STRATEGY STUDIO / PUBLIC DATA EXPLORER

SERVICE EMPLOYEES HEALTH AND WELFARE TRUST: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
SERVICE EMPLOYEES HEALTH AND WELFARE TRUST (EIN 23-7122650)
Tax period
2010-05-01 to 2011-04-30
Filed
2012-03-09
IRS object ID
201230699349300348
Schema version
2010v3.4
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

FieldValueIRS element (for citing)
Timestamp2012-03-09T16:19:11-06:00Timestamp
Tax Period End Date2011-04-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line13000 NORTHUP WAY SUITE 200AddressLine1
CityBELLEVUECity
StateWAState
ZIP Code980041446ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-05-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN237122650EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SERVICE EMPLOYEES HEALTH AND WELFARE TRUSTBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSERVNameControl
Phone2063294900Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12323 EASTLAKE AVENUE EASTAddressLine1
CitySEATTLECity
StateWAState
ZIP Code98102ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSERGIO SALINASName
TitleCHAIRMANTitle
Phone2064487348Phone
Date Signed2012-03-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKENNETH L CLENIN CPAName
Phone4252506100Phone
Date Prepared2012-03-08DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSERGIO SALINASNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13720 AIRPORT WAY SAddressLine1
CitySEATTLECity
StateWAState
ZIP Code98124ZIPCode
FieldValueIRS element (for citing)
Gross Receipts21767972GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1970YearFormation
State Legal DomicileWAStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE H & W BENEFITSActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers8TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14762094ProgramServiceRevenuePriorYear
Program Service Revenue CY15957051ProgramServiceRevenueCY
Investment Income Prior Year11874InvestmentIncomePriorYear
Investment Income Current Year8974InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year14773968TotalRevenuePriorYear
Total Revenue Current Year15966025TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year15667289BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY15985832BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year238428OtherExpensePriorYear
Other Expenses Current Year211918OtherExpensesCurrentYear
Total Expenses Prior Year15905717TotalExpensesPriorYear
Total Expenses Current Year16197750TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1131749RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-231725RevenuesLessExpensesCY
Total Assets BOY7308776TotalAssetsBOY
Total Assets EOY7119910TotalAssetsEOY
Total Liabilities BOY2514537TotalLiabilitiesBOY
Total Liabilities EOY2560326TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4794239NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY4559584NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE HEALTH AND WELFARE BENEFITS TO QUALIFIED PARTICIPANTS ASSPECIFIED IN THE PLAN.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
DescriptionTO PROVIDE HEALTH AND WELFARE BENEFITS TO QUALIFIED PARTICIPANTS AS SPECIFIED IN THE PLAN.Description
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest1ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10962NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1NORTHWEST ADMINISTRATORS INCBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2063294900TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12323 EASTLAKE AVENUE EASTAddressLine1
CitySEATTLECity
StateWAState
ZIP Code98102ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (10 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerFormerFormer
MARLINE PEDREGOSA
TRUSTEE1.00X000
FRED PROCKIW
TRUSTEE1.00X000
EDISA MUSINOVIC
TRUSTEE1.00X000
JIM RAGSDALE
TRUSTEE1.00X000
SERGIO SALINAS
TRUSTEE1.00X000X
TIM BREKKE
TRUSTEE1.00X000
CHARLIE JONES
TRUSTEE1.00X000X
DAN HALL
TRUSTEE1.00X000
LARRY KAISER
FORMER TRUSTEE1.00000X
KEVIN DAVIS
FORMER TRUSTEE1.00000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1NORTHWEST ADMINISTRATORS INCBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12323 EASTLAKE AVENUE EASTAddressLine1
CitySEATTLECity
StateWAState
ZIP Code98102ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesADMINISTRATIVEDescriptionOfServices
Compensation102719Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTR.5251001590491415904914
EMPLOYEE CONTR.5251004605246052
LIQUIDATED DAMAGES52510060856085
FieldValueIRS element (for citing)
Total Program Service Revenue15957051TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column10921TotalRevenueColumn
Exclusion$10,921ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities5800000Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities5801947Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-1947Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-1947TotalRevenueColumn
Related Or Exempt Function Income-1947RelatedOrExemptFunctionIncome

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column15966025TotalRevenueColumn
Related Or Exempt Function Income15955104RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$10,921ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total15985832Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total98292Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3974Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total34941Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total13814Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total50458Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4992Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total919Total

Insurance Insurance

FieldValueIRS element (for citing)
Total4528Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total16197750Total

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3551523BOY
EOY3147234EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
EOY2800EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY1087263BOY
EOY1283259EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
EOY14026EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2648920BOY
EOY2500503EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY21070BOY
EOY172088EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7308776BOY
EOY7119910EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2514537BOY
EOY2560326EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2514537BOY
EOY2560326EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY4794239BOY
EOY4559584EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4794239BOY
EOY4559584EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7308776BOY
EOY7119910EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-231725ReconcilationRevenueExpenses
Reconcilation Other Changes-2930ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings
Total Revenue15966025TotalRevenue
Total Expenses16197750TotalExpenses
Excess Or Deficit For Year-231725ExcessOrDeficitForYear
Net Unrealized GL On Investments-2930NetUnrealizedGLOnInvestments
Total Adjustments-2930TotalAdjustments
Excess Or Deficit Per FS-234655ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt15949281TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-2930NetUnrealizedGainsInvestments
Revenue Not Rptd F990-2930RevenueNotRptdF990
Revenue Subtotal15952211RevenueSubtotal
Investment Expenses Not Included13814InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt13814RevenueNotRptdOnFinStmt
Total Revenue Per Form99015966025TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt16112735TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal16112735ExpensesSubtotal
Investment Expenses Not Included213814InvestmentExpensesNotIncluded2
Other Expenses Not Included71201OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt85015ExpensesNotRptdOnFinStmt
Total Expenses Per Form99016197750TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF APRIL 30, 2011 THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS, HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2007.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:CHANGE IN PREMIUMS PAYABLE 71,201.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 3THE DAY TO DAY OPERATIONS OF THE PLAN ARE MANAGED BY NORTHWEST ADMINISTRATORS, INC..
FORM 990, PART VI, SECTION B, LINE 11FORM 990 REVIEWED BY THE GOVERNING BODY PRIOR TO FILING.
THE TRUSTEES ARE REQUIRED TO ANNUALLY PROVIDE A WRITTEN STATEMENT THAT THEY ARE NOT AWARE OF ANY CONFLICTS OF INTEREST.FORM 990, PART VI, SECTION B, LINE 12C
AVAILABLE ON REQUESTFORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED LOSSES ON INVESTMENTS: -2,930.FORM 990, PART XI, LINE 5:
THE PROCESS HAS NOT CHANGED FROM THAT REPORTED IN PRIOR YEARS.