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ILWU LOCAL 142 HEALTH & WELFARE TR: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
ILWU LOCAL 142 HEALTH & WELFARE TR (EIN 20-2076868)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-13
IRS object ID
202323179349311337
Schema version
2022v5.0
Note
A later return for the same period supersedes this one.
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)
Return2023-11-13T18:11:52-06:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN990155373PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1LEMKE CHINEN & TANAKA CPA INCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 ALA MOANA BLVD BLDG 2 302AddressLine1Txt
CityHONOLULUCityNm
State AbbreviationHIStateAbbreviationCd
ZIP96813ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN202076868EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ILWU LOCAL 142 HEALTH AND WELFARE TRUSTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlILWUBusinessNameControlTxt
Phone8084418600PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11440 KAPIOLANI BLVD 800AddressLine1Txt
CityHONOLULUCityNm
State AbbreviationHIStateAbbreviationCd
ZIP96814ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonGUY FUJIMURA-UNION TRUSTEEPersonNm
Person TitleCARLA THOMAS-MGMT TRUSTEEPersonTitleTxt
Phone8084418600PhoneNum
Signature2023-11-07SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstGUYPersonFirstNm
Person LastFUJIMURA-UNION TRUSTPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTERRY TAKAKIPreparerPersonNm
PTINP00036112PTIN
Phone8085336254PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerGUY FUJIMURA-UNION TRUSTEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11440 KAPIOLANI BLVD 800AddressLine1Txt
CityHONOLULUCityNm
State AbbreviationHIStateAbbreviationCd
ZIP96814ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$123,668,332GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation2005FormationYr
Legal Domicile StateHILegalDomicileStateCd
Activity Or MissionTO PROVIDE HEALTH & WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS IN ACCORDANCE W/PLAN DOCUMENTS.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$42,451,639PYProgramServiceRevenueAmt
CY Program Service Revenue$52,093,598CYProgramServiceRevenueAmt
PY Investment Income$1,304,986PYInvestmentIncomeAmt
CY Investment Income$882,153CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$1,774CYOtherRevenueAmt
PY Total Revenue$43,756,625PYTotalRevenueAmt
CY Total Revenue$52,977,525CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$39,885,635PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$41,225,852CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,854,368PYOtherExpensesAmt
CY Other Expenses$1,968,186CYOtherExpensesAmt
PY Total Expenses$41,740,003PYTotalExpensesAmt
CY Total Expenses$43,194,038CYTotalExpensesAmt
PY Revenues Less Expenses$2,016,622PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$9,783,487CYRevenuesLessExpensesAmt
Total Assets BOY$45,783,009TotalAssetsBOYAmt
Total Assets EOY$53,414,024TotalAssetsEOYAmt
Total Liabilities BOY$174,421TotalLiabilitiesBOYAmt
Total Liabilities EOY$751,684TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$45,608,588NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$52,662,340NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR FAMILIES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$29,434,091ExpenseAmt
DescTO PROVIDE SELF-FUNDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS IN ACCORDANCE WITH THE TERMS SET FORTH IN THE TRUST AGREEMENTS,RULES AND REGULATIONS OF THE PLAN AND CBA (MEDICAL $23,453,091, DRUG $6,141,372 DRUG REBATES $-2,232,999 AND DENTAL $2,072,627)Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$11,791,761ExpenseAmt
DescTO PROVIDE INSURED BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS - (MEDICAL $11,440,742 CHIROPRACTIC $78,209, AND VISION $272,810)Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$1,180,377ExpenseAmt
DescTO PROVIDE SELF-FUNDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS FOR THE CLAIMS ADMINISTRATIVE FEE (MEDICAL $1,180,377, DRUG $3,349 DENTAL $133,628)Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$42,406,229TotalProgramServiceExpensesAmt
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document5IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PACIFIC ADMINISTRATORS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8084418600PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11440 KAPIOLANI BLVD SUITE 800AddressLine1Txt
CityHONOLULUCityNm
State AbbreviationHIStateAbbreviationCd
ZIP96814ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
GUY FUJIMURA
UNION TRUSTEE1.00Yes (X)$0$0$0
CARLA THOMAS
EMPLOYER TRUSTEE1.00Yes (X)$0$0$0
ROBERTO ANDRION JR
UNION TRUSTEE1.00Yes (X)$0$0$0
ERIC LOTTERMOSER
EMPLOYER TRUSTEE1.00Yes (X)$0$0$0
EVANGELINE SOBREPENA
EMPLOYER TRUSTEE1.00Yes (X)$0$0$0
ELMER GOROSPE
UNION TRUSTEE1.00Yes (X)$0$0$0
JEAN EWING
ALTERNATE EMPLOYER TRUSTEE1.00Yes (X)$0$0$0
ROSELYN MOLINA
ALTERNATE UNION TRUSTEE1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HAWAII MEDICAL SERVICE ASSOCIATION
818 KEEAUMOKU STHONOLULUHI96814CLAIMS SERVICE FEES AND CASE MANAGEMENT$1,043,400
PACIFIC ADMINISTRATORS
1440 KAPIOLANI BLVD 800HONOLULUHI96814ADMINISTRATIVE FEES AND PAYROLL AUDIT$288,841
HAWAII DENTAL SERVICE
700 BISHOP STREET 700HONOLULUHI96813CLAIMS SERVICE FEES AND CASE MANAGEMENT$133,628
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYERS' CONTRIBUTIO900099$52,011,575$52,011,575
EMPLOYEES' CONTRIBUTIO900099$82,023$82,023
FieldValueIRS element (for citing)
Total Program Service Revenue$52,093,598TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$878,840TotalRevenueColumnAmt
Exclusion$878,840ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$70,694,120SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$70,690,807SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$3,313SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,313TotalRevenueColumnAmt
Related Or Exempt Func Income$3,313RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Business541100BusinessCd
Total Revenue Column$1,774TotalRevenueColumnAmt
Exclusion$1,774ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,774OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$52,977,525TotalRevenueColumnAmt
Related Or Exempt Func Income$52,096,911RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$880,614ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$41,225,852TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$282,160TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$23,617TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$50,930TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$104,543TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,351,860TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$54,741TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$28,201TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$72,134TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$43,194,038TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$5,353,658BOYAmt
EOY$4,579,988EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$6,709,399BOYAmt
EOY$7,581,716EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,849,835BOYAmt
EOY$1,707,201EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$31,870,117BOYAmt
EOY$39,545,119EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$45,783,009BOYAmt
EOY$53,414,024EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$130,803BOYAmt
EOY$131,319EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$43,618BOYAmt
EOY$620,365EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$174,421BOYAmt
EOY$751,684EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$45,608,588BOYAmt
EOY$52,662,340EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$45,608,588BOYAmt
EOY$52,662,340EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$45,783,009BOYAmt
EOY$53,414,024EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$9,783,487ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$2,729,735NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescEMPLOYER CONTRIBUTION OVERPAYMENTDesc
Amt$620,365Amt
FieldValueIRS element (for citing)
Total Liability$620,365TotalLiabilityAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS PRESENTED TO THE CO-CHAIRS (MANAGEMENT TRUSTEE AND UNION TRUSTEE) FOR REVIEW AND SIGNATURE PRIOR TO THE FILING OF THE FORM 990
FORM 990, PART VI, SECTION B, LINE 12CTRUSTEES REVIEW POLICY AND DISCUSS ANY ARISING ISSUES/QUESTIONS WITH LEGAL COUNSEL
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTS ARE MADE AVAILABLE UPON REQUEST

