2022-11-15T18:17:01-06:00 2021-12-31 450250958 EIDE BAILLY LLP 10681 FOOTHILL BLVD STE 300 RANCHO CUCAMONGA CA 917303831 990 2021-01-01 686068469 PORAC INSURANCE - SAFETY PEACE OFFICERS RESEARCH ASSOC OF CA PORA 9169283780 2960 ADVANTAGE WAY SACRAMENTO CA 95834 RICHARD BUSS TRUSTEE 9169283780 2022-11-15 1 RICHARD BUSS 999009999 CATHERINE L GRAY CPA P01294460 9094664410 2022-11-15 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z X X RICHARD BUSS 2960 ADVANTAGE WAY SACRAMENTO CA 95834 194737604 0 X N/A X 1991 CA TO PROVIDE DISABILITY, LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT, CANCER, ACCIDENT AND HOSPITAL BENEFITS TO MEMBERS. 11 11 0 11 2801818 0 0 0 174070403 191932286 2959415 2801818 18926139 3500 195955957 194737604 0 0 158302520 190918752 0 720415 0 0 0 11389220 15536095 169691740 207175262 26264217 -12437658 132160569 140454222 19229357 34121624 112931212 106332598 NONE 0 0 TO PROVIDE DISABILITY, LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT, CANCER, ACCIDENT AND HOSPITAL BENEFITS TO APPROXIMATELY 22658 MEMBERS, THE CONTRIBUTIONS FOR WHICH ARE MADE BY MEMBERS, MEMBER ASSOCIATIONS AND IN SOME CASES BY MEMBERS' EMPLOYERS, IN ACCORDANCE WITH COLLECTIVE BARGAINING AGREEMENTS. IN ADDITION, A MAJOR MEDICAL ADMINISTRATIVE SERVICES BENEFIT WAS ESTABLISHED ON JANUARY 1, 2018 AND BEGAN RECEIVING CONTRIBUTIONS AND PROVIDING BENEFITS FROM THIS TRUST. PREVIOUS TO THIS DATE, PARTICIPANTS WERE PART OF FULLY INSURED BENEFIT PLAN. ONLY AS OF JANUARY 1, 2018, DID THIS TRUST INCLUDE A SELF-INSURED MAJOR MEDICAL PLAN FOR SUCH PARTICIPANTS. 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 30 0 1 0 1 1 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X PORAC INSURANCE AND BENEFITS TRUST 9169283777 2960 ADVANTAGE WAY SACRAMENTO CA 95834 X DAVE WILSON TRUSTEE 5.00 X 0 0 0 FRANCO VADO TRUSTEE 5.00 X X 0 0 0 RICHARD BUSS CHAIRMAN 5.00 X X 0 0 0 DUSTIN BRUZEE TRUSTEE 5.00 X X 0 0 0 DAMON KURTZ PRESIDENTS APPOINTEE 5.00 X 0 0 0 BRYAN HUBBARD VICE CHAIRMAN 5.00 X X 0 0 0 PATRICK MARTIN TRUSTEE 5.00 X 0 0 0 CODY GREEN TRUSTEE 5.00 X 0 0 0 GARY FRACE TRUSTEE 5.00 X 0 0 0 ROGER GARCIA TREASURER 5.00 X 0 0 0 STEVE LATHAM TRUSTEE 5.00 X 0 0 0 MARIA JIMENEZ COO 40.00 X 306335 0 500 306335 0 500 1 0 1 0 MYERS-STEVENS TOOHEY 26101 MARGUERITE PARKWAY MISSION VIEJO CA 92692 PROVIDER 552668 1 PARTICIPANT CONTRIBUTIONS 167320677 167320677 PREMIUM CONTRIBUTIONS REVENUE 8122093 8122093 STOP LOSS RECOVERIES 5698437 5698437 PRESCRIPTION REBATES 5608499 5608499 PRESCRIPTION PERFORMANCE GUARANTE 4337744 4337744 844836 844836 191932286 2801818 2801818 OTHER 3500 3500 3500 194737604 191935786 2801818 0 190918752 306835 372505 41075 1417163 192674 40662 598576 12384959 97116 132445 49582 116429 82244 124504 127500 SUPPLIES AND TELEPHONE 73987 PCORI FEE 66435 MISCELLANEOUS 15089 TRAINING 10931 5799 207175262 17781470 3605874 433028 13360355 13265690 69894 86972 10845186 130104 5778017 