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ALASKA PUBLIC EMPLOYEES INSURANCE GROUP TRUST: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
ALASKA PUBLIC EMPLOYEES INSURANCE GROUP TRUST (EIN 92-0087261)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-03-26
IRS object ID
201300859349300815
Schema version
2011v1.5
Note
A later return for the same period supersedes this one.
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

FieldValueIRS element (for citing)
Timestamp2013-03-26T16:43:55-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line13000 NORTHUP WAY SUITE 200AddressLine1
CityBELLEVUECity
StateWAState
ZIP Code98004ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN920087261EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ALASKA PUBLIC EMPLOYEES INSURANCE GROUPBusinessNameLine1
Business Name Line2INSURANCE TRUSTBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlALASNameControl
Phone9073491415Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line17550 OLD SEWARD HIGHWAY NO 200AddressLine1
CityANCHORAGECity
StateAKState
ZIP Code99518ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKRIS NEDWICKName
TitleINSTITUTIONAL CUSTODIANTitle
Phone9073491415Phone
Date Signed2013-03-09DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBRUCE C RESTAD CPAName
PTINP00030875PTIN
Phone4252506100Phone
Date Prepared2013-03-09DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRICHARD HAZENNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line17550 OLD SEWARD HIGHWAY NO 200AddressLine1
CityANCHORAGECity
StateAKState
ZIP Code99518ZIPCode
FieldValueIRS element (for citing)
Gross Receipts3396270GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1998YearFormation
State Legal DomicileAKStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HEALTH BENEFITS TO QUALIFIED PARTICIPANTSActivityOrMissionDescription
Nbr Voting Members Governing Body1NbrVotingMembersGoverningBody
Nbr Independent Voting Members1NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year4685751ProgramServiceRevenuePriorYear
Program Service Revenue CY3395685ProgramServiceRevenueCY
Investment Income Prior Year1355InvestmentIncomePriorYear
Investment Income Current Year585InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year4687106TotalRevenuePriorYear
Total Revenue Current Year3396270TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year3698845BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY4247704BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year270430OtherExpensePriorYear
Other Expenses Current Year294277OtherExpensesCurrentYear
Total Expenses Prior Year3969275TotalExpensesPriorYear
Total Expenses Current Year4541981TotalExpensesCurrentYear
Revenues Less Expenses Prior Year717831RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1145711RevenuesLessExpensesCY
Total Assets BOY2495348TotalAssetsBOY
Total Assets EOY1257962TotalAssetsEOY
Total Liabilities BOY1074294TotalLiabilitiesBOY
Total Liabilities EOY982619TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1421054NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY275343NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE HEALTH BENEFITS TO EMPLOYERS IN RURAL ALASKAMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
DescriptionTO PROVIDE HEALTH BENEFITS TO QUALIFIED PARTICIPANTS AS SPECIFIED IN THE PLANDescription
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members1NbrVotingGoverningBodyMembers
Number Independent Voting Members1NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy0ConflictOfInterestPolicy
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1BETH HAZEN - EMAINCBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9073491415TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line17550 OLD SEWARD HIGHWAY 200AddressLine1
CityANCHORAGECity
StateAKState
ZIP Code99518ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA

FieldValueIRS element (for citing)
Name PersonKEY TRUST COMPANY OF AKNamePerson
TitleTRUSTEETitle
Average Hours Per Week0.00AverageHoursPerWeek
Institutional TrusteeXInstitutionalTrustee
Reportable Comp From Organization0ReportableCompFromOrganization
Reportable Comp From Related Orgs0ReportableCompFromRelatedOrgs
Other Compensation0OtherCompensation
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CIGNABusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1900 COTTAGE GROVE ROADAddressLine1
CityBLOOMFIELDCity
StateCTState
ZIP Code06002ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesCLAIMS ADMINISTRATORDescriptionOfServices
Compensation185885Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS52510033539883353988
PARTICIPANT CONTRIBUTI5251004169741697
FieldValueIRS element (for citing)
Total Program Service Revenue3395685TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column585TotalRevenueColumn
Exclusion$585ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column3396270TotalRevenueColumn
Related Or Exempt Function Income3395685RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$585ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total4247704Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total281323Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total8000Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total4954Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total4541981Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY202425BOY
EOY202587EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY388BOY
EOY100EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY59918EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY2292535BOY
EOY995357EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2495348BOY
EOY1257962EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY427BOY
EOY1917EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1073867BOY
EOY980702EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1074294BOY
EOY982619EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY1421054BOY
EOY275343EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1421054BOY
EOY275343EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2495348BOY
EOY1257962EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-1145711ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee0AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionSHORT TERM FUNDSDescription
Book Value995357BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities995357TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
TERMINAL PREMIUM LIABILITY$947,685
CLAIMS PAYABLE$30,915
PREMIUMS PAYABLE$2,102
FieldValueIRS element (for citing)
Total Of Amounts980702TotalOfAmounts
Total Revenue3396270TotalRevenue
Total Expenses4541981TotalExpenses
Excess Or Deficit For Year-1145711ExcessOrDeficitForYear
Excess Or Deficit Per FS-1145711ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt3396270TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal3396270RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9903396270TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt4635146TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal4635146ExpensesSubtotal
Other Expenses Not Included-93165OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt-93165ExpensesNotRptdOnFinStmt
Total Expenses Per Form9904541981TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X: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 INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF JUNE 30, 2012 AND 2011, 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 2009.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:CHANGE IN TERMINAL PREMIUM OBLIGATION -90,654. CHANGE IN CLAIMS PAYABLE -4,613. CHANGE IN PREMIUMS PAYABLE 2,102.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 3THE TRUST IS MANAGED ON A DAILY BASIS BY EMA, INC, AN ALASKA CORPORATION. THEY FACILITATE THE DAILY BUSINESS OPERATIONS OF THE TRUST.
FORM 990, PART VI, SECTION A, LINE 8BTHE TRUST DOES NOT MAINTAIN ANY SUB-COMMITEES OR BODIES WITH ATHORITY TO ACT ON BEHALF OF THE TRUST.
FORM 990, PART VI, SECTION B, LINE 11THE TRUST CPA PREPARES THE ANNUAL AUDIT AND FORM 990. THESE DOCUMENTS ARE FORWARED BY THE CPA TO THE TRUST CUSTODIAN WHO REVIEWS THE RETURN, SIGNS IT AND SUBMITS IT IN ACCORDANCE WITH STATUTORY REQUIREMENTS.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST
FORM 990, PART VIIKEY TRUST COMPANY OF AK - P O BOX 100900, ANCHORAGE, AK 99510.CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionControlled OrgControlledOrg
CITY OF UNALASKA
PO BOX 610UNALASKAAK99685920036399CITY MANAGEMENTAK501(C)(1)0
UNALASKA CITY SCHOOL DISTRICT
PO BOX 570UNALASKAAK99685926000161EDUCATIONAK501(C)(1)0
IDITAROD AREA SCHOOL DISTRICT
PO BOX 90MCGRATHAK99627920057970EDUCATIONAK501(C)(1)0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg