2011-09-14T13:49:42-05:00 2010-11-30 Lindquist LLP 5000 Executive Parkway Suite 400 San Ramon CA 94583 990 2009-12-01 946072964 Bay Area Automotive Group Welfare Fund BAYA 5105287100 4160 Dublin Boulevard No 400 Dublin CA 945687756 ERNIE YATES 5105287100 2011-09-14 1 9252779100 2009 2016-03-07 17:11:31Z ERNIE YATES 160 Airway Blvd Livermore CA 94551 43492179 0 X n/a X 1954 CA TO PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS AND DEPENDENTS. 6 6 29 0 0 0 0 29554735 29700257 556762 672704 2201 265616 30113698 30638577 0 28730968 29261632 37716 37421 0 0 1481190 1557404 30249874 30856457 -136176 -217880 20909891 20868315 4383642 4664812 16526249 16203503 To provide health benefits to eligible participants and dependents. 0 0 provided health benefits to eligible participants and dependents 0 0 0 0 0 0 0 0 1 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 0 0 0 1 1179 0 1 29 1 0 0 0 0 0 6 6 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X HEALTH SERVICES & BENEFIT ADMINISTRAT 9254497070 4160 Dublin Boulevard suite 400 Dublin CA 98568 X John Horton 1.00 X 0 0 0 LaWRENCE ROSE 1.00 X 0 0 0 mark gleason 1.00 X 0 0 0 Ernie yates 1.00 X 0 0 0 Chuck Andrew 1.00 X 0 0 0 David Pansini 1.00 X 0 0 0 0 0 0 0 0 0 0 health services & benefit admin 4160 dublin boulevard suite 400 dublin CA 945687756 administrator fee 888077 lindquist LLP 5000 executive parkway suite 400 san ramon CA 945834346 aCCOUNTING FEE 143499 blue cross of california Department 5812 los angeles CA 900745812 ppo network fee 124373 3 Employer Contributions 900099 29043699 29043699 Participant Contributi 900099 498783 498783 Stop Loss Income 900099 157775 157775 29700257 447361 447361 13078945 12853602 225343 225343 225343 COBRA Subsidy 900099 136777 136777 Settlement Income 900099 125000 125000 Other Income 900099 3839 3839 265616 30638577 29965873 0 672704 29261632 37421 865199 103134 144014 41088 284490 75852 11502 32125 30856457 1577265 2329562 484152 247744 3746981 3377508 25427 24657 14978160 14739353 97906 149491 20909891 20868315 1234642 1414812 3149000 3250000 4383642 4664812 X 0 0 0 0 16526249 16203503 16526249 16203503 20909891 20868315 X 0 1 1 X 0 0 Accumulated Eligibility Credits 3250000 3250000 30638577 30856457 -217880 -104866 274521 169655 -48225 30492623 -104866 -104866 30597489 41088 41088 30638577 30540848 0 30540848 41088 274521 315609 30856457 Part XI, Line 8 - Other Adjustments: change in benefit obligations Part XIII, Line 4b - Other Adjustments: Change in benefit obligations Form 990, Part VI, Section A, line 3 THE TRUST HAS CONTRACTED WITH HEALTH SERVICE BENEFIT ADMINISTRATORS, INC. TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION. Form 990, Part VI, Section A, line 8b THERE IS NO COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. Form 990, Part VI, Section B, line 11 A copy of the Form 990 was provided to the Board of Trustees for review. Review of the Form 990 was conducted by the Board prior to filing with the IRS. Form 990, Part VI, Section B, line 12c At least once a year, trustees and other individuals who are subject to the conflict on interest policy will be asked to disclose in writing any relationship or interests that could give rise to a conflict. Should any individual covered by the policy determine or suspect that he or she possesses an actual or potential conflict of interest, such individual must disclose the existence of the financial interest or relationship giving rise to the conflict and disclose all relevant facts prior to participating any decision to enter into any proposed transaction or arrangement or, if later, as soon as the actual or potential conflict is recognized. Form 990, Part VI, Section C, line 19 The organization does not make its governing documents,conflict of interest policy and financial statements available to the public. Upon request, the organization makes its governing documents,conflict of interest policy and financial information available to the PARTICIPANTS. FORM 990, PART XI, LINE 2C: THE BOARD OF TRUSTEES ASSUMES RESPONSIBILTY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT AUDITOR. Form 990, Part V, Line 2a: The Trust does not have employees. However, the Trust is required to report taxable disability and domestic partner benefits on Form W-2 for participants that receive taxable benefits.