UBC HEALTHCARE TRUST FUND: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: UBC HEALTHCARE TRUST FUND (EIN 23-7331128)
Tax period: 2011-02-01 to 2012-01-31
Filed: 2012-09-12
IRS object ID: 201242569349300539
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
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-09-12T14:27:18-05:00	Timestamp
Tax Period End Date	2012-01-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	L M HENDERSON & COMPANY LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	450 E 96TH ST STE 200	AddressLine1
City	INDIANAPOLIS	City
State	IN	State
ZIP Code	46240	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-02-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	237331128	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CARPENTERS INDUSTRIAL COUNCIL TRUST	BusinessNameLine1
Business Name Line2	FUND	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	CARP	NameControl
Phone	8003324732	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	602 VIRGINIA STREET EAST	AddressLine1
City	CHARLESTON	City
State	WV	State
ZIP Code	25301	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	STEVE HERRING	Name
Title	CHAIRMAN	Title
Phone	8003324732	Phone
Date Signed	2012-08-02	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	JAMES J CLINE	Name
Phone	3175661000	Phone
Date Prepared	2012-08-02	DatePrepared

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	STEVE HERRING	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	602 VIRGINIA STREET EAST	AddressLine1
City	CHARLESTON	City
State	WV	State
ZIP Code	25301	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	81260397	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c	X	Organization501c
Web Site	N/A	WebSite
Type Of Organization Trust	X	TypeOfOrganizationTrust
Year Formation	1972	YearFormation
State Legal Domicile	TN	StateLegalDomicile
Activity Or Mission Description	PROVIDING HEALTH AND WELFARE BENEFITS	ActivityOrMissionDescription
Nbr Voting Members Governing Body	6	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	6	NbrIndependentVotingMembers
Total Nbr Employees	0	TotalNbrEmployees
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	18025565	ProgramServiceRevenuePriorYear
Program Service Revenue CY	15378673	ProgramServiceRevenueCY
Investment Income Prior Year	1657676	InvestmentIncomePriorYear
Investment Income Current Year	1687676	InvestmentIncomeCurrentYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	19683241	TotalRevenuePriorYear
Total Revenue Current Year	17066349	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	15763056	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	13603914	BenefitsPaidToMembersCY
Salaries Etc Current Year	0	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	1998963	OtherExpensePriorYear
Other Expenses Current Year	1667130	OtherExpensesCurrentYear
Total Expenses Prior Year	17762019	TotalExpensesPriorYear
Total Expenses Current Year	15271044	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	1921222	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	1795305	RevenuesLessExpensesCY
Total Assets BOY	32362483	TotalAssetsBOY
Total Assets EOY	34697693	TotalAssetsEOY
Total Liabilities BOY	5820841	TotalLiabilitiesBOY
Total Liabilities EOY	5422210	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	26541642	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	29275483	NetAssetsOrFundBalancesEOY
Mission Description	PROVIDING HEALTH AND WELFARE BENEFITS	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Description	THE ORGANIZATION PROVIDES HOSPITAL, MEDICAL, DENTAL, VISION CARE, DISABILITY, AND LIFE INSURANCE BENEFITS TO ITS PARTICIPANTS AND THEIR BENEFICIARIES.	Description
Described In501 C3	false	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	false	ReportLandBldgEquip
Report Invest Oth Securities	true	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	300	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	0	NumberOfEmployees
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	6	NbrVotingGoverningBodyMembers
Number Independent Voting Members	6	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	true	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	false	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	false	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	HEALTHSMART BENEFIT SOLUTIONS TPA	NamePerson
Telephone Number	8003324732	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	602 VIRGINIA STREET EAST	AddressLine1
City	CHARLESTON	City
State	WV	State
ZIP Code	25301	ZIPCode

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

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
STEVE HERRING
CHAIRMAN	12.00	X	X	0	0	0
CARL YOUNG
SECRETARY	1.20	X	X	0	0	0
LARRY WYATT
TRUSTEE	1.00	X		0	0	0
MIKE PIETI
TRUSTEE	1.00	X		0	0	0
MICHELE ASTEMBORSKI
TRUSTEE	1.00	X		0	0	0
BROOKS BURTON
TRUSTEE	1.00	X		0	0	0
CLOVIS YOUNG
TRUSTEE		X		0	0	0

