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AFL HOTEL & RESTAURANT WORKERS HEALTH & WELFARE TRUST FUND: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
AFL HOTEL & RESTAURANT WORKERS HEALTH & WELFARE TRUST FUND (EIN 99-6008823)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-10-17
IRS object ID
201132909349301023
Schema version
2010v3.4
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-10-17T13:01:05-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1LEMKE CHINEN & TANAKA CPA INCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1210 WARD AVE SUITE 336AddressLine1
CityHONOLULUCity
StateHIState
ZIP Code96814ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN996008823EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1AFL HOTEL & RESTAURANT WORKERSBusinessNameLine1
Business Name Line2HEALTH & WELFARE PLANBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlAFLHNameControl
Phone8085230199Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1560 N NIMITZ HWY NO 209AddressLine1
CityHONOLULUCity
StateHIState
ZIP Code96817ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameERIC GILLGAYLYNNE SAKUDAName
TitleTRUSTEESTitle
Phone8085230199Phone
Date Signed2011-10-04DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTERRY TAKAKIName
Phone8085336254Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonERIC GILLGAYLYNNE SAKUDANameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1560 N NIMITZ HWY NO 209AddressLine1
CityHONOLULUCity
StateHIState
ZIP Code96817ZIPCode
FieldValueIRS element (for citing)
Gross Receipts81030003GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1955YearFormation
State Legal DomicileHIStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HEALTH & WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AS PRESCRIBED BY THE PLANActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year74843408ProgramServiceRevenuePriorYear
Program Service Revenue CY80149800ProgramServiceRevenueCY
Investment Income Prior Year1562980InvestmentIncomePriorYear
Investment Income Current Year1288426InvestmentIncomeCurrentYear
Other Revenue Prior Year-487631OtherRevenuePriorYear
Other Revenue Current Year-408223OtherRevenueCurrentYear
Total Revenue Prior Year75918757TotalRevenuePriorYear
Total Revenue Current Year81030003TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year66578015BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY71386602BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1051436OtherExpensePriorYear
Other Expenses Current Year1047704OtherExpensesCurrentYear
Total Expenses Prior Year67629451TotalExpensesPriorYear
Total Expenses Current Year72434306TotalExpensesCurrentYear
Revenues Less Expenses Prior Year8289306RevenuesLessExpensesPriorYear
Revenues Less Expenses CY8595697RevenuesLessExpensesCY
Total Assets BOY54229853TotalAssetsBOY
Total Assets EOY62839646TotalAssetsEOY
Total Liabilities BOY67320TotalLiabilitiesBOY
Total Liabilities EOY81416TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY54162533NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY62758230NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE MEDICAL, DENTAL,PRESCRIPTION DRUG, CHIROPRACTIC CARE, VISION, AND DEATH BENEFITS TO ELIGIBLE MEMBERSMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense39996088Expense
DescriptionTO PROVIDE SELF FUNDED HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS IN ACCORDANCE WITH TERMS SET FORTH IN THE TRUST AGREEMENTS, RULES AND REGULATIONS OF THE PLAN AND CBADescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense31245264Expense
DescriptionPROVIDE INSURED MEDICAL BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTSDescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense145250Expense
DescriptionTO PROVIDE DEATH BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTSDescription
FieldValueIRS element (for citing)
Total Program Service Expense71386602TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10962NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1BENEFIT RISK MANAGEMENT SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8085230199TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1560 N NIMITZ HWY NO 209AddressLine1
CityHONOLULUCity
StateHIState
ZIP Code96817ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
ERIC GILL
LABOR TRUSTEE0.50X000
HERNANDO TAN
LABOR TRUSTEE0.50X000
NONA TAMANAHA
MANAGEMENT TRUSTEE0.50X000
GAYLYNNE SAKUDA
MANAGEMENT TRUSTEE0.50X000
DORYNE JARDINE
ALT LABOR TRUSTEE0.50X000
JULIE WALKER
MANAGEMENT TRUSTEE0.50X000
CARLA THOMAS
ALT MANAGEMENT TRUSTEE0.50X000
ROSS BANIAGA
ALT LABOR TRUSTEE0.50X000
KEVIN GLEASON
ALT MANAGEMENT TRUSTEE0.50X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HMA INC
1440 KAPIOLANI BLVDHONOLULUHI96814MEDICAL CLAIMS ADMINISTRATOR1773927
BENEFIT RISK & MANAGEMENT SERVICES
560 N NIMITZ HWY STE 209HONOLULUHI96817PLAN ADMINISTRATOR504924
CATALYST RX
92525 HILLWOOD DRLAS VEGASNV89134DRUG CLAIMS ADMINISTRATOR263203
BENEFIT PLAN SOLUTIONS
680 IWIEI ROAD STE 528HONOLULUHI96817CONSULTING151125
FIRST HAWAIIAN BANK
999 BISHOP STREETHONOLULUHI96813CUSTODIAN124949
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTONS9000997966769979667699
EMPLOYEE CONTRIBUTIONS900099439704439704
LIQUIDATED DAMAGES9000993973239732
RETIREE COPAYMENTS90009926652665
FieldValueIRS element (for citing)
Total Program Service Revenue80149800TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1288426TotalRevenueColumn
Exclusion$1,288,426ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
LEGAL SETTLEMENT PROCE90009968029$68,029
UNREALIZED APPR/DEPR900001-476252-$476,252
FieldValueIRS element (for citing)
Total Other Revenue-408223TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column81030003TotalRevenueColumn
Related Or Exempt Function Income80149800RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$880,203ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total71386602Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total96757Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total41873Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total43793Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total11431Total

