BETA

SHEET METAL WORKERS LOCAL 104 HEALTH CARE PLAN: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
SHEET METAL WORKERS LOCAL 104 HEALTH CARE PLAN (EIN 94-2541328)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-04-21
IRS object ID
202211119349301011
Schema version
2020v4.2
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)
Return2022-04-21T11:50:50-05:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN222027092PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WITHUMSMITHBROWN PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15000 EXECUTIVE PARKWAY SUITE 400AddressLine1Txt
CitySAN RAMONCityNm
State AbbreviationCAStateAbbreviationCd
ZIP945834210ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN942541328EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SHEET METAL WORKERS LOCAL 104 HEALTHBusinessNameLine1Txt
Business Name Line2CARE PLANBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlSHEEBusinessNameControlTxt
Phone9252089999PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13240B CONSTITUTION DRIVEAddressLine1Txt
CityLIVERMORECityNm
State AbbreviationCAStateAbbreviationCd
ZIP94551ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRICK WERNERPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone9252089999PhoneNum
Signature2022-04-21SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstRICKPersonFirstNm
Person LastWERNERPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJESSICA R ROSTERPreparerPersonNm
PTINP01317380PTIN
Phone9252779100PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd
Principal OfficerRICK WERNERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13240B CONSTITUTION DRIVEAddressLine1Txt
CityLIVERMORECityNm
State AbbreviationCAStateAbbreviationCd
ZIP94551ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$122,415,535GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1979FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionTO PROVIDE HEALTH BENEFITS AND SUPPLEMENTAL UNEMPLOYMENT BENEFITSActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
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$120,782,774PYProgramServiceRevenueAmt
CY Program Service Revenue$119,274,871CYProgramServiceRevenueAmt
PY Investment Income$15,666,216PYInvestmentIncomeAmt
CY Investment Income$3,140,664CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$136,448,990PYTotalRevenueAmt
CY Total Revenue$122,415,535CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$94,914,593PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$114,089,884CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$57,202PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$55,834CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$5,198,094PYOtherExpensesAmt
CY Other Expenses$4,989,107CYOtherExpensesAmt
PY Total Expenses$100,169,889PYTotalExpensesAmt
CY Total Expenses$119,134,825CYTotalExpensesAmt
PY Revenues Less Expenses$36,279,101PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,280,710CYRevenuesLessExpensesAmt
Total Assets BOY$221,679,948TotalAssetsBOYAmt
Total Assets EOY$245,411,370TotalAssetsEOYAmt
Total Liabilities BOY$36,819,222TotalLiabilitiesBOYAmt
Total Liabilities EOY$42,360,683TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$184,860,726NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$203,050,687NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE HEALTH BENEFITS AND SUPPLEMENTAL UNEMPLOYMENT BENEFITS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescPROVIDED HEALTH AND WELFARE BENEFITS AND SUPPLEMENTAL UNEMPLOYMENT BENEFITS TO PARTICIPANTS AND THEIR ELIGIBLE DEPENDENTS.Desc
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 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
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 Document7IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
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 Members14GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
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 BodyYes (1)Form990ProvidedToGvrnBodyInd
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 Line1BENESYS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9252089994PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13240B CONSTITUTION DRIVEAddressLine1Txt
CityLIVERMORECityNm
State AbbreviationCAStateAbbreviationCd
ZIP94551ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
RICK WERNER
CHAIRMAN4.00Yes (X)$0$0$0
RICHARD KOENIG
TRUSTEE2.00Yes (X)$0$0$0
BRIAN WERNER
TRUSTEE2.00Yes (X)$0$0$0
BRIAN MASTERS
TRUSTEE2.00Yes (X)$0$0$0
DOMINIC TORREANO
TRUSTEE2.00Yes (X)$0$0$0
KEITH DIAS
TRUSTEE2.00Yes (X)$0$0$0
JOSEPH MARACCINI
TRUSTEE2.00Yes (X)$0$0$0
ERIC HAYNES
TRUSTEE2.00Yes (X)$0$0$0
SEAN O'DONOGHUE
TRUSTEE2.00Yes (X)$0$0$0
BOB BRAMLETT
TRUSTEE2.00Yes (X)$0$0$0
CHRIS ENFANTINO
TRUSTEE2.00Yes (X)$0$0$0
PAUL STECKEL
TRUSTEE2.00Yes (X)$0$0$0
KATHY DE JONG
TRUSTEE2.00Yes (X)$0$0$0
DUANE DAVIES
TRUSTEE2.00Yes (X)$0$0$0
RANDY ATTAWAY
