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 52533574 | ExpensesSubtotal |
| Total Expenses Per Form990 | 52533574 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART X, LINE 2: | Identifier |
| Return Reference | The Plan has adopted guidance on accounting for uncertainty in income | ReturnReference |
| Explanation | taxes issued by the Financial Accounting Standards Board. The Plan administrator believes that the Plan has taken no uncertain tax positions that require adjustment to the financial statements to comply with the provisions of this guidance. Certain information returns are subject to examination by authorities. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART I, LINE 1 AND PART III, LINES 1 AND 4A - ORGANIZATION'S MISSION: | Identifier |
| Return Reference | TO PROVIDE HEALTH BENEFITS TO ELIGIBLE ACTIVE PARTICIPANTS AND | ReturnReference |
| Explanation | THEIR COVERED DEPENDENTS. THE PLAN ALSO PROVIDES HEALTH BENEFITS TO SELF-PAY PARTICIPANTS AND RETIREES FOR WHICH A CONTRIBUTION IS RECEIVED. PART VI, LINE 2: TRUSTEES RODGER M. GLOS AND DEREK GLOS ARE FATHER AND SON. PART VI, LINE 11B: FORM 990 WAS REVIEWED BY THE ADMINISTRATIVE OFFICE PRIOR TO BEING FILED. THE ADMINISTRATIVE OFFICE WILL NOTIFY THE BOARD OF TRUSTEES OF UNUSUAL OR SIGNIFICANT ITEMS, IF NOTED. PART VI, LINE 12C: TRUSTEES ARE REQUIRED TO NOTIFY THE TRUST OF ANY CHANGES IN THEIR INTEREST THAT COULD GIVE RISE TO CONFLICTS. PART VI, LINE 19: THE PLAN'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MAINTAINED AT THE ADMINISTRATIVE OFFICE AND ARE AVAILABLE UPON REQUEST. PART VII - SECTION A: SALARIES PAID TO TRUSTEES BY THEIR NON-PROFIT EMPLOYERS IS PROPERLY reported ON THE EMPLOYER'S ANNUAL PAYROLL TAX FILINGS AND THEREFORE, NOT REPORTED OR KNOWN TO THE ADMINISTRATIVE OFFICE. | Explanation |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | See Supplemental Information | BusinessNameLine1 |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | see supplemental information | BusinessNameLine1 |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | na | BusinessNameLine1 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | see supplemental information | BusinessNameLine1 |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | na | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART II - IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS: | Identifier |
| Return Reference | THE ADMINISTRATIVE OFFICE DOES NOT CURRENTLY MAINTAIN THIS INFORMATION FOR | ReturnReference |
| Explanation | THE 35 CONTRIBUTING EMPLOYERS. PLEASE CONTACT THE ADMINISTRATIVE OFFICE IF YOU HAVE ANY QUESTIONS. part iii - identification of related organizations taxable as A partnership: the administrative office does not currently maintain this information for the 35 contributing employers. please contact the administrative office if you have any questions. part Iv - identification of related organizations taxable as A corporation or trust: the administrative office does not currently maintain this information for the 35 contributing employers. please contact the administrative office if you have any questions. | Explanation |