Field	Value	IRS element (for citing)
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
ANTHEM INSURANCE COMPANIES INC
220 VIRGINIA STREET	INDIANAPOLIS	IN	46204	CLAIM PROCESSIN	950083
WELLS FARGO TPA
602 VIRGINIA ST EAST	CHARLESTON	WV	25301	GENERAL PLAN AD	292969

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

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS	525100	15089303	15089303
EMPLOYEE CONTRIBUTIONS	525100	231756	231756
COBRA SUBSIDY REIMBURSEMENT	525100	57614	57614

Field	Value	IRS element (for citing)
Total Program Service Revenue	15378673	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	788570	TotalRevenueColumn
Related Or Exempt Function Income	788570	RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	65093154	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	64194048	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	899106	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	899106	TotalRevenueColumn
Related Or Exempt Function Income	899106	RelatedOrExemptFunctionIncome

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	17066349	TotalRevenueColumn
Related Or Exempt Function Income	17066349	RelatedOrExemptFunctionIncome

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	13603914	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	93042	Total

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	32784	Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal
ADMINISTRATION FEES	1253591
BANK & INVESTMENT FEES	173070
TRUSTEE MEETINGS	49786
FIDUCIARY INSURANCE	41556

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	23301	Total

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	15271044	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	2826473	BOY
EOY	2800371	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	667373	BOY
EOY	277979	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	17029	BOY
EOY	15803	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	28851608	BOY
EOY	31603540	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	32362483	BOY
EOY	34697693	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	52740	BOY
EOY	198631	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	5768101	BOY
EOY	5223579	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	5820841	BOY
EOY	5422210	EOY

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

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

Field	Value	IRS element (for citing)
BOY	26541642	BOY
EOY	29275483	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	26541642	BOY
EOY	29275483	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	32362483	BOY
EOY	34697693	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	1795305	ReconcilationRevenueExpenses
Reconcilation Other Changes	938536	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Disclosed Orgs Legal Control	false	DisclosedOrgsLegalControl
Disclosed For Charitable Purposes	false	DisclosedForCharitablePurposes
Written Policy Monitoring	false	WrittenPolicyMonitoring
Sect170h Requirements Satisfied	false	Sect170hRequirementsSatisfied
Solicited Assets For Sale	false	SolicitedAssetsForSale
Agent Trustee Etc	false	AgentTrusteeEtc
Included On FS	false	IncludedOnFS
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	false	AreRelatedOrgsListedScheduleR

Other Securities OtherSecurities (4 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
U.S. GOV'T/MORTGAGE-BACKED SEC.	16118765	F
CORPORATE & FOREIGN BONDS	8099823	F
MUTUAL FUNDS	4614512	F
PREFERRED & COMMON STOCK	2770440	F

Field	Value	IRS element (for citing)
Total Of Book Value Securities	31603540	TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescription	AmountAmount
BENEFIT OBLIGATION	$5,143,359
CHECKS WRITTEN IN EXCESS OF	$80,220
AVAILABLE BALANCES

Field	Value	IRS element (for citing)
Total Of Amounts	5223579	TotalOfAmounts
Total Revenue	17066349	TotalRevenue
Total Expenses	15271044	TotalExpenses
Excess Or Deficit For Year	1795305	ExcessOrDeficitForYear
Net Unrealized GL On Investments	377032	NetUnrealizedGLOnInvestments
Other	$561,504	OtherAmount
Total Adjustments	938536	TotalAdjustments
Excess Or Deficit Per FS	2733841	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	17270311	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	377032	NetUnrealizedGainsInvestments
Revenue Not Rptd F990	377032	RevenueNotRptdF990
Revenue Subtotal	16893279	RevenueSubtotal
Investment Expenses Not Included	173070	InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt	173070	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	17066349	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	14536470	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	14536470	ExpensesSubtotal
Investment Expenses Not Included2	173070	InvestmentExpensesNotIncluded2
Other Expenses Not Included	561504	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	734574	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	15271044	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
LIABILITY UNDER FIN 48 FOOTNOTE	SCHEDULE D, PAGE 3, PART X	THE FUND'S TRUSTEES AND LEGAL COUNSEL BELIEVE THAT THE FUND IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THEREFORE, THE FUND WAS QUALIFIED AND THE RELATED TRUST WAS TAX-EXEMPT AS OF THE FINANCIAL STATEMENT DATE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE FUND MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FUND AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE FUND ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE FUND, AND HAS CONCLUDED THAT AS OF JANUARY 31, 2012, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE FUND IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE FUND ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE TAX YEARS PRIOR TO 2008.
RECONCILIATION OF CHANGES - OTHER	SCHEDULE D, PAGE 4, PART XI, LINE 8	CURRENT YEAR ACTUARIAL CHANGE IN BENEFIT OBLIGATION 561,504
EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER	SCHEDULE D, PAGE 4, PART XIII, LINE 4B	CURRENT YEAR ACTUARIAL CHANGE IN BENEFIT OBLIGATION 561,504