TRUSTEE - PAST2.00Yes (X)$0$0$0
SEE SCHEDULE O FOR COMPENSATION PAI
PAID BY RELATED ORGANIZATIONS0.00Yes (X)$0$1$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1TotReportableCompRltdOrgAmt
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 (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
BENESYS INC
2610 CROW CANYON ROAD SUITE 200SAN RAMONCA94583ADMINISTRATION$2,625,683
BLUE SHIELD OF CALIFORNIA
50 BEALE STREETSAN FRANCISCOCA941051808CLAIMS PROCESSING$1,483,907
DELTA DENTAL OF CALIFORNIA
PO BOX 997330SACRAMENTOCA958997330CLAIMS PROCESSING$683,668
PART D ADVISORS INC
17199 N LAUREL PARK DR STE 400LIVONIAMI48152CONSULTING$134,639
NORTHWEST PLAN SERVICES INC
160 W SANTA CLARA STREET SUITE 15SAN JOSECA95113CONSULTING$116,000
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYER CONTRIBUTIONS900099$102,674,122$102,674,122
EMPLOYEE CONTRIBUTIONS900099$12,801,728$12,801,728
PRESCRIPTION REBATES900099$2,094,054$2,094,054
MEDICARE - D REBATES900099$1,612,614$1,612,614
MISC. INCOME900099$92,353$92,353
FieldValueIRS element (for citing)
Total Program Service Revenue$119,274,871TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,140,664TotalRevenueColumnAmt
Exclusion$3,140,664ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$122,415,535TotalRevenueColumnAmt
Related Or Exempt Func Income$119,274,871RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$3,140,664ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$114,089,884TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$55,834TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,397,004TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$102,452TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$43,777TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$83,830TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,082,323TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$171,159TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,265TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$52,797TotalAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmt
SETTLEMENT$35,000
PCORI TAX$19,500

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$119,134,825TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY-$219,166BOYAmt
EOY-$314,204EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$62,040,340BOYAmt
EOY$49,290,528EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$20,598,109BOYAmt
EOY$22,135,473EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$53,579BOYAmt
EOY$50,000EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$139,207,086BOYAmt
EOY$174,249,573EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$221,679,948BOYAmt
EOY$245,411,370EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$821,295BOYAmt
EOY$948,361EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$1,027,927BOYAmt
EOY$1,009,322EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$34,970,000BOYAmt
EOY$40,403,000EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$36,819,222BOYAmt
EOY$42,360,683EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

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

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$184,860,726BOYAmt
EOY$203,050,687EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$184,860,726BOYAmt
EOY$203,050,687EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$221,679,948BOYAmt
EOY$245,411,370EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$3,280,710ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$14,909,251NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

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

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
ACCUMULATED ELIGIBILITY CREDITS$29,893,000
CLAIMS PAYABLE & INCURRED BUT NOT REPORTED CLAIMS$10,510,000
FieldValueIRS element (for citing)
Total Liability$40,403,000TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$137,240,956TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$14,909,251NetUnrealizedGainsInvstAmt
Revenue Not Reported$14,909,251RevenueNotReportedAmt
Revenue Subtotal$122,331,705RevenueSubtotalAmt
Investment Expenses Not Incld$83,830InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$83,830RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$122,415,535TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$113,617,995TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$113,617,995ExpensesSubtotalAmt
Investment Expenses Not Incld2$83,830InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$5,433,000OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$5,516,830ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$119,134,825TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE PLAN'S ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF JUNE 30, 2021, THERE ARE NO UNCERTAIN POSITIONS TAKEN, OR EXPECTED TO BE TAKEN, THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN'S ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL YEARS PRIOR TO 2018.
