2014-11-05T18:12:23-06:00 2013-12-31 300702322 HEMMING MORSE CPA'S AND CONSULTANTS 155 BOVET ROAD SUITE 600 SAN MATEO CA 94402 990 2013-01-01 946401544 U A LOCAL 393 HEALTH & WELFARE TR UALO 4084368210 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 SCOTT STRAWBRIDGE TRUSTEE 4084368210 2014-11-05 1 P01781096 4158364000 2013 2015-11-30 17:44:51Z SCOTT STRAWBRIDGE 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 62863075 0 X N/A X 1952 CA TO PROVIDE ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS WITH HEALTH & WELFARE BENEFITS. 8 8 398 0 0 0 0 0 41072399 44843410 866651 957228 357782 327433 42296832 46128071 0 0 33724654 36576736 0 0 0 0 0 1668152 1716777 35392806 38293513 6904026 7834558 66479441 78816383 33057798 34482651 33421643 44333732 NONE 0 0 TO PROVIDE ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS WITH HEALTH & WELFARE BENEFITS ACCORDING TO COLLECTIVE BARGAINING AGREEMENTS BETWEEN EMPLOYERS AND THE UNION. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 1 312 0 398 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X BENESYS ADMINISTRATORS 4084368210 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 X DOUG JONES TRUSTEE 5.00 X 0 0 0 SCOTT STRAWBRIDGE CO-CHAIRMAN 5.00 X 0 0 0 MICHAEL J VLAMING TRUSTEE 5.00 X 0 0 0 LARRY GATES TRUSTEE 5.00 X 0 0 0 WAYD LA PEARLE TRUSTEE 5.00 X 0 0 0 BILL MEYER CHAIRMAN 5.00 X 0 0 0 GARY GLENN TRUSTEE 5.00 X 0 0 0 GREGORY GONZALES TRUSTEE 5.00 X 0 0 0 0 0 0 0 0 0 0 BENESYS ADMINISTRATORS 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 CONTRACT ADMINISTRATOR 560560 BLUE CROSS OF CALIFORNIA 21555 OXNARD STREET WOODLAND HILLS CA 91367 CLAIMS ADMINISTRATOR 295778 DELTA DENTAL 100 FIRST ST SAN FRANCISCO CA 94105 CLAIMS ADMINISTRATOR 147982 3 EMPLOYER CONTRIBUTIONS 900099 44130145 44130145 ERA CONTRIBUTIONS 900099 2993130 2993130 COBRA CONTRIBUTIONS 900099 1600 1600 RECIPROCITY CONTRIBUTIONS 900099 -2281465 -2281465 44843410 921606 921606 16770626 16735004 35622 35622 35622 MEDICARE D SUBSIDY 900099 245155 245155 OTHER INCOME 900099 74903 74903 LIQUIDATED DAMAGES 900099 7375 7375 327433 46128071 45206465 0 921606 36576736 560560 91445 83262 128226 12944 6327 DELTA DENTAL 295778 BLUE CROSS 147982 MEMBER ADVOCATE 96258 BENEFIT CONSULTING 93000 200995 38293513 1744309 1517193 11338887 20910882 4554432 3846186 2521 3641 48627014 52379515 212278 158966 66479441 78816383 1646048 631981 31411750 33850670 33057798 34482651 X 0 0 0 0 33421643 44333732 33421643 44333732 66479441 78816383 7834558 3077531 0 X X 0 1 X 1 0 0 SELF FUNDED BENEFITS PAYABLE 2993197 GROUP INSURANCE PREMIUMS PAYABLE 2414076 BANK OF HRS LIABILITY FOR EXT. COVERAGE 10457100 PARTICIPANT RESERVE ACCOUNT 16777597 CLAIMS INCURRED BUT NOT REPORTED 1208700 33850670 49205602 3077531 3077531 46128071 0 46128071 38293513 0 38293513 0 38293513 FORM 990, PART IV, LINE 34 THE TRUST FUND HAS A SPECIFIC PROCEDURE IN PLACE FOR THIS NEW DISCLOSURE REQUIREMENT ON THE SCHEDULE R. THE ADMINISTRATOR HAS SENT OUT A QUESTIONNAIRE TO OBTAIN THE REQUIRED INFORMATION FROM THE CONTRIBUTING EMPLOYERS. THE ABOVE INFORMATION REPRESENTS WHAT THE TRUST FUNDS HAS RECEIVED TO DATE. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES CONTROL OVER MANAGEMENT DUTIES CUSTOMARILY PERFORMED BY OR UNDER THE DIRECT SUPERVISION OF OFFICERS, DIRECTORS, TRUSTEES OR KEY EMPLOYEES TO THE CONTRACT ADMINISTRATOR. FORM 990, PART VI, SECTION A, LINE 8B THE PLAN DOES NOT HAVE ANY COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE TRUSTEES DESIGNATE THE ADMINISTRATOR TO REVIEW THE FORM. FORM 990, PART VI, SECTION B, LINE 12C REVIEW WITH BOARD OF TRUSTEES ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST TO ALL PLAN PARTICIPANTS. FORM 990, PART XI, LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSEEING THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND FOR SELECTING THE INDEPENDENT AUDITOR. 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