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ADDITIONAL INFORMATION	FORM 990, PART VI	SECTION B, LINE 13: THE TRUST FUND DOES NOT RETAIN A WRITTEN WHISTLEBLOWER POLICY, BUT THE BOARD OF TRUSTEES AND THE TRUST FUND CONFORM WITH ERISA RULES AND REGULATIONS WITH REGARDS TO THE WHISTLEBLOWER POLICY. SECTION C, LINE 18: THE BOARD OF TRUSTEES AND THE TRUST FUND CONFORM WITH ERISA RULES AND REGULATIONS WITH REGARDS TO MAKING ITS FORMS 1023 AND 990 AVAILABLE FOR PUBLIC INSPECTION.
MANAGEMENT DELEGATED	FORM 990, PAGE 6, PART VI, LINE 3	THE BOARD OF TRUSTEES HAS OUTSOURCED THE DAY TO DAY ADMINISTRATION OF THE TRUST FUND TO HEALTHSMART BENEFIT SOLUTIONS TPA.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	FORM 990 IS AVAILABLE TO EACH TRUSTEE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
ENFORCEMENT OF CONFLICTS POLICY	FORM 990, PAGE 6, PART VI, LINE 12C	THE BOARD OF TRUSTEES AND THE TRUST FUND CONFORM WITH ERISA RULES AND REGULATIONS WITH RESPECT TO REGULARLY AND CONSISTENTLY MONITORING AND ENFORCING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	THE TRUST FUND MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE TRUST FUND AND THE BOARD OF TRUSTEES CONFORM WITH ERISA RULES AND REGULATIONS RELATING TO THIS MATTER.
OTHER CHANGES IN NET ASSETS EXPLANATION	FORM 990, PART XI, LINE 5	CURRENT YEAR ACTUARIAL CHANGE IN BENEFIT OBLIGATION : 561,504 NET CHANGE IN UNREALIZED APPRECIATION IN FAIR VALUE OF INVESTMENTS : 377,032 TOTAL OTHER CHANGES IN NET ASSETS OR FUND BALANCES: 938,536

Schedule R IRS990ScheduleR

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	GEORGIA-PACIFIC WOOD PRODUCTS LLC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	133 PEACHTREE STREET NE	AddressLine1
City	ATLANTA	City
State	GA	State
ZIP Code	30303	ZIPCode

Field	Value	IRS element (for citing)
EIN	562306364	EIN
Primary Activity	MANUFACTUR	PrimaryActivity
Legal Domicile State	DE	LegalDomicileState
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Disproportionate Allocations	false	DisproportionateAllocations
General Or Managing Partner	false	GeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	WEYERHAEUSER NR COMPANY	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	33663 WEYERHAEUSER WAY SOUTH	AddressLine1
City	FEDERAL WAY	City
State	WA	State
ZIP Code	98003	ZIPCode

Field	Value	IRS element (for citing)
EIN	263481257	EIN
Primary Activity	MANUFACTUR	PrimaryActivity
Legal Domicile State	WA	LegalDomicileState
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Type Of Entity	C CORP	TypeOfEntity

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	false	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	false	SharingOfPaidEmployees
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	true	OtherTransferFromOtherOrg