PART XII, LINE 4B - OTHER ADJUSTMENTS:CHANGE IN BENEFIT OBLIGATIONS

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THE PLAN HAS CONTRACTED WITH BENESYS, INC. TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11BA COPY OF THE FORM 990 WAS PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW BEFORE IT WAS FILED.
FORM 990, PART VI, SECTION B, LINE 12CTRUSTEES ARE REQUIRED TO DISCLOSE IN WRITING ANY RELATIONSHIPS OR INTEREST THAT COULD GIVE RISE TO A CONFLICT. IF THERE IS A CONFLICT OF INTEREST, THE CONFLICTING INTEREST IS FULLY DISCLOSED AND DOCUMENTED IN WRITING; THE TRUSTEE OR FIDUCIARY WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION.
FORM 990, PART VI, SECTION C, LINE 19UPON REQUEST, THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT-OF-INTEREST POLICY AND FINANCIAL INFORMATION AVAILABLE.
FORM 990, PART VII, SECTION A, LINE 1A:TRUSTEES ARE NOT COMPENSATED BY THE TRUST. COMPENSATION PAID TO TRUSTEES EMPLOYED BY OTHER RELATED ORGANIZATIONS IS REPORTED ON THE FORM 990 FILED WITH THE INTERNAL REVENUE SERVICE BY THE RELATED TAX EXEMPT ORGANIZATION. IF YOU WOULD LIKE ADDITIONAL INFORMATION, PLEASE CONTACT THE THIRD-PARTY ADMINISTRATOR, BENESYS, INC.
FORM 990, PART XII LINE 2C:THE ORGANIZATION HAS A BOARD OF TRUSTEES THAT ASSUMES RESPONSIBLITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
LOCAL 104 SUPPLEMENTAL PENSION PLAN
3240B CONSTITUTION DRIVELIVERMORECA94551946560138THE PLAN PROVIDES SUPPLEMENTAL PENSION BENEFITSCA501AN/AN/A0
SHEET METAL WORKERS PENSION TRUST OF NORTHERN CALIFORNIA
3240B CONSTITUTION DRIVELIVERMORECA94551516115939THE PLAN PROVIDES PENSION BENEFITS TO RETIREESCA501AN/AN/A0
SHEET METAL WORKERS INTERNATIONAL ASSN LOCAL UNION NO 104
3232 CONSTITUTION DRIVELIVERMORECA94551940859420UNIONCA501C(5)N/AN/A0
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 OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS:FormAndLineReferenceDesc
ExplanationTHE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF JUNE 30, 2021, THERE ARE APPROXIMATELY 216 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. THE FEDERAL TAX CLASSIFICATION (DISREGARDED ENTITY, TAX-EXEMPT ORGANIZATION, PARTNERSHIP, TAXABLE CORPORATION OR TRUST) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT, THE NAMES OF THE CONTRIBUTING EMPLOYERS ARE LISTED ON PART VII BELOW AND NOT ON PARTS II THROUGH IV BY FEDERAL TAX CLASSIFICATION. A & B MECHANICAL, INC. A G C, INC A I M SHEET METAL A. ZAHNER CO. AAERO HEATING & S/M CO ABCO MECHANICAL CONTR ABM BUILDING SOLUTIONS, LLC ABOVO SOLUTIONS, LLC ACCEL AIR SYSTEMS INC. ACCO ENGINEERED SYS ACI MECHANICAL INC. ADVANCED AIRE SYSTEMS ADVANCED SOLUTIONS,INC ADVNC AIR TECHNOLOGIES AGC INC. AIR CONDITIONING SYSTEM AIR EXCHANGE AIR SYSTEMS SERVICE & CONST. AIR SYSTEMS, INC. AIRCAL HTG. & S/M AIRCO MECHANICAL INC AIRE SHEET METAL AIRTEC SERVICE AKIMA, LLC ALL BAY MECHANICAL, INC. ALL TEMPERATURE SERVICE AIR ALLIED HTG & AIR COND ALPHA AIR BALANCING AG ALPINE MECH SERVICE CO AMERICAN METAL PROD ANDERSON ROWE & BUCKLEY ANNING JOHNSON APEX MECHANICAL, INC. APOLLO SHEET METAL INC. DBA ARENA & SONS ASCO SERVICE, INC. ASSOCIATED AIR BAL. & CERTIFIC AUTOMATED SOLUTIONS GROUP AXIS MECHANICAL BAY AREA HVAC, INC. BAY CITY MECHANICAL BAY POINT CONTROL BAYSIDE HTG & A/C BC RESTAURANT EQUIPMENT BEL AIR MECHANICAL BELL PRODUCTS BERLIN FOOD EQUIPMENT BEST CONTRACTING SERVICES BIG PIPE MECHANICAL BIM DESIGNS, INC. BLOCKA CONSTR INC BOGNER SHEET METAL BRADY AIR CONDITNG. BRADY AIR SERVICE, INC. BROADWAY MECH. CONTRACTORS BROADWAY S/M MFG INC BROWN SHEET METAL BUENA VISTA CONSTRUCTION BULLARD'S HEATING & AIR, INC. BURLINGAME HTG VENT CO CALIFORNIA AIR INC CALIFORNIA CLIMATE SYSTEMS CALIFORNIA UNITED MECHANICAL, CARQUINEZ HEATING A/C & S/M CHAMPION INDUSTRIAL CONTRACTOR CITY MECHANICAL, INC. CLINTON HTG & AIR COND COLD CRAFT COLTON HEATING COMFORT CONTROL COMFORT DYNAMICS INC. CONGI INC. DBA CARTER AIR CONTROL AIR ENTERPRISE, LLC CRITCHFIELD MECHANICAL CROWN CORR, INC. CROWN SHEET METAL & CULINARY STAINLESS FABRICATORS DDK MECHANICAL, INC. DEBELLA MECHANICAL,INC DEGREE HVAC, INC. DEHARO MECHANICAL INC. DELCON HEATING & A/C, INC. DELLA MORA HTG,S/M, & A/C, INC DEPENDABLE SHEET METAL DESERT MECHANICAL, INC. DOWDLE & SONS MECHANICAL, INC DOWNING HEATING & AIR COND. DURR EAST BAY RESTAURANT INSTALL. ECHO MECHANICAL SYSTEMS ENERGY MECHANIX INC. ENVIRONMENTAL SYSTEMS INC. EXTREME AIR INC F S I FAIRVIEW HEATING & A/C FERTADO HEATING & AIR, INC. FOOTHILL AIR COND FRANK M BOOTH GLOBAL SPECIALTIES DIRECT, INC H-SQUARE MECHANICAL, INC. HARDIN & SONS, INC. HARRIS BAY AREA, LLC HARRIS MOUNTAIN WEST, LLC HEATHORN & ASSOCIATES DBA HVAC CAD SERVICE HYDRA VENTURES, INC. I E S INDOO ENVIRO SVS ICOM MECHANICAL INDEPENDENT AIR BALANCE, INC. INFINITY MECHANICAL, INC. INNOVATIVE MECH INC INTECH MECHANICAL CO., INC. IZMIRIAN ROOFING & S/M