2011-11-07T10:55:54-06:00 2010-12-31 HEMMING MORSE CPA'S AND CONSULTANTS 160 SPEAR STREET SUITE 1900 SAN FRANCISCO CA 94105 990 2010-01-01 946401544 U A LOCAL 393 HEALTH & WELFARE TR UALO 4084368210 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 LIZ JESINGER 4084368210 2011-11-07 1 4158364000 2010 2016-03-07 17:11:31Z 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 45860271 0 X N/A X 1952 CA TO PROVIDE ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS WITH HEALTH & WELFARE BENEFITS. 10 10 116 0 0 0 0 0 30659103 29069409 1524838 1548206 929536 428062 33113477 31045677 0 0 29436164 32927173 0 0 0 0 0 1471748 1607290 30907912 34534463 2205565 -3488786 55324966 54640216 29154454 30312868 26170512 24327348 NONE 0 0 TO PROVIDE ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS WITH HEALTH & WELFARE BENEFITS ACCORDING TO COLLECTIVE BARGAINING AGREEMENTS BETWEEN EMPLOYERS AND THE UNION. 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 0 0 0 0 0 0 1 0 0 0 1 928 0 116 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X BENESYS ADMINISTRATORS 4084368210 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 X ROGER ANAYA 5.00 X 0 0 0 EDWARD CALCANY 5.00 X 0 0 0 SCOTT STRAWBRIDGE 5.00 X 0 0 0 MILT GOODMAN 5.00 X 0 0 0 WAYD LA PEARLE 5.00 X 0 0 0 BILL MEYER 5.00 X 0 0 0 GARY GLENN 5.00 X 0 0 0 LARRY GATES 5.00 X 0 0 0 MICHAEL J VLAMING 5.00 X 0 0 0 MICHAEL SMITH 5.00 X 0 0 0 0 0 0 0 0 0 0 BENESYS ADMINISTRATORS 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 CONTRACT ADMINISTRATOR 536439 DELTA DENTAL PO BOX 444460 SAN FRANCISCO CA 94144 CLAIMS ADMINISTRATOR 215677 TOM ALEXANDER C/0 UA LOCAL 393 1731 TECHNOLOGY D SAN JOSE CA 95110 MEMBER ADVOCATE 153234 3 EMPLOYER CONTRIBUTIONS 900099 28089222 28089222 COBRA SUBSIDY 900099 415321 415321 COBRA CONTRIBUTIONS 900099 295468 295468 RECIPROCITY CONTRIBUTI 900099 269398 269398 29069409 1259728 1259728 15103072 14814594 288478 288478 288478 OTHER INCOME 900099 270551 270551 MEDICARE D SUBSIDY 900099 150761 150761 LIQUIDATED DAMAGES 900099 6750 6750 428062 31045677 29497471 0 1548206 32927173 536439 95945 84752 116702 38895 8053 DELTA DENTAL 215677 MEMBER ADVOCATE 153234 BENEFIT CONSULTING 85200 POSTAGE 67605 BEAT IT PROGRAM FEES 55200 149588 34534463 1832799 1824730 11121956 5901097 2496880 1760325 5944 6727 38898693 44926778 968694 220559 55324966 54640216 855762 974926 28298692 29337942 29154454 30312868 X 0 0 0 0 26170512 24327348 26170512 24327348 55324966 54640216 X -3488786 1645622 X X 0 1 1 X 0 0 SELF FUNDED BENEFITS PAYABLE 3247655 GROUP INSURANCE PREMIUMS PAYABLE 2145346 BANK OF HRS LIABILITY FOR EXT. COVERAGE 6834700 PARTICIPANT RESERVE ACCOUNT 15326941 CLAIMS INCURRED BUT NOT REPORTED 1783300 29337942 31045677 34534463 -3488786 1645622 1645622 -1843164 32691299 1645622 1645622 31045677 0 31045677 34534463 0 34534463 0 34534463 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES CONTROL OVER MANAGEMENT DUTIES CUSTOMARILY PERFORMED BY OR UNDER THE DIRECT SUPERVISION OF OFFICERS, DIRECTORS, TRUSTEES OR KEY EMPLOYEES TO THE CONTRACT ADMINISTRATOR. FORM 990, PART VI, SECTION A, LINE 8B THE PLAN DOES NOT HAVE ANY COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE TRUSTEES DESIGNATE THE ADMINISTRATOR TO REVIEW THE FORM. FORM 990, PART VI, SECTION B, LINE 12C REVIEW WITH BOARD OF TRUSTEES ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST TO ALL PLAN PARTICIPANTS. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 1,645,622. FORM 990, PART XI, LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSEEING THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND FOR SELECTING THE INDEPENDENT AUDITOR. U A LOCAL 393 PENSION TRUST FUND 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 946359772 TO PROVIDE PENSION AND DEATH BENEFITS TO ELIGIBLE PARTICIPANTS CA 401(A) N/A 0 U A LOCAL 393 TRUST FUND DEFINED 1731 TECHNOLOGY DRIVE SUITE 570 SAN JOSE CA 95110 946075617 TO PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS COVERED BY CBA CA 401(B) N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0