UBC HEALTHCARE TRUST FUND: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- UBC HEALTHCARE TRUST FUND (EIN 23-7331128)
- Tax period
- 2012-02-01 to 2013-01-31
- Filed
- 2013-09-13
- IRS object ID
- 201342569349300019
- Schema version
- 2012v2.1
- 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 | 2013-09-13T11:03:56-05:00 | Timestamp |
| Tax Period End Date | 2013-01-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | L M HENDERSON & COMPANY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 450 E 96TH ST STE 200 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46240 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-02-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237331128 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARPENTERS INDUSTRIAL COUNCIL TRUST | BusinessNameLine1 |
| Business Name Line2 | FUND | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CARP | NameControl |
| Phone | 8003324732 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 602 VIRGINIA STREET EAST | AddressLine1 |
| City | CHARLESTON | City |
| State | WV | State |
| ZIP Code | 25301 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | STEVE HERRING | Name |
| Title | CHAIRMAN | Title |
| Phone | 8003324732 | Phone |
| Date Signed | 2013-08-14 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAMES J CLINE | Name |
| Phone | 3175661000 | Phone |
| Date Prepared | 2013-08-14 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | STEVE HERRING | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 602 VIRGINIA STREET EAST | AddressLine1 |
| City | CHARLESTON | City |
| State | WV | State |
| ZIP Code | 25301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 74078870 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | N/A | WebSite |
| Type Of Organization Trust | X | TypeOfOrganizationTrust |
| Year Formation | 1972 | YearFormation |
| State Legal Domicile | TN | StateLegalDomicile |
| Activity Or Mission Description | PROVIDING HEALTH AND WELFARE BENEFITS | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 6 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 15378673 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 13686846 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1687676 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1830647 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 17066349 | TotalRevenuePriorYear |
| Total Revenue Current Year | 15517493 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 13603914 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 11889640 | BenefitsPaidToMembersCY |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1667130 | OtherExpensePriorYear |
| Other Expenses Current Year | 1543285 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 15271044 | TotalExpensesPriorYear |
| Total Expenses Current Year | 13432925 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1795305 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2084568 | RevenuesLessExpensesCY |
| Total Assets BOY | 34697693 | TotalAssetsBOY |
| Total Assets EOY | 36339232 | TotalAssetsEOY |
| Total Liabilities BOY | 5422210 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 4464322 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 29275483 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 31874910 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROVIDING HEALTH AND WELFARE BENEFITS | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Description | THE ORGANIZATION PROVIDES HOSPITAL, MEDICAL, DENTAL, VISION CARE, DISABILITY, AND LIFE INSURANCE BENEFITS TO ITS PARTICIPANTS AND THEIR BENEFICIARIES. | Description |
| Described In501 C3 | false | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| 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 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| 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 | 6 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | 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 | false | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| 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 | HEALTHSMART BENEFIT SOLUTIONS TPA | NamePerson |
| Telephone Number | 8003324732 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 602 VIRGINIA STREET EAST | AddressLine1 |
| City | CHARLESTON | City |
| State | WV | State |
| ZIP Code | 25301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (6 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| STEVE HERRING | ||||||
| CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 |
| CARL YOUNG | ||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 |
| LARRY WYATT | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| MIKE PIETI | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| JOHN SKEDGELL | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| BROOKS BURTON | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 |
|---|---|---|---|---|---|
| ANTHEM INSURANCE COMPANIES INC | |||||
