2012-11-12T10:10:14-06:00 2011-12-31 990 2011-01-01 030438558 Oxbow Affiliated Companies Health Benefit Plan % ZACHARY SHIPLEY OXBO 5616974300 1601 Forum Place West Palm Beach FL 33401 ZACHARY SHIPLEY 5616974300 2012-11-12 2011 2016-02-24 21:20:13Z X ZACHARY K SHIPLEY 1601 Forum Place Ste P2 West Palm Beach FL 33401 9411066 false X N/A X 2002 FL THE ORGANIZATION'S PRIMARY PURPOSE IS TO PAY OUT HEALTH BENEFITS ON BEHALF OF ITS PARTICIPANTS AND COLLECT PAYMENTS FROM PARTICIPANTS. 1 0 0 0 0 0 0 6905694 9411066 0 0 0 0 6905694 9411066 0 0 4533201 7053340 0 0 0 0 0 661042 2292564 5194243 9345904 1711451 65162 4548568 4613729 471156 840400 4077412 3773329 THE ORGANIZATION'S PRIMARY PURPOSE IS TO PAYOUT HEALTH BENEFITS ON BEHALF OF ITS PARTICIPANTS AND TO COLLECT PAYMENTS FROM PARTICIPANTS. false false PAYMENT OF HEALTH CARE BENEFITS ON BEHALF OF ITS PARTICIPANTS. false false false false false false false false false false false false true false true false false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 0 0 0 false false false false false false 1 0 false false false false false false false true true false false true false false false false false false FL X ZACHARY SHIPLEY 5616974300 C/O OXBOW CARBON 1601 FORUM PL 14 W PALM BCH FL 33401 X ZACHARY K SHIPLEY 0.0 X 0 1688983 0 0 1688983 0 0 false true false 0 0 CONTRIBUTIONS 525100 9411066 9411066 9411066 0 0 0 0 0 0 0 0 9411066 9411066 0 0 0 7053340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ADMINISTRATIVE EXPENSES 43340 STOP LOSS INSURANCE EXPENSE 2249224 9345904 4548568 4613729 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4548568 4613729 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 471156 840400 471156 840400 X 4077412 3773329 0 0 0 0 4077412 3773329 4548568 4613729 X 65162 -369245 X false true true X false 0 BENEFITS OBLIGATION 840400 840400 9411066 9345904 65162 -369244 -369244 -304082 9411066 9411066 9411066 9715148 369244 369244 9345904 9345904 Part XIII Line 2d Other Expenses on Books, Not on Return Estimated Claims Incurred but not Paid or Reported (369,244) Part XI, Line 8 Other Changes to Net Assets Estimated Claims Incurred but not Paid or Reported 369,244 false false false ZACHARY K SHIPLEY 0 0 0 0 0 1688983 0 0 0 0 0 1688983 0 0 Part VII, Section B, Line 11 Form 990 Review Process No review was or will be conducted by the Trustee. Part VII, Section C, Line 19 Public Disclosure of Documents The financial statements, governing documents, and conflict of interest policy are not made available to the public. Part XI, Line 5 Other Changes in Net Assets Estimated Claims Incurred but not Paid or Reported 369,245 Part VII, Section A, Line 1, Column E Reportable Compensation from Related Organizations Zachary Shipley's compensation is for services rendered to a related organization and is paid by the related organization in the form of a guaranteed payment reportable on Schedule K-1. Zachary is not compensated for services provided to Oxbow Affiliated Companies Health Benefit Plan. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ZACHARY K. SHIPLEY TITLE:TRUSTEE HOURS:40 Oxbow Carbon LLC 1601 Forum Pl W Plm Bch FL 33401 208709417 Petroleum product FL na n/a Oxbow Calcining USA Inc 1601 Forum Pl Ste 1400 West Palm Beach FL 33401 760576974 Holding Company DE na C Centurion Residence Services Inc 1601 Forum Pl Ste 1400 West Palm Beach FL 33401 650261002 Domestic svcs DE na S Oxbow Carbon & Minerals Holdings Inc 1601 Forum Pl Ste 1400 West Palm Beach FL 33401 232432218 Holding Company DE na S Gunnison Energy Corporation 1601 Forum Pl Ste 1400 West Palm Beach FL 33401 651106222 Drilling DE na S Oxbow Corporation 1601 Forum Pl Ste 1400 West Palm Beach FL 33401 042800610 Management Svcs MA na C false false false false false false false false false false false false false false false false false true Oxbow Carbon LLC r 3658975 accrual Oxbow Calcining USA Inc r 2964456 accrual Centurion Residence Services Inc r 608876 accrual Oxbow Carbon & Minerals Holdings Inc r 173261 accrual Gunnison Energy Corporation r 319577 accrual