2011-10-12T14:27:48-05:00 2010-12-31 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 945834346 990 2010-01-01 936021113 UNITED ASSOC LOC NO 290 PLUMBER STEAMFITTER & SHIPFITTER IND H & W PLAN UNIT 5034543800 7600 SW MOHAWK STREET TUALATIN OR 97062 ED GORMLEY 5034543800 2011-10-12 1 9252779100 2010 2016-03-07 17:11:31Z ED GORMLEY POBOX 117 1715 LAFAYETTE MCMINNVILLE OR 97128 91911588 0 X N/A X 1957 OR PROVIDE HEALTH AND WELFARE BENEFITS. 8 8 110 0 0 0 0 0 32870911 35541024 2080204 2609675 3549814 385668 38500929 38536367 0 0 36143737 31868870 0 0 0 0 0 1243473 1197819 37387210 33066689 1113719 5469678 57105914 59815528 23487351 20552897 33618563 39262631 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS. 0 0 PROVIDED HEALTH, DENTAL, VISION, TIME LOSS, LIFE INSURANCE AND AD & D BENEFITS FOR ELIGIBLE PARTICIPANTS. 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 2113 0 1 110 1 0 0 0 0 0 0 X 8 8 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X ASSOCIATED THIRD PARTY ADMINISTRATORS 5034543800 7600 SW MOHAWK STREET TUALATIN OR 97062 X ED GORMLEY 1.00 X 0 0 0 LOU CHRISTIAN 1.00 X 0 0 0 FRANK WALL 1.00 X 0 0 0 BOB RANDOLPH 1.00 X 0 0 0 DAN SMITH 1.00 X 0 0 0 MIKE ANDERSON 1.00 X 0 0 0 JOHN ENDICOTT 1.00 X 0 0 0 KEN EDENS 1.00 X 0 0 0 JON BERRY 1.00 X 0 0 0 0 0 0 0 0 0 0 ASSOCIATED THIRD PARTY ADMINISTRATORS 7600 SW MOHAWK STREET TUALATIN OR 97062 CONTRACT ADMINISTRATOR 732485 1 EMPLOYER CONTRIBUTIONS 900099 28091290 28091290 PARTICIPANT CONTRIBUTI 900099 3462568 3462568 SUBSIDY FROM OTHER PLA 900099 2952380 2952380 IRS COBRA STIMULUS 900099 427170 427170 MEDICARE-RETIREE DRUG 900099 308270 308270 299346 299346 35541024 1477153 1477153 54507743 53375221 1132522 1132522 1132522 PRESCRIPTION REBATES 900099 321044 321044 STOP LOSS REIMBURSEMEN 900099 62380 62380 MISCELLANEOUS INCOME 900099 2244 2244 385668 38536367 35926692 0 2609675 31868870 732485 52156 43157 24010 196296 118623 9067 17440 MISCELLANEOUS 3451 UA RECIPROCITY FEES 1134 33066689 2270827 807078 19074497 20798083 3084727 3445043 8720 32675863 34756604 57105914 59815528 124415 96897 23362936 20456000 23487351 20552897 X 0 0 0 0 33618563 39262631 33618563 39262631 57105914 59815528 X 5469678 174390 X X 0 1 1 X 0 0 ACCUMULATED ELIGIBILITY CREDITS 17628700 CLAIMS PAYABLE AND INCURRED BUT NOT REPORTED 2827300 20456000 38536367 33066689 5469678 174390 -2906936 -2732546 2737132 38686747 174390 174390 38512357 24010 24010 38536367 35949615 0 35949615 24010 -2906936 -2882926 33066689 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 PLAN HAS CONTRACTED WITH ASSOCIATED THIRD PARTY ADMINISTRATORS TO PROVIDE ADMINISTRATIVE SERVICES FOR THE PLAN. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE ORGANIZATION'S FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE GOVERNING BODY OF THE ORGANIZATION PRIOR TO ITS FILING WITH THE IRS. ALSO, THE ORGANIZATION'S ATTORNEY AND THE CHAIRMAN OF THE BOARD OF TRUSTEES READ THE FORM 990 FOR COMPLETENESS AND ACCURACY, PRIOR TO FILING THE FORM WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ADOPTED THEIR CONFLICT OF INTEREST POLICY DURING MARCH 2009. THE POLICY COVERS ALL TRUSTEES AND SERVICE PROVIDERS. THE POLICY PROVIDES FOR AN ANNUAL REVIEW OF PARTY-IN-INTEREST TRANSACTIONS; THE ADMINISTRATOR AND LEGAL COUNSEL ARE TO DISTRIBUTE PARTY-IN-INTEREST INQUIRIES AND REVIEW RESPONSES TO THE INQUIRIES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSIGHT OF THE ANNUAL AUDIT AND FOR SELECTION OF THE INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART XI, LINE 5, CHANGES IN NET ASSETS: NET UNREALIZED GAINS ON INVESTMENTS: $174,390 UA UNION LOCAL NO 290 PLUMBER STEAMFITTER & SHIPFITTER INDUSTRY 401K PLAN 7600 SW MOHAWK ST TUALATIN OR 97062 931143757 TO PROVIDE RETIREMENT BENEFITS. OR 501A N/A N/A 0 UA UNION LOCAL NO 290 PLUMBER STEAMFITTER & SHIPFITTER IND PENSION PLAN 7600 SW MOHAWK ST TUALATIN OR 97062 936021114 TO PROVIDE PENSION BENEFITS. OR 501A N/A N/A 0 UA UNION LOCAL NO 290 PLUMBER STEAMFITTER & SHIPFITTER IND RETIREE HLTH 7600 SW MOHAWK ST TUALATIN OR 97062 931143759 TO PROVIDE HEALTH AND WELFARE BENEFITS. OR 501(C)(9) N/A N/A 0 UA UL NO 290 PL ST & SH IND EDU REIMBURSEMENT SCH & VACATION PLAN 7600 SW MOHAWK ST TUALATIN OR 97062 931255764 TO PROVIDE VACATION, SCHOLARSHIP AND EDUCATIONAL REIMBURSEMENT BENEFITS. OR 501(C)(9) N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 UNITED ASSOC UNION LOC #290 PLUMBER STEAMFITTER & SHIPFITTER IND RET HEAL R 2952380 OBTAINED FROM THE PLAN'S RECORDS.