| 220 VIRGINIA STREET | INDIANAPOLIS | IN | 46204 | CLAIM PROCESSIN | 836958 |
| HEALTHSMART BENEFIT SOLUTIONS INC | |||||
| 602 VIRGINIA ST EAST | CHARLESTON | WV | 25301 | GENERAL PLAN AD | 245788 |
| SLEVIN & HART PC | |||||
| 1625 MASSACHUSETTS AVE NW SUITE 450 | WASHINGTON | DC | 20036 | LEGAL | 104990 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| EMPLOYER CONTRIBUTIONS | 525100 | 13544658 | 13544658 |
| EMPLOYEE CONTRIBUTIONS | 525100 | 142188 | 142188 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 13686846 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 768546 | TotalRevenueColumn |
| Related Or Exempt Function Income | 768546 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 59623478 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 58561377 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1062101 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1062101 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1062101 | RelatedOrExemptFunctionIncome |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 15517493 | TotalRevenueColumn |
| Related Or Exempt Function Income | 15517493 | RelatedOrExemptFunctionIncome |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11889640 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 104990 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51485 | Total |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal |
|---|---|
| ADMINISTRATION FEES | 1107484 |
| BANK & INVESTMENT FEES | 177970 |
| TRUSTEE MEETINGS | 47664 |
| FIDUCIARY INSURANCE | 41834 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11858 | Total |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13432925 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2800371 | BOY |
| EOY | 672892 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 277979 | BOY |
| EOY | 625899 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15803 | BOY |
| EOY | 7984 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31603540 | BOY |
| EOY | 35032457 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34697693 | BOY |
| EOY | 36339232 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 198631 | BOY |
| EOY | 207028 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5223579 | BOY |
| EOY | 4257294 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5422210 | BOY |
| EOY | 4464322 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29275483 | BOY |
| EOY | 31874910 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29275483 | BOY |
| EOY | 31874910 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34697693 | BOY |
| EOY | 36339232 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 2084568 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | -378308 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 893167 | ReconcilationOtherChanges |
| 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 |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule D IRS990ScheduleD
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| BENEFIT OBLIGATION | $4,250,192 |
| CHECKS WRITTEN IN EXCESS OF | $7,102 |
| AVAILABLE BALANCES |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 4257294 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 14961215 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -378308 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | -378308 | RevenueNotRptdF990 |
| Revenue Subtotal | 15339523 | RevenueSubtotal |
| Investment Expenses Not Included | 177970 | InvestmentExpensesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 177970 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 15517493 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 12361788 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 12361788 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 177970 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 893167 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 1071137 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 13432925 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| LIABILITY UNDER FIN 48 FOOTNOTE | SCHEDULE D, PAGE 3, PART X | THE FUND'S TRUSTEES AND LEGAL COUNSEL BELIEVE THAT THE FUND IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THEREFORE, THE FUND WAS QUALIFIED AND THE RELATED TRUST WAS TAX-EXEMPT AS OF THE FINANCIAL STATEMENT DATE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE FUND MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FUND AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE FUND ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE FUND, AND HAS CONCLUDED THAT AS OF JANUARY 31, 2013, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE FUND IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE FUND ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE TAX YEARS PRIOR TO 2009. |
| EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER | SCHEDULE D, PAGE 4, PART XII, LINE 4B | CURRENT YEAR ACTUARIAL CHANGE IN BENEFIT OBLIGATION 893,167 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ADDITIONAL INFORMATION | FORM 990, PART VI | SECTION B, LINE 13: THE TRUST FUND DOES NOT RETAIN A WRITTEN WHISTLEBLOWER POLICY, BUT THE BOARD OF TRUSTEES AND THE TRUST FUND CONFORM WITH ERISA RULES AND REGULATIONS WITH REGARDS TO THE WHISTLEBLOWER POLICY. SECTION C, LINE 18: THE BOARD OF TRUSTEES AND THE TRUST FUND CONFORM WITH ERISA RULES AND REGULATIONS WITH REGARDS TO MAKING ITS FORMS 1023 AND 990 AVAILABLE FOR PUBLIC INSPECTION. |
| MANAGEMENT DELEGATED | FORM 990, PAGE 6, PART VI, LINE 3 | THE BOARD OF TRUSTEES HAS OUTSOURCED THE DAY TO DAY ADMINISTRATION OF THE TRUST FUND TO HEALTHSMART BENEFIT SOLUTIONS TPA. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | FORM 990 IS AVAILABLE TO EACH TRUSTEE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | THE BOARD OF TRUSTEES AND THE TRUST FUND CONFORM WITH ERISA RULES AND REGULATIONS WITH RESPECT TO REGULARLY AND CONSISTENTLY MONITORING AND ENFORCING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE TRUST FUND MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE TRUST FUND AND THE BOARD OF TRUSTEES CONFORM WITH ERISA RULES AND REGULATIONS RELATING TO THIS MATTER. |
| RECONCILIATION OF CHANGES - OTHER | FORM 990, PART XI, LINE 9 | CURRENT YEAR ACTUARIAL CHANGE IN BENEFIT OBLIGATION 893,167 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part III Form990ScheduleRPartIII (8 entries)
| Primary ActivityPrimaryActivity | Direct Controlling Entity NADirectControllingEntityNA | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|
| GEORGIA-PACIFIC WOOD PRODUCTS LLC | |||
| CONTRACTOR | N/A | false | false |
| SAWCO LLC | |||
| CONTRACTOR | N/A | false | false |
| GEORGIA-PACIFIC WOOD PRODUCTS LLC | |||
| CONTRACTOR | N/A | false | false |
| SAWCO LLC | |||
| CONTRACTOR | N/A | false | false |
| GEORGIA-PACIFIC WOOD PRODUCTS LLC | |||
| CONTRACTOR | N/A | false | false |
| SAWCO LLC | |||
| CONTRACTOR | N/A | false | false |
| GEORGIA-PACIFIC WOOD PRODUCTS LLC | |||
| CONTRACTOR | N/A | false | false |
| SAWCO LLC | |||
| CONTRACTOR | N/A | false | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV (52 entries)
| Primary ActivityPrimaryActivity | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|
| WEYERHAEUSER NR COMPANY | ||
| CONTRACTOR | N/A | false |
| ARMSTRONG-JACKSON | ||
| CONTRACTOR | N/A | false |
| CSOL | ||
| CONTRACTOR | N/A | false |
| JOHNSTON TOMBIGBEE | ||
| CONTRACTOR | N/A | false |
| KLIPSCH | ||
| CONTRACTOR | N/A | false |
| KOPPERS | ||
| CONTRACTOR | N/A | false |
| MIL-DEL CORPORATION | ||
| CONTRACTOR | N/A | false |
| MILFORD NURSING HOME | ||
| CONTRACTOR | N/A | false |
| OVERHEAD DOOR - OHIO | ||
| CONTRACTOR | N/A | false |
| PASQUIER PANEL PRODUCTS | ||
| CONTRACTOR | N/A | false |
| ROSEBURG | ||
| CONTRACTOR | N/A | false |
| SEAFORD NURSING HOME | ||
| CONTRACTOR | N/A | false |
| WEST FRASER | ||
| CONTRACTOR | N/A | false |
| WEYERHAEUSER NR COMPANY | ||
| CONTRACTOR | N/A | false |
| ARMSTRONG-JACKSON | ||
| CONTRACTOR | N/A | false |
| CSOL | ||
| CONTRACTOR | N/A | false |
| JOHNSTON TOMBIGBEE | ||
| CONTRACTOR | N/A | false |
| KLIPSCH | ||
| CONTRACTOR | N/A | false |
| KOPPERS | ||
| CONTRACTOR | N/A | false |
| MIL-DEL CORPORATION | ||
| CONTRACTOR | N/A | false |
| MILFORD NURSING HOME | ||
| CONTRACTOR | N/A | false |
| OVERHEAD DOOR - OHIO | ||
| CONTRACTOR | N/A | false |
| PASQUIER PANEL PRODUCTS | ||
| CONTRACTOR | N/A | false |
| ROSEBURG | ||
| CONTRACTOR | N/A | false |
| SEAFORD NURSING HOME | ||
| CONTRACTOR | N/A | false |
| WEST FRASER | ||
| CONTRACTOR | N/A | false |
| WEYERHAEUSER NR COMPANY | ||
| CONTRACTOR | N/A | false |
| ARMSTRONG-JACKSON | ||
| CONTRACTOR | N/A | false |
| CSOL | ||
| CONTRACTOR | N/A | false |
| JOHNSTON TOMBIGBEE | ||
| CONTRACTOR | N/A | false |
| KLIPSCH | ||
| CONTRACTOR | N/A | false |
| KOPPERS | ||
| CONTRACTOR | N/A | false |
| MIL-DEL CORPORATION | ||
| CONTRACTOR | N/A | false |
| MILFORD NURSING HOME | ||
| CONTRACTOR | N/A | false |
| OVERHEAD DOOR - OHIO | ||
| CONTRACTOR | N/A | false |
| PASQUIER PANEL PRODUCTS | ||
| CONTRACTOR | N/A | false |
| ROSEBURG | ||
| CONTRACTOR | N/A | false |
| SEAFORD NURSING HOME | ||
| CONTRACTOR | N/A | false |
| WEST FRASER | ||
| CONTRACTOR | N/A | false |
| WEYERHAEUSER NR COMPANY | ||
| CONTRACTOR | N/A | false |
| ARMSTRONG-JACKSON | ||
| CONTRACTOR | N/A | false |
| CSOL | ||
| CONTRACTOR | N/A | false |
| JOHNSTON TOMBIGBEE | ||
| CONTRACTOR | N/A | false |
| KLIPSCH | ||
| CONTRACTOR | N/A | false |
| KOPPERS | ||
| CONTRACTOR | N/A | false |
| MIL-DEL CORPORATION | ||
| CONTRACTOR | N/A | false |
| MILFORD NURSING HOME | ||
| CONTRACTOR | N/A | false |
| OVERHEAD DOOR - OHIO | ||
| CONTRACTOR | N/A | false |
| PASQUIER PANEL PRODUCTS | ||
| CONTRACTOR | N/A | false |
| ROSEBURG | ||
| CONTRACTOR | N/A | false |
| SEAFORD NURSING HOME | ||
| CONTRACTOR | N/A | false |
| WEST FRASER | ||
| CONTRACTOR | N/A | false |
| 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 | true | OtherTransferFromOtherOrg |