2012-05-14T12:58:56-05:00 2011-07-31 SCHOEDEL & SCHOEDEL CPAS PLLC 422 W RIVERSIDE AVE STE 1420 SPOKANE WA 992010395 990 2010-08-01 910597991 Employee Painters' Trust PAIN 2062824100 201 Queen Anne Avenue North No 100 Seattle WA 98109 Mike Ball Stacey Grund 2062824100 2012-05-14 1 SCOTT OPPERUD CPA 5097472158 2012-05-08 2010 2016-02-24 21:20:13Z Mike Ball Stacey Grund 201 Queen Anne Avenue North No 100 Seattle WA 98109 112644913 0 X N/A X 1952 WA To provide health and welfare benefits pursuant to a collective bargaining agreement between delegates of union locals of the Brotherhood of Painters, Decorators and Paperhangers of America and participating employers. 9 9 0 0 0 0 0 0 43087375 38709795 3915806 3919560 460574 1005775 47463755 43635130 0 0 51008839 46486546 0 0 0 0 0 3304005 3489230 54312844 49975776 -6849089 -6340646 86038387 77852019 7770497 6749374 78267890 71102645 X The Trust provides health and welfare benefits to qualified employees of participating employers in the painting, drywall, floor covering, glassworkers, glaziers and sign painters/paint maker industries that are required to contribute as a result of a collective bargaining agreements or a special agreement with the Board of Trustees. 0 0 The Trust provides health and welfare benefits pursuant to collective bargaining and special agreements between various employers and the Trust. 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 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 X 9 9 1 1 0 0 0 1 0 1 1 0 0 1 1 1 1 0 1 0 0 0 X Zenith American Solutions 2062824100 201 Queen Avenue North Suite 100 Seattle WA 98109 X Nancy Gudmundson 1.00 X X 0 0 0 Stacey Grund 1.00 X 0 0 0 Mike Guza 1.00 X 0 0 0 Bob Puzas 1.00 X 0 0 0 Tim Bendokas 1.00 X 0 0 0 Mike Ball 1.00 X X 0 0 0 Denis Sullivan 1.00 X 0 0 0 Tim Carrier 1.00 X 0 0 0 Todd Koch 1.00 X 0 0 0 Bud Bartunek 1.00 X 0 0 0 John Smirk 1.00 X 0 0 0 Tom Pfundstein 1.00 X 0 0 0 0 0 0 0 0 0 0 Zenith American Solutions 18861 90th Avenue Suite A Mokena IL 60448 Contracted administrator 1298833 Ekman Bohrer & Thulin PS 220 W Mercer Suite 400 Seattle WA 98119 Attorney on retainer, collections 262927 Innovative Care Management PO Box 22346 Portland OR 97269 Utilization review, and medical review 229186 Lindquist CPAs LLP 5000 Executive Parkway Suite 400 San Ramon CA 94583 Payroll auditor 187882 Christensen James & Martin 7440 W Sahara Ave Las Vegas NV 89117 Collection attorney 162516 5 Employer contributions 525100 37814639 37814639 Participant contributi 525100 895156 895156 38709795 3410467 3410467 69518876 69009783 509093 509093 509093 COBRA Subsidies 525100 784563 784563 Payroll audit related 525100 211407 211407 Miscellaneous income 525100 9805 9805 1005775 43635130 39715570 0 3919560 46486546 1298833 471913 253256 232121 888988 211696 54085 34970 Bank fees 39308 Dues 4060 49975776 969919 301976 984601 4891741 4218970 14138 21290 79211525 70369777 1619007 1287462 86038387 77852019 125178 77260 7645319 6672114 7770497 6749374 X 0 0 0 0 78267890 71102645 78267890 71102645 86038387 77852019 X -6340646 -824599 X 0 1 0 X 0 0 Premiums due insurers 35114 Benefits claims payable 1200000 Claims incurred but not reported 5437000 6672114 43635130 49975776 -6340646 -824599 -824599 -7165245 42578410 -824599 -824599 43403009 232121 232121 43635130 49743655 0 49743655 232121 232121 49975776 Nancy Gudmundson Trustee 260013 Nancy Gudmundson is both a trustee of this trust and employee of Gudmundson company, a participating employer contributing to this trust. During the year ended July 31, 2011, contributions to this trust from Gudmundson Company totaled $260,013. 0 Tom Pfundstein Trustee 45941 Tom Pfundstein is both a trustee of this trust and employee of PDCA (in Henderson, Nevada), a participating employer contributing to this trust. during the year ended July 31, 2011, contributions from PDCA totaled $45,941. 0 Mike Guza Trustee 6955 Mike Guza is both a trustee of this trust and employee of Rainbow Painting Company (in Montana), a participating employer contributing to this trust. During the year ended July 31, 2011, contributions from Rainbow Painting Company totaled $6,955. 0 Bob Puzas Trustee 93704 Bob Puzas is both a trustee of this trust and employee of Rainbow Painting Company (in Oregon), a participating employer contributing to this trust. During the year ended July 31, 2011, contributions from Rainbow Painting Company totaled $93,704. 0 Mike Ball Trustee 333304 Mike Ball is both a trustee of this trust and an employee of IUPAT District Council #5 - Seattle, a participating employer contributing to this trust. During the year ended July 31, 2011, contributions to this trust from IUPAT District Council #5 totaled $333,304. 0 Mike Ball Trustee 32100 Mike Ball is both a trustee of this trust and a trustee of Painters Apprenticeship Trust. The Painters Apprenticeship Trust is a participating employer contributing to this trust. During the year ended July 31, 2011, contributions to this trust from the Training Fund totaled $32,100. 0 Mike Ball Trustee 104883 Mike Ball is both a trustee of this trust and a trustee of the Western Washington apprentice & Traing Trust (Training Trust), a participating employer contibuting to this trust. During the year ended July 31, 2011, contributions to this trust from the Training Trust totaled $104,883. 0 Denis Sullivan Trustee 32100 Denis Sullivan is both a trustee of this trust and a trustee of the Painters Apprenticeship Trust. The Painters Apprenticeship Trust is a participating employer contributing to this trust. During the year ended July 31, 2011, contributions to this trust from the Training Fund totaled $32,100. 0 Denis Sullivan Trustee 104883 Denis Sullivan is both a trustee of this trust and a trustee of the Western Washington apprentice & Traing Trust (Training Trust), a participating employer contibuting to this trust. During the year ended July 31, 2011, contributions to this trust from the Training Trust totaled $104,883. 