2012-03-21T17:47:16-05:00 2011-06-30 BERNARD KOTKIN AND COMPANY LLP 533 SOUTH FREMONT AVENUE SUITE 802 LOS ANGELES CA 900711706 990 2010-07-01 956034886 OPERATING ENGINEERS HEALTH AND WELFARE FUND OPER 6263561000 100 EAST CORSON STREET PASADENA CA 91103 MICHAEL GRAYDON 6263561000 2012-03-21 2138929090 2010 2016-02-24 21:20:13Z MICHAEL GRAYDON 100 EAST CORSON STREET PASADENA CA 91103 213840490 0 X WWW.OEFUNDS.ORG X 1954 CA TO PROVIDE MEDICAL BENEFITS TO APPROXIMATELY 10,000 ACTIVE AND 5,000 RETIRED PARTICIPANTS. 13 13 0 0 0 0 0 0 151277326 175425861 -17589 52133 0 12891039 151259737 188369033 0 0 195480092 153193509 6246113 5904275 0 0 0 5951694 5259360 207677899 164357144 -56418162 24011889 35810716 56845991 108321834 105348272 -72511118 -48502281 THE FUND'S MISSION IS TO ADMINISTER AND PROVIDE MEDICAL, DENTAL, VISION, PRESCRIPTION DRUGS, DISABILITY AND DEATH BENEFITS TO THE ACTIVE AND RETIRED MEMBERS OF I.U.O.E LOCAL 12 AND THEIR DEPENDENTS AND BENEFICIARIES. 0 0 155354270 TO PROVIDE MEDICAL, HOSPITAL, DENTAL, LIFE INSURANCE, PRESCRIPTION DRUGS AND VISION BENEFITS TO APPROXIMATELY 10,000 ACTIVE AND 5,000 RETIRED PARTICIPANTS. 155354270 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 8726 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 1 0 0 X OPERATING ENGINEERS FUNDS INC 6263561000 100 EAST CORSON STREET PASADENA CA 91103 DAN BILLY 1.00 X 0 0 0 TIM MACDONALD 1.00 X 0 0 0 MICHAEL CRAWFORD 1.00 X 0 0 0 CHARLES W POSS 1.00 X 0 0 0 LES FARROW 1.00 X 0 0 0 WILLIAM WAGGONER 1.00 X 0 0 0 STEVE BILLY 1.00 X 0 0 0 MICKEY J ADAMS 1.00 X 0 0 0 WALT ELLIOT 1.00 X 0 0 0 KURT GLASS 1.00 X 0 0 0 MITCH WHITE 1.00 X 0 0 0 JOHN NELSON 1.00 X 0 0 0 MIKE RODDY 1.00 X 0 0 0 RON SIKORSKI 1.00 X 0 0 0 BRUCE COOKSEY 1.00 X 0 0 0 MICHAEL GRAYDON 35.00 X 0 254142 28395 MARGARET BOWEN 35.00 X 0 214607 28395 DENISE DARWIN 35.00 X 0 109166 28395 DOUGLAS INOUYE 35.00 X 0 119417 28395 MICHAEL DECHELLIS 35.00 X 0 145404 28395 LINDA HUGHES 35.00 X 0 117239 28395 JON LEE 35.00 X 0 107024 28395 0 1066999 198765 0 0 1 0 LAQUER URBAN CLIFFORD & HODGE 225 S LAKE AVENUE SUITE 200 PASADENA CA 91101 ATTORNEY 734320 THE SEGAL COMPANY PO BOX 4070 CHURCH ST STATION NEW YORK NY 10261 ACTUARY 189487 2 EMPLOYER CONTRIBUTIONS 900099 147205255 147205255 SELF PAY PREMIUMS 900099 27726510 27726510 DELINQUENCY ASSESSMENT 900099 264734 264734 MISCELLANEOUS 900099 224192 224192 INTEREST ON DELINQUENC 900099 5170 5170 175425861 10893 10893 25512697 25471457 41240 41240 41240 REBATES & SUBSIDIES 900099 12891039 12891039 12891039 188369033 188369033 0 0 153193509 153193509 4315175 4315175 490925 490925 746415 746415 351760 351760 748984 748984 58260 58260 45114 45114 332170 332170 686006 686006 282528 282528 723722 723722 19862 19862 14492 14492 30028 30028 117613 117613 69848 69848 CLAIMS