JACOBSEN ALVES GOODEILL INC. JAMES LONG CONSTRUCTION JEFFCO CUSTOM METALS, INC. JENSEN MECHANICAL, INC. JEROME & HORNER SHEET METAL JMS MECHANICAL K & M INSTALLATION KAMRAN METAL WORKS, INC. KEL AIRE HTG KINETIC MECHANICAL SERVICE INC KINETIC SYSTEMS, INC KT MECHANICAL INC. L J KRUSE COMPANY LARGE'S METAL FAB LASLEY MECHANICAL LAWSON MECHANICAL LEFCO INC M T B INCORPORATED M.E.S.A. 3, INC MARELICH MECHANICAL CO MARTINEZ SHEET METAL MATRIX HG, INC. MAUCK SHEET METAL WORKS MECHANICAL SERVICES LLC MELROSE METAL PRODUCTS MESA ENERGY SYSTEMS INC. MG MCGRATH, INC. MILESTONE CONTRACTORS INC. DBA MINA METALS MIRADOR CONSTRUCTION MONARCH MECHANICAL MONSTER MECHANICAL, INC. MONTEREY MECHANICAL CO MSR MECHANICAL LLC MURRAY PLUMBING & HTG CORP. NATIONAL AIR BALANCE NATIONAL SHOP FAB INC. NEW ENGLAND S/M AND MECH. CO. NORTH BAY COMMERCIAL SVCS INC NORTHERN SERVICES, INC. O C MCDONALD CO., INC. OCEAN PARK MECHANICAL, INC. OMNI SHEET METAL, INC. ORSON MECHANICAL CO., INC. OTAVILLA MECHANICAL CONTR. PACIFIC COAST BALANCING PACIFIC COAST TRANE SVC PACIFIC TEST AND BALANCE, INC. PAN-PACIFIC MECHANICAL, LLC PARAGON MECHANICAL INC PATRIOT CONTRACTING, INC. PERFORMANCE AIR SERVICE, INC. PETERSON MECHANICAL, INC. PIONEER ROOFING ORGANIZATION POMI MECHANICAL INC. PRECISION CAD SERVICES, INC. PRIME MECHANICAL SERVICE, INC. PROJECT BUILT, INC. QUALTECH MECHANICAL, INC. R E MILANO PLUMBING CORP. R J MECHANICAL, INC RAY L HELLWIG MECH REACO HEATING & A/C RECIP L162 RECIP-SASMI RMI MECHANICAL, INC. RODRIGUEZ SHEET METAL RS ANALYSIS, INC. RVTDESK, INC. RYMAC, INC. S & H CONSTRUCTION, INC. SAL J ACOSTA MFG CO INC SCHAFERS S/M & MFG CO SERVICE METAL PROD INC SHEET METAL WRKS LU 104 SHELDON MECHANICAL SILICON VALLEY MECHANICAL, INC SIMPSON SHEET METAL, INC. SMITH MECHANICAL-ELECT.-PLBG SMW 104 BAY AREA IND TRAIN FUN SOUTHLAND INDUSTRIES SOUTHWEST DESIGN & SUPPLY CO. STANDARD S/M & MARINE STATE OF CA. DEPT. OF CORRECT. STATE SHEET METAL WORKS STUMBAUGH & ASSOCIATES, INC. SUPERIOR MECH. SERVICES, INC. T.A.B.C.O. INC THE TIN MAN THERMA, LLC THERMAL MECHANICAL, INC. TRADEWINDS COOLING, LLC VAL'S PLUMBING VAN MULDER SHEET METAL VENTEC VERDEGAAL HEATING INC WCASM INC, DBA WEST COAST ASM WEST COAST FIRESTOPPING, INC. WEST COAST MECHANICAL WEST COAST TEST AND BALANCE WESTCAL DESIGN AND BUILD, INC. WESTERN ALLIED MECHANICAL, INC YOUR WARM FRIEND,INC.ExplanationTxt

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