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1SEE SCHEDULE R SUPPLEMENTAL INFORMATIONBusinessNameLine1Txt

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SEE SCHEDULE R SUPPLEMENTAL INFORMATIONBusinessNameLine1Txt

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SEE SCHEDULE R SUPPLEMENTAL INFORMATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE R, PARTS II, III, AND IVFormAndLineReferenceDesc
ExplanationTHE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER PLAN THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS IN ACCORDANCE WITH THE TERMS SET FORTH IN THE TRUST AGREEMENT, RULES, AND REGULATIONS OF THE PLAN AND COLLECTIVE BARGAINING AGREEMENTS. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF CONTRIBUTING EMPLOYERS INCLUDING THE NAMES, ADDRESSES, AND OTHER CONTACT INFORMATION. HOWEVER, THE LEGAL STRUCTURE (CORPORATION, PARTNERSHIP, ETC.) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND COULD NOT BE REASONABLY OBTAINED. AS A RESULT, THE CONTRIBUTING EMPLOYERS COULD NOT BE SEPARATED BY TYPE OF ORGANIZATION. HOWEVER, THEY ARE LISTED BELOW: ALOHILANI RESORT AT WAIKIKI BEACH FKA PACIFIC BEACH HOTEL ANDAZ MAUI AT WAILEA GRAND HYATT KAUAI GRAND WAILEA RESORT HOTEL & SPA HILTON WAIKOLOA VILLAGE HONOLULU AIRPORT HOTEL HYATT REGENCY MAUI KAANAPALI BEACH HOTEL LANAI RESORTS, LLC. (SHUTTLE DRIVERS) LANAI RESORTS, LLC. FKA FOUR SEASONS LANAI MAUNA KEA BEACH HOTEL PRINCEVILLE UTILITIES CO., INC. THE WESTIN MAUI RESORT & SPA TROON GOLF (MAKAI)ExplanationTxt

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