2012-03-14T12:48:55-05:00 2011-05-31 HEMMING MORSE CPA'S AND CONSULTANTS 160 SPEAR STREET SUITE 1900 SAN FRANCISCO CA 94105 990 2010-06-01 941235152 LABORERS HEALTH & WELFARE TRUST FUND FOR NORTHERN CALIFORNIA LABO 7078642800 220 CAMPUS LANE FAIRFIELD CA 945341498 ED SMITH 7078642800 2012-03-14 1 4158364000 2010 2016-02-24 21:20:13Z ED SMITH 220 CAMPUS LANE FAIRFIELD CA 945341498 512716333 0 X N/A X 1953 CA SEE PART III LINE 4A 10 10 0 0 0 0 0 0 135693302 151105674 15284236 13064488 6256049 4315941 157233587 168486103 0 0 128721945 168808629 0 0 0 0 0 11154616 10807078 139876561 179615707 17357026 -11129604 187701286 192079122 83532824 87750948 104168462 104328174 NONE 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS ACCORDING TO THE TERMS OF THE COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE EMPLOYERS AND THE UNION 0 0 0 0 0 0 0 0 0 1 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 0 1 342 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 0 0 0 1 0 0 0 1 1 0 0 1 1 0 0 0 X EDWARD SMITH SECRETARY 7078642800 220 CAMPUS LANE FAIRFIELD CA 94534 X LARRY TOTTEN 5.00 X 0 0 0 BYRON LONEY 5.00 X 0 0 0 CLAIRE KOENIG 5.00 X 0 0 0 ROBERT CHRISP 5.00 X 0 0 0 TERENCE STREET 5.00 X 0 0 0 BRUCE RUST 5.00 X 0 0 0 OSCAR DE LA TORRE 5.00 X 0 0 0 JAMES HOMER 5.00 X 0 0 0 DOYLE RADFORD 5.00 X 0 0 0 DAVID GORGAS 5.00 X 0 0 0 0 0 0 0 0 0 0 LABORERS FUND ADMINISTRATIVE OFFICE OF N 220 CAMPUS LANE FAIRFIELD CA 94534 ADMINISTRATOR 5180935 BLUE CROSS OF CALIFORNIA PO BOX 70000 VAN NUYS CA 914700001 CLAIMS ADMINISTRATION 2036142 HEALTHWAYS 21281 BURBANK BLVD WOODLAND HILLS CA 91367 CLAIMS ADMINISTRATION 853856 DELTA DENTAL 100 FIRST STREET SAN FRANCISCO CA 94105 CLAIMS ADMINISTRATION 800639 HEALTH AND SAFETY FUND 905 16TH STREET NW WASHINGTON DC 20006 MEDICAL CONSULTING 429059 11 EMPLOYER CONTRIBUTIONS 900099 134709948 134709948 PARTICIPANT CONTRIBS 900099 15178148 15178148 COBRA CONTRIBUTIONS 900099 1217578 1217578 151105674 8415539 8415539 348879179 344230230 4648949 4648949 4648949 REBATES AND SUBSIDIES 900099 3908292 3908292 LIQUIDATED DAMAGES 900099 403211 403211 OTHER INCOME 900099 4438 4438 4315941 168486103 160070564 0 8415539 168808629 5180935 354539 52625 495623 8779 12390 ADMINISTRATIVE FEES 4326012 CONSULTANT 183764 MEDICAL REVIEW SERVICES 155643 POSTAGE AND PRINTING 35060 MISCELLANEOUS 1658 50 179615707 4971177 3070812 1095605 2834077 11178436 14034688 145860046 141839948 20209015 26256061 4387007 4043536 187701286 192079122 1797170 1250689 81735654 86500259 83532824 87750948 X 0 0 0 0 104168462 104328174 104168462 104328174 187701286 192079122 X -11129604 11289316 X X 0 1 0 X 0 0 DUE TO LABORERS FUNDS ADMINISTRATIVE OFFICES OF NORTHERN CALIFORNIA, INC. 962886 GROUP INSURANCE PEMIUMS PAYABLE 5942650 SELF-FUNDED BENEFIT CLAIMS PAYABLE 17717723 IBNR 17713000 BANK OF HOURS 44164000 86500259 168486103 179615707 -11129604 11289316 11289316 159712 179775419 11289316 11289316 168486103 0 168486103 179615707 0 179615707 0 179615707 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS DELEGATED CONTROL OVER MANAGEMENT DUTIES CUSTOMARILY PERFORMED BY OR UNDER THE DIRECT SUPERVISION OF OFFICERS, DIRECTORS OR TRUSTEES, OR KEY EMPLOYEES TO THE ADMINISTRATIVE OFFICE. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY SUB-COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE TRUSTEES HAVE DESIGNATED THE ADMINISTRATOR TO REVIEW THE FORM PRIOR TO FILING OF THE FORM 990. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 11,289,316. FORM 990, PART XI, LINE 2C THE BOARD OF TRUSTEES OF THE ORGANIZATION ASSUME'S RESPONSIBILITY FOR THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND THE SELECTION OF THE INDEPENDENT AUDITOR. LABORERS PENSION TRUST FUND FOR NORTHERN CALIFORNIA 220 CAMPUS LANE FAIRFIELD CA 94534 946277608 TO PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS CA 401B 0 LABORERS PENSION TRUST FUND FOR NORTHERN CALIFORNIA - ANNUITY PLAN 220 CAMPUS LANE FAIRFIELD CA 94534 946277608 TO PROVIDE ANNUITY BENEFITS TO ELIGIBLE PARTICIPANTS CA 401B 0 LABORERS VACATION-HOLIDAY TRUST FUND FOR NORTHERN CALIFORNIA 220 CAMPUS LANE FAIRFIELD CA 94534 946092198 TO PROVIDE VACATION AND HOLIDAY BENEFITS TO ELIGIBLE PARTICIPANTS CA 501(C)(9) 0 LABORERS TRAINING AND RETRAINING TRUST FUND FOR NORTHERN CALIFORNIA 220 CAMPUS LANE FAIRFIELD CA 94534 941688279 TO PROVIDE TRAINING SERVICES TO ELIGIBLE PARTICIPANTS CA 501(C)(3) 0 LABORERS FUND ADMINISTRATIVE OFFICE OF NORTHERN CALIFORNIA 220 CAMPUS LANE FAIRFIELD CA 94534 941563547 TO PROVIDE ADMINISTRATIVE SERVICES CA N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0