REVIEW EXPENSE 1090399 1090399 BLUE CROSS DUES & EXP. 1033350 1033350 CASE MANAGEMENT 6984 6984 164357144 155354270 9002874 0 20750464 28333907 14931999 28397084 13253 0 115000 115000 35810716 56845991 4818834 4815272 103503000 100533000 108321834 105348272 X 0 0 0 0 -72511118 -48502281 -72511118 -48502281 35810716 56845991 X 24011889 -3052 X X 0 1 1 X 0 0 MEDICAL BENEFITS PAYABLE 100533000 100533000 188369033 164357144 24011889 -3052 -3052 24008837 188365981 0 188365981 3052 3052 188369033 167327144 0 167327144 -2970000 -2970000 164357144 PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT FEES 3,052. PART XIII, LINE 4B - OTHER ADJUSTMENTS: DECREASE IN PLAN'S TOTAL BENEFIT OBLIGATIONS, OTHER THAN POSTRETIREMENT -2,970,000. 1 X X X 0 0 0 MICHAEL GRAYDON 0 254142 0 0 0 0 0 12987 0 15408 0 282537 0 0 MARGARET BOWEN 0 214607 0 0 0 0 0 12987 0 15408 0 243002 0 0 MICHAEL DECHELLIS 0 145404 0 0 0 0 0 12987 0 15408 0 173799 0 0 PART I, LINE 1A PER THE TRAVEL & EXPENSE REIMBURSEMENT POLICY, IF TRAVEL TIME EXCEEDS TWO HOURS AND IS NOT ON THE WEST COAST, FIRST-CLASS TRAVEL IS AN OPTION. OTHERWISE, AIR TRAVEL IS LIMITED TO COACH. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF TRUSTEES AND FUND MANAGER REVIEWS THE FORM 990 BEFORE FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 15A IN 2008, THE FUND MANAGER NEGOTIATED AN EMPLOYMENT CONTRACT WITH THE BOARD OF TRUSTEES. COMPENSATION FOR THE OTHER KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES IS BASED ON COMPARABLE COMPENSATION AT SIMILAR ORGANIZATIONS. COMPENSATION FOR THESE INDIVIDUALS WAS ADJUSTED BY THE FUND MANAGER IN FISCAL YEAR 2010. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE FOR INSPECTION UPON REQUEST AT THEIR ADMINISTRATIVE OFFICE, WHICH IS LOCATED AT 100 EAST CORSON STREET, 1ST FLOOR, IN PASADENA, CA. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: INVESTMENT EXPENSES: -3,052. FORM 990, PART XII, LINE 2C: THE ORGANIZATION DOES NOT HAVE A SEPARATE AUDIT COMMITTEE. THE BOARD OF TRUSTEES HAS RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND THE SELECTION OF INDEPENDENT ACCOUNTANTS. OPERATING ENGINEERS PENSION TRUST 100 EAST CORSON STREET PASADENA CA 91103 956032478 TO PROVIDE PENSION BENEFITS TO RETIRED ELIGIBLE MEMBERS. CA 401(A) 0 OPERATING ENGINEERS JOURNEYMAN & APPRENTICESHIP TRAINING TRUST 100 EAST CORSON STREET PASADENA CA 91103 956105499 TO TRAIN ELIGIBLE OPERATING ENGINEER JOURNEYMEN. CA 501(C)(5) 0 OPERATING ENGINEERS VACATION-HOLIDAY SAVINGS TRUST 100 EAST CORSON STREET PASADENA CA 91103 956067144 TO PROVIDE SAVINGS BENEFITS TO ELIGIBLE MEMBERS. CA 501(C)(9) 0 OPERATING ENGINEERS FUNDS INC 100 EAST CORSON STREET PASADENA CA 91103 952694167 TO ADMINISTER THE TRUST FUNDS FOR I.U.O.E. LOCAL 12 CA C 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0