SOUTHERN DISTRICT UBC HEALTH TRUST: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: SOUTHERN DISTRICT UBC HEALTH TRUST (EIN 74-6075997)
Tax period: 2011-01-01 to 2011-12-31
Filed: 2012-10-15
IRS object ID: 201212919349300326
Schema version: 2011v1.2
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
Form 990
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-10-15T15:31:17-05:00	Timestamp
Tax Period End Date	2011-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	741695589	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	HARPER & PEARSON COMPANY PC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	ONE RIVERWAY SUITE 1000	AddressLine1
City	HOUSTON	City
State	TX	State
ZIP Code	77056	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	746075997	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	TEXAS CARPENTERS AND MILLWRIGHTS HEALTH	BusinessNameLine1
Business Name Line2	& WELFARE FUND	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	TEXA	NameControl
Phone	4056822323	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1300 SOUTH MERIDIAN SUITE 200	AddressLine1
City	OKLAHOMA CITY	City
State	OK	State
ZIP Code	731081751	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	PAUL OLIVER	Name
Title	EMPLOYER TRUSTEE	Title
Phone	4056822323	Phone
Date Signed	2012-10-08	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	KEVIN E BIENVENU CPA	Name
PTIN	P00079403	PTIN
Phone	7136222310	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	PAUL OLIVER	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1300 SOUTH MERIDIAN 200	AddressLine1
City	OKLAHOMA CITY	City
State	OK	State
ZIP Code	731081751	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	54972682	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c	X	Organization501c
Web Site	N/A	WebSite
Type Of Organization Trust	X	TypeOfOrganizationTrust
Year Formation	1960	YearFormation
State Legal Domicile	TX	StateLegalDomicile
Activity Or Mission Description	TO PROVIDE MEDICAL BENEFITS FOR ELIGIBLE MEMBERS AND THEIR DEPENDENTS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	17	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	17	NbrIndependentVotingMembers
Total Nbr Employees	0	TotalNbrEmployees
Total Nbr Volunteers	0	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	0	ContributionsGrantsPriorYear
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	11163832	ProgramServiceRevenuePriorYear
Program Service Revenue CY	13766370	ProgramServiceRevenueCY
Investment Income Prior Year	427708	InvestmentIncomePriorYear
Investment Income Current Year	642685	InvestmentIncomeCurrentYear
Other Revenue Prior Year	995672	OtherRevenuePriorYear
Other Revenue Current Year	532791	OtherRevenueCurrentYear
Total Revenue Prior Year	12587212	TotalRevenuePriorYear
Total Revenue Current Year	14941846	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	13876358	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	13333700	BenefitsPaidToMembersCY
Salaries Etc Prior Year	0	SalariesEtcPriorYear
Salaries Etc Current Year	0	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	383421	OtherExpensePriorYear
Other Expenses Current Year	545072	OtherExpensesCurrentYear
Total Expenses Prior Year	14259779	TotalExpensesPriorYear
Total Expenses Current Year	13878772	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-1672567	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	1063074	RevenuesLessExpensesCY
Total Assets BOY	18013932	TotalAssetsBOY
Total Assets EOY	18603900	TotalAssetsEOY
Total Liabilities BOY	10358405	TotalLiabilitiesBOY
Total Liabilities EOY	9885299	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	7655527	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	8718601	NetAssetsOrFundBalancesEOY
Mission Description	PROVISION OF HEALTH BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	13878772	Expense
Revenue	14941846	Revenue
Description	PROVISION OF HEALTH BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS.	Description
Total Program Service Expense	13878772	TotalProgramServiceExpense
Described In501 C3	0	DescribedIn501C3
Schedule B Required	0	ScheduleBRequired
Political Activities	0	PoliticalActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	0	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	0	ReportFin48Footnote
Independent Audit Financial Stmt	1	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	0	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	0	Hospital
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	0	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	0	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	0	NumberOfEmployees
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	17	NbrVotingGoverningBodyMembers
Number Independent Voting Members	17	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	0	CompensationProcessCEO
Compensation Process Other	0	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	BOARD OF TRUSTEES	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	4056822323	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1300 SOUTH MERIDIAN SUITE 200	AddressLine1
City	OKLAHOMA CITY	City
State	OK	State
ZIP Code	731081751	ZIPCode

Field	Value	IRS element (for citing)
No Listed Persons Compensated	X	NoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
JAMES BROOKES
SECRETARY	2.00	X	0	0	0
JAMES SCHWINKEN
EMPLOYER TRUSTEE	2.00	X	0	0	0
MARIO VARGAS
UNION TRUSTEE	2.00	X	0	0	0
TOMMY GILBERT
UNION TRUSTEE	2.00	X	0	0	0
DAVID BONDS
UNION TRUSTEE	2.00	X	0	0	0
CONRAD MASTERS
UNION TRUSTEE	2.00	X	0	0	0
RICHARD ARISPE
EMPLOYER TRUSTEE	2.00	X	0	0	0
STEVE LUEBBEHUSE
EMPLOYER TRUSTEE	2.00	X	0	0	0
RICHARD TRAVIS
EMPLOYER TRUSTEE	2.00	X	0	0	0
MIKE HINES
UNION TRUSTEE	2.00	X	0	0	0
MARCO VARGAS
UNION TRUSTEE	2.00	X	0	0	0
KENNETH FONTENOR
UNION TRUSTEE	2.00	X	0	0	0
PAT KILEY
EMPLOYER TRUSTEE	2.00	X	0	0	0
PAUL OLIVER
CHAIRMAN	2.00	X	0	0	0
JOHN HANKS
EMPLOYER TRUSTEE	2.00	X	0	0	0
MICHAEL BREDA
EMPLOYER TRUSTEE	2.00	X	0	0	0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	0	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	0	TotalOtherCompensation
Number Individuals GT100 K	0	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	0	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
BLUE CROSS BLUE SHIELD
2425 WEST LOOP SOUTH 1000	HOUSTON	TX	77027	CLAIMS PROCESSING	801306
ZENITH ADMINISTRATORS
9555 W SAM HOUSTON PKWY 400	HOUSTON	TX	77099	ADMINISTRATION	448903

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	2	NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS	900099	13319024	13319024
PARTICIPANT CONTRIBUTI	900099	447346	447346

Field	Value	IRS element (for citing)
Total Program Service Revenue	13766370	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	540520	TotalRevenueColumn
Related Or Exempt Function Income	540520	RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	40133001	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	40030836	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	102165	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	102165	TotalRevenueColumn
Related Or Exempt Function Income	102165	RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
OTHER INCOME	900099	342081	342081
UNREALIZED GAINS	900099	190710	190710

Field	Value	IRS element (for citing)
Total Other Revenue	532791	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	14941846	TotalRevenueColumn
Related Or Exempt Function Income	14941846	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	13333700	Total
Program Services	13333700	ProgramServices

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	88539	Total
Program Services	88539	ProgramServices

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	41082	Total
Program Services	41082	ProgramServices

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	70415	Total
Program Services	70415	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
ADMINISTRATION FEES	448903	448903
OTHER	70438	70438
CONSULTING FEES	28000	28000
FIDUCIARY LIABILITY INS	15776	15776

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	-218081	Total
Program Services	-218081	ProgramServices

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	13878772	Total
Program Services	13878772	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	102715	BOY
EOY	189177	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	1424147	BOY
EOY	1562543	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	16487070	BOY
EOY	16852180	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	18013932	BOY
EOY	18603900	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	1421153	BOY
EOY	1166128	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	8937252	BOY
EOY	8719171	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	10358405	BOY
EOY	9885299	EOY

Field	Value	IRS element (for citing)
Do Not Follow SFAS117	X	DoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	7655527	BOY
EOY	8718601	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	18013932	BOY
EOY	18603900	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	1063074	ReconcilationRevenueExpenses
Reconcilation Other Changes	0	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	0	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
CLAIMS IBNR	$2,381,243
BANK LIABILITY	$6,337,928

Field	Value	IRS element (for citing)
Total Of Amounts	8719171	TotalOfAmounts
Total Revenue	14941846	TotalRevenue
Total Expenses	13878772	TotalExpenses
Excess Or Deficit For Year	1063074	ExcessOrDeficitForYear
Excess Or Deficit Per FS	1063074	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	14941846	TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F990	0	RevenueNotRptdF990
Revenue Subtotal	14941846	RevenueSubtotal
Revenue Not Rptd On Fin Stmt	0	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	14941846	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	13878772	TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F990	0	ExpensesNotRptdF990
Expenses Subtotal	13878772	ExpensesSubtotal
Expenses Not Rptd On Fin Stmt	0	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	13878772	TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

Return ReferenceReturnReference	ExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11	FORM 990 IS REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO IT BEING SIGNED AND FILED.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST POLICY IS SIGNED BY ALL TRUSTEES & INTERESTED PARTIES. MONITORING AND ENFORCEMENT IS AN ONGOING PROCESS REVIEWED AT ALL BOARD MEETINGS.
FORM 990, PART VI, SECTION C, LINE 19	FORM 990 IS FILED WITH THE INTERNAL REVENUE SERVICE AND IS AVAILABLE FOR PUBLIC INSPECTION THROUGH THE AGENCY OR WRITTEN REQUESTS TO THE BOARD OF TRUSTEES.
FORM 990, PART XI, LINE 2C	THE COMMITTEE DID NOT CHANGE ITS OVERSIGHT PROCESS DURING THE TAX YEAR