2011-10-07T16:07:21-04:00 2010-12-31 MILLER KAPLAN ARASE & CO LLP 4123 LANKERSHIM BLVD NORTH HOLLYWOOD CA 916022828 990 2010-01-01 936042567 Portland Area UFCW Local 555- Employers Health Plan PORT 8006544411 7600 SW MOHAWK STREET TUALATIN OR 970628121 PATI PIRO-BOSLEY 2011-10-07 true miller kaplan arase Co llp 8187692010 2010 2016-03-07 17:11:31Z SCOTT POWERS 7600 SW MOHAWK STREET TUALATIN OR 970628121 81831704 false X N/A X 1957 OR SEE SCHEDULE O 10 0 0 0 0 0 0 57879299 79098497 262676 31616 0 58141975 79130113 0 63015643 77932297 0 0 0 1491970 1482219 64507613 79414516 -6365638 -284403 14983704 20822874 12500674 18414923 2483030 2407951 X SEE SCHEDULE O false false see schedule o false false false false false false false false false false false false true true true false false false false false false false false false false false false false false false false false false false false false false false false false false false false true 711 0 true 0 false false false false false false X 10 0 false true false false false false false true true false false true true true true true true false X PATI PIRO-BOSLEY 8006544411 7600 SW MOHAWK ST TUALATIN OR 970628121 X Jeff Anderson 1.0 X 0 0 0 dAn clay 1.0 X 0 0 0 matt smith 1.0 X 0 0 0 lisa dupell 1.0 X 0 0 0 DAVID JOHNS 1.0 X 0 0 0 ken spray 1.0 X 0 0 0 STEPHEN ERDMANN 1.0 X 0 0 0 scott powers 1.0 X 0 0 0 cynthia thornton 1.0 X 0 0 0 lynda hart 1.0 X 0 0 0 0 0 0 0 false false false ASSOCIATED THIRD PARTY ADMINISTRATO 7600 SW MOHAWK ST TUALATIN OR 97062 CONTRACT ADMIN. 1125300 REGENCE BLUECROSS BLUESHIELD of ore PO BOX 1271 M/S ELLA PORTLAND OR 97207 PPO PROVIDER ADMIN. 5340518 MILLIMAN inc 650 CALIFORNIA ST SAN FRANCISCO CA 94108 CONSULTANT 155531 EXPRESS SCRIPTS PO BOX 390873 BLOOMINGTON MN 55439 CLAIMS COST CONTROL 470226 4 0 EMPLOYER CONTRIBUTIONS 900099 73193926 73193926 PARTICIPANT CONTRIBUTIONS 900099 5904571 5904571 79098497 138489 138489 0 0 2594718 2701591 -106873 -106873 -106873 0 0 0 0 79130113 79098497 31616 0 0 0 77932297 0 0 0 0 0 0 827104 93364 42770 0 0 17062 155531 0 289782 0 0 0 0 0 22451 0 0 0 34155 79414516 4053033 9175022 5485576 7968031 30667 31761 5414428 3648060 14983704 20822874 531488 15736 11969186 18399187 12500674 18414923 X 2483030 2407951 2483030 2407951 14983704 20822874 X -284403 209324 X false true true X 0 CLAIMS INCURRED BUT NOT REPORTED 7851100 ACCUMULATED ELIGIBILITY CREDIT 10548087 18399187 79130113 79414516 -284403 209324 6430001 6639325 6354922 79339437 209324 209324 79130113 79130113 72984515 72984515 6430001 6430001 79414516 part xi, line 8 and part xiii, line 4b: ADJUSTMENTS FOR BENEFITS PAID FROM ACCRUAL BASIS (FORM 990) TO CASH basis (FINANCIAL STATEMENTS) = $6,430,001 part x, line 2: The Plan has adopted guidance on accounting for uncertainty in income taxes issued by the Financial Accounting Standards Board. The Plan administrator believes that the Plan has taken no uncertain tax positions that require adjustment to the financial statements to comply with the provisions of this guidance. Certain Information returns are subject to examination by authorities. PART I, LINE 1 AND PART III, LINE 1 - ORGANIZATION'S MISSION: TO PROVIDE MEDICAL, VISION, DENTAL, PRESCRIPTION, SUPPLEMENTAL INCOME, LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS TO PARTICIPANTS ON WHOSE BEHALF EMPLOYERS CONTRIBUTE TO THE PLAN IN ACCORDANCE WITH THEIR COLLECTIVE BARGAINING AGREEMENTS. PART VI, LINE 11b: FORM 990 WAS DISTRIBUTED TO ALL TRUSTEES PRIOR TO FILING. PART VI, LINE 12C: TRUSTEES ARE REQUIRED TO NOTIFY THE TRUST OF ANY CHANGES IN THEIR INTERESTS THAT COULD GIVE RISE TO CONFLICTS. PART VI, LINE 19: THE TRUST DOCUMENT, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MAINTAINED IN THE TRUSTS' OFFICE AND ARE AVAILABLE UPON REQUEST. PART XI, LINE 5: UNREALIZED GAIN = $209,324.