10715082 86639900 108386536 8097905 4394068 132160569 140454222 4311013 9081488 14918344 25040136 19229357 34121624 X 0 0 0 0 112931212 106332598 112931212 106332598 132160569 140454222 -12437658 10652202 -4813158 0 X X 0 1 X 1 0 9584033 9584033 1261153 130104 1131049 10715082 ACCRUED VACATION/PAYROLL TAXES 101590 GROUP INSURANCE PREMIUMS PAYABLE 405611 SELF-FUNDED BENEFITS CLAIMS PAYABLE 1536386 INCURRED BUT NOT REPORTED CLAIMS 13346515 DUE TO OTHER TRUST 240065 PREMIUMS PAYABLE 58794 UBS LOAN ACCOUNT 7009070 OTHER ACCRUED EXPENSES 2342105 25040136 X 204791231 10652202 10652202 194139029 598576 598576 194737605 206009171 0 206009171 598576 567515 1166091 207175262 PART X, LINE 2: THE TRUST HAS ADOPTED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD. THE TRUST ADMINISTRATOR BELIEVES THAT THE TRUST HAS NOT TAKEN UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS AS A TAX LIABILITY. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN NET BENEFIT OBLIGATIONS 567,515. 0 0 0 MARIA JIMENEZ COO 305835 0 500 0 0 0 0 0 500 0 306835 0 0 0 FORM 990, PART VI, SECTION A, LINE 7A THE PORAC PRESIDENT YEARLY MAKES 3 APPOINTMENTS TO THE TRUST: 1) PRESIDENTS APPOINTMENT, 2) BOARD REPRESENTATIVE AND 3) RETIREE REPRESENTATIVE FORM 990, PART VI, SECTION B, LINE 11B THE TRUSTEES ARE PROVIDED THE TAX RETURNS AND ASKED TO REMARK IF THEY HAVE ANY CHANGES. FORM 990, PART VI, SECTION B, LINE 12C NEW TRUSTEES ARE REQUIRED TO ATTEND ANNUAL TRAINING. 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 VII SECTION A COLUMN E AND F ALL THE TRUSTEES ARE VOLUNTEERS AND ARE NOT COMPENSATED BY ANY RELATED ENTITIES FOR THEIR WORK ON THE TRUST. RETIRED TRUSTEES AND MOST ACTIVE TRUSTEES ARE NOT COMPENSATED BY A CONTRIBUTING EMPLOYER OR SPONSOR ORGANIZATION. AN ACTIVE TRUSTEE OF THE TRUST IS AN EMPLOYEE OF A RELATED SPONSOR ORGANIZATION UNDER THE DEFINITIONS IN SCHEDULE R. THE TRUST REQUESTED THE COMPENSATION INFORMATION REGARDING THE RELATED ORGANIZATION FROM THE VOLUNTEER TRUSTEE. THE TRUST PROVIDED A QUESTIONNAIRE REQUESTING THE REQUIRED INFORMATION ALONG WITH INSTRUCTIONS TO EXPLAIN THE INFORMATION NEEDED. THE TRUST IS UNABLE TO REPORT COMPENSATION AND BENEFITS PAID TO VOLUNTEER TRUSTEES BY RELATED ORGANIZATIONS AS IT WAS UNABLE TO OBTAIN THE INFORMATION AFTER MAKING REASONABLE EFFORTS. FORM 990,PART XII, LINE 2C THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE PLAN'S FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT AUDITOR. ALAMEDA CO DSA ALAMEDA POA ALBANY POA ALHAMBRA POA AMADOR CO SOA ANAHEIM POA ANTIOCH POA ANTIOCH PSMA ARCADIA POA ARCATA POA ARROYO GRANDE POA ATWATER POA AUBURN POA AZUSA POA AZUSA PMA BART POA BART PMA BELMONT POA BERKELEY POA BRENTWOOD POA BUENA PARK POA BURBANK AIRPORT POA (NS) BUTTE CO CORRECTIONS BUTTE CO DSA CALAVERAS CO DSA CALAVERAS CO SHERIFF'S MGMNT CENTRAL MARIN POLICE AUTH CERES POA CHICO POA CHOWCHILLA POA CHULA VISTA POA CITY OF HERCULES POA CITY OF SANTA ROSA POA CITY OF SANTA ROSA PMA CLOVIS POA COLTON POA CONTRA COSTA CO DSA COTATI POA DESERT HOT SPRINGS POA EAST BAY REG PARK EL MONTE POA EL SEGUNDO POA ESCONDIDO POA EUREKA POA EXETER POA FONTANA PMA FONTANA SCHOOLS POA FT BRAGG POA FOUNTAIN VALLEY POA FRESNO CO DSA FRESNO CO DAIA FRESNO POA GARDENA POA GILROY POA GRASS VALLEY POA GUSTINE POA HANFORD POA HOLLISTER POA HUMBOLDT CO DSO IMPERIAL CO DAIA IMPERIAL CO DSA IMPERIAL CO PSMA INYO CO DSA KINGS CO DSA LA HABRA POA LA MESA POA LA PALMA POA LAKE CO CORRECTIONS LAKE CO DSA LAKEPORT POA LEMOORE POA LIVERMORE POA LODI POA LA AIRPORT LOCAL 777 LA AIRPORT SUPERVISORS LINCOLN POA MAMA OF LODI MADERA CO DSA MANHATTAN BCH POA MANTECA POA MARIN CO DSA MARTINEZ POA MODESTO POA MODOC CO DSA MONTEREY CO DSA MONTEREY CO SHERIFF'S MGMNT ASSOC MONTEREY CO PROBATION MONTEREY PK POA MONTEREY PK MID MGMNT MOUNTAIN VIEW POA NAPA CO DSA NAPA POA NAPA MID-MANAGEMENT POA NEWMAN POA NOVATO PMA NOVATO POA OAKDALE POA OAKLAND POA ORANGE POA OROVILLE POA OXNARD POA PALM SPRINGS POA PALO ALTO PMA PALO ALTO POA PIEDMONT POA PINOLE PEA PITTSBURG POA PLACER CO DSA PLEASANT HILL POA PLEASANTON POA POMONA POA PORT SAN LUIS PORTERVILLE POA REDDING PMA ROCKLIN POA ROHNERT PARK POA ROSEVILLE POA SACRAMENTO (SCALE) SACRAMENTO POA SALINAS POA SAN BENITO DSA SAN BERNARDINO POA SAN BERNARDINO SCHOOLS POA SAN DIEGO SCHOOLS POA SAN DIEGO SCHOOLS PMA SAN DIEGO HARBOR SAN FRANCISCO DSA SAN JOAQUIN CORRECTIONS SAN JOAQUIN DAIA SAN JOAQUIN DSA SAN JOSE POA SAN LEANDRO PMA SAN LUIS OBISPO DSA SAN LUIS OBISPO (ASLOCDS) SAN MATEO POA SAN MATEO PROBATION ASSOC SAN MATEO SAFETY MGMNT SAN MATEO POLICE SGTS ASSOC SAN RAFAEL POA SANGER POA SANTA ANA SCHOOL POA SANTA BARBARA DSA SANTA BARBARA POA SANTA CLARA CORRECTIONS SANTA CLARA CO DAIA SANTA CRUZ CO CORRECTIONS SANTA CRUZ DSA SANTA CRUZ LT'S SANTA CRUZ REP UNIT SANTA MARIA POA SANTA MARIA PA OF MID MGMNT SANTA MONICA POA SEBA SEBASTOPOL POA SHASTA CO DSA SHASTA CO DMA SOLANO CO DSA SONOMA CO LEA SONOMA CO LEA MGRS SONOMA CO DSA & MGMNT SONORA POA STANISLAUS CO DSA STANISLAUS SPRVSRS STANISLAUS DA INV STANISLAUS SWORN DEPUTIES STOCKTON UNIFIED POA SUISUN CITY TRACY POA TRUCKEE POA TULARE CO DSA TUOLUMNE CO DSA VACAVILLE PMA VACAVILLE POA VALLEJO POA VENTURA CO DSA VENTURA POA WEST SACRAMENTO POA WHITTIER POA WHITTIER PMA WOODLAND PROF PEA YOLO CO DSA YREKA POA YUBA CITY POA YUBA CO SMSA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 PARTS II, III, AND IV - IDENTIFICATION OF RELATED TAX ORGANIZATIONS IN A MULTIEMPLOYER PLAN, A CONTRIBUTING EMPLOYER IS CONSIDERED A RELATED ORGANIZATION BECAUSE THEY ARE OBLIGATED TO CONTRIBUTE TO THE PLAN PURSUANT TO THE TERMS IN THE COLLECTIVE BARGAINING OR PARTICIPATION AGREEMENT. THE ADMINISTRATIVE OFFICE ONLY MAINTAINS THE DATA NECESSARY TO FULFILL THE OBLIGATION TO CONTRIBUTE, IT DOES NOT MAINTAIN SPECIFIC BUSINESS DATA REGARDING THE EMPLOYERS, SUCH AS ENTITY TYPE OR TAX INFORMATION.