0 Tim Carrier Trustee 333304 Tim Carrier is both a trustee of this trust and an employee of IUPAT District Council #5 - Portland, a participating employer contributing to this trust. During the year ended July 31, 2011, contributions to this trust from IUPAT District Council #5 totaled $333,304. 0 Todd Koch Trustee 10323 odd Koch is both a trustee of this trust and an employee of IUPAT Local #567, a participating employer contributing to this trust. During the year ended July 31, 2011, contibutions to this trust from IUPAT Local #567 totaled $10,323. 0 John Smirk Trustee 149056 John Smirk is both a trustee of this trust and and employee of IUPAT Local #159, a participating employer contributing to this trust. During the year ended July 31, 2011, contributions to this trust from IUPAT Local #159 totaled $149,056. 0 Stacey Grund Trustee 347967 Stacey Grund is both a trustee of this trust and and employee of Grund & Company a participating employer contributing to this trust. During the year ended July 31, 2011, contributions to this trust from Grund & Company totaled $347,967. 0 Stacey Grund Trustee 13607 Stacey Grund is both a trustee of this trust and and employee of Tatley-Grund, Inc., a participating employer contributing to this trust. During the year ended July 31, 2011, contributions to this trust from Tatley-Grund, Inc.totaled $13,607. 0 Bud Bartunek Trustee 333304 Bud Bartunek is both a trustee of this trust and an employee of IUPAT District Council #5 - Portland, a participating employer contributing to this trust. During the year ended July 31, 2011, contributions to this trust from IUPAT District Council #5 totaled $333,304. 0 Form 990, Part VI, Section A, line 2 Mike Ball, Denis Sullivan and Tim Carrier are all trustees of this trust and employees of International Union of Painters and Allied Trades District Council #5, a participating employer of this trust. Mike Ball and Denis Sullivan are also trustees of this trust and trustees of Painters Apprenticeship Trust and Western Washington Apprenticeship & Training Trust, participating employers of this trust. Form 990, Part VI, Section A, line 3 The Trust has contracted with a third-party administrator (Zenith American Solutions) to provide bookkeeping and administrative services. Form 990, Part VI, Section A, line 7a The trust is administered by a ten-member Board of Trustees. Individual trustee positions are filled and removed by the appointing authorites described below. Union trustees: District Council #5 of the the Internation Union of Painters and Allied Trades (IUPAT) has the appointing and removal authority, according to it internal rules, procedures or practices, over three union trustee positions. Painters Union Local No. 159 of the IUPAT has similar authority over one union trustee position. Together, these four union trustee postitions have the appointing and removal authority over the one at-large union trustee position. Employer Trustees: Western Washington Signatory Painting employers have the appointing and removal authority over two employer trustee postions. The signatory Painting Contractors of Oregon have similar authority over one employer trustee position. Together, these three employer trustee positions have the appointing and removal authority over the two at-large employer trustee positions. Each trustee consents to and accepts his/her appointment as a trustee in writing. Form 990, Part VI, Section B, line 11 The Form 990 was prepared by the independent accounting firm SCHOEDEL & SCHOEDEL, Certified Public Accountants, PLLC from information provided by the third-party administrator and other consultants and advisors. Draft copies of the Trust's financial statements and Form 990 were first provided to the Trust's consultants and advisors, who reviewed the Form 990 for accuracy and completeness. Any questions, concerns or issues raised by the consultants and advisors were addressed and any necessary revisions were made to the Form 990. The revised Form 990 was then provided to the Board of Trustees for its review and approval. Any additional questions, concerns or issues raised by the Board of Trustees were addressed and any necessary revisions were made to the Form 990. The final version of the Form 990 was reviewed, approved and filed by the Board of Trustees. Form 990, Part VI, Section B, line 12c A copy of the Trust's Conflict of Interest Policy has been distributed to each Trustee. At a designated board meeting, at least annually, the Board of Trustees reviews the policy. Further, any interested party who has knowledge of any transaction that may arguably be restricted pursuant to the policy, is under a continuing obligation to disclose such information to the Board of Trustees at the earliest opportunity. the Board of Trustees will document such information and investigate. Documentation will include a description of the issue, pertinent facts, circumstances and inquiries, as well as conclusions reached by the Board of Trustees and related actions taken by the Board of Trustees. If the Board of Trustees determines that a conflict exists between the Trust and a Trustee, the Trustee will be pronibited from discussions, votes or attempts to influence the issue or decision that is impacted. There are no compensated management officials, officers or key employees of the organization. If the organization had such compensated individuals, policies and procedures would be developed to determine compensation. Form 990, Part VI, Section C, line 19 The Trust's governing documents, conflict of interest policy, financial statements and Form 990 is available to the general public upon written request sent to Zenith American Solutions at: 201 Queen Avenue North, Suite 100, Seattle, WA 98109. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized losses on investments: -824,599.