Insurance Insurance

FieldValueIRS element (for citing)
Total4463Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotal
ADMINISTRATIVE FEES504924
CONSULTANT FEES208704
CO-TRUSTEE FEES124949
BANK SERVICE CHARGES10810

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total72434306Total

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY15778486BOY
EOY10914856EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY7666025BOY
EOY8581929EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY704BOY
EOY405EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY30784638BOY
EOY43342456EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY54229853BOY
EOY62839646EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY67320BOY
EOY81416EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY67320BOY
EOY81416EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY54162533BOY
EOY62758230EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY54162533BOY
EOY62758230EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY54229853BOY
EOY62839646EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses8595697ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings
Total Revenue81030003TotalRevenue
Total Expenses72434306TotalExpenses
Excess Or Deficit For Year8595697ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS8595697ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt80905054TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal80905054RevenueSubtotal
Investment Expenses Not Included124949InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt124949RevenueNotRptdOnFinStmt
Total Revenue Per Form99081030003TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt72309357TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal72309357ExpensesSubtotal
Investment Expenses Not Included2124949InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt124949ExpensesNotRptdOnFinStmt
Total Expenses Per Form99072434306TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION B, LINE 11ALL DOCUMENTS ARE REVIEWED BY MANAGEMENT TRUSTEE AND UNION TRUSTEE REPRESENTATIVES BEFORE SIGNING AND FILING
TRUSTEES EXECUTE A STATEMENT OF COMPLIANCE WHICH IS KEPT ON FILEFORM 990, PART VI, SECTION B, LINE 12C
POLICIES ARE MADE AVAILABLE TO MEMBERS UPON REQUESTFORM 990, PART VI, SECTION C, LINE 19
FORM 990, PART XII, LINE 2C: NO CHANGE IN REVIEW PROCESS FROM PRIOR YEAR. BOARD OF TRUSTEES SELECT AN INDEPENDENT AUDITOR. ADMINISTRATOR FORMALLY REVIEWS AND APPROVES THE FINANCIAL STATEMENTS. BOARD OF TRUSTEES REVIEWS AND APPROVES THE FINANCIAL STATEMENTS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
HOTEL AND RESTAURANT INDUSTRY EMPLOYMENT AND TRAINING PLAN
560 N NIMITZ HIGHWAY 209HONOLULUHI96817996009966PROVIDE TRAINING BENEFITS TO ELIGIBLE EMPLOYEESHI501(C)(5)N/AN/A0
HOTEL UNION AND HOTEL INDUSTRY OF HAWAII PENSION PLAN
560 N NIMITZ HIGHWAY 209HONOLULUHI96817990155373PROVIDE RETIREMENT BENEFITS TO ELIGIBLE EMPLOYEES AND BENEFICIARIESHI401(A)N/AN/A0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg