2021-01-25T19:25:06-06:00 2020-06-30 205496781 James P Hasselman CPA LLC PO Box 11149 Honolulu HI 96828 990 2019-07-01 996006907 Roofers Union Local 221 Health and Welfare Plan ROOF 8088417575 200 N Vineyard Blvd No 100 Honolulu HI 96817 Vaughn Chong Trustee 8088417575 2021-01-25 1 James Hasselman P00653759 8087215483 2021-01-22 X 2019 2022-09-23 18:48:47Z Vaughn Chong 200 N Vineyard Blvd No 100 Honolulu HI 96817 5332785 0 X N/A X 1965 HI The purpose of the plan is to provide health and welfare benefits to employees covered by the collective bargaining agreement. 6 5 0 0 0 0 0 0 1938728 2003331 184189 332970 0 0 2122917 2336301 0 0 2665776 2580170 0 0 0 0 0 258661 271491 2924437 2851661 -801520 -515360 6744194 6073964 1924229 1900845 4819965 4173119 The purpose of the Plan is to provide health and welfare benefits to employees covered by the collective bargaining agreement. 0 0 The Plan provided health and welfare benefits to employees covered by the collective bargaining agreement. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 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 1 2 0 1 0 0 0 0 0 0 0 0 0 0 0 X 6 5 1 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X Hawaii Benefit Administrators Inc 8088417575 200 N Vineyard Blvd Suite 100 Honolulu HI 96817 Scott Ai Trustee/Co-Chairman 1.00 X X 0 0 0 Vaughn Chong Trustee/Co-Chairman 1.00 X X 0 0 0 Enrique Subiono Trustee/Secretary 0.10 X X 0 100640 33091 Nephi Kaonohi Trustee 0.10 X 0 0 0 Tim Lyons Trustee 0.10 X 0 0 0 Fred Kaohe Jr Alternate Trustee 0.10 X 0 0 0 Steve Robidoux Trustee 0.10 X 0 0 0 Jason Clark Alternate Trustee 0.10 X 0 0 0 0 100640 33091 0 0 0 0 Hawaii Benefit Administrators Inc 200 N Vineyard Blvd Ste 100 Honolulu HI 96817 Administrative services 140521 1 Employer contributions 900099 1956191 1956191 Liquidated damages 900099 29062 29062 Participant contributions 900099 18078 18078 2003331 168937 168937 3160517 2996484 164033 164033 164033 2336301 2167364 0 168937 2580170 140521 23860 19424 19569 47323 10169 1538 1579 6440 1068 2851661 11458 5372 214727 188930 253429 285859 2190 2138 6169850 5490724 92540 100941 6744194 6073964 17795 18836 1906434 1882009 1924229 1900845 X 0 0 0 0 4819965 4173119 4819965 4173119 6744194 6073964 -515360 -131486 0 X X 0 1 X 1 0 0 Plan benefit obligations 1882009 1882009 X 2188807 -131486 -131486 2320293 16008 16008 2336301 2835653 0 2835653 16008 16008 2851661 Part X, Line 2: Accounting principles generally accepted in the United States of America require Fund management to evaluate tax positions taken by the Fund and recognize a tax liability (or asset) if the organization has taken an uncertain position that more likely than not would not be sustained upon examination by the Internal Revenue Service. The Fund administrator has analyzed the tax positions taken by the Fund and has concluded that there are no uncertain positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the financial statements. The Fund is subject to routine audits by taxing jurisdictions, however there are currently no audits for any tax periods in progress. The Fund administrator believes the Fund is no longer subject to income tax examinations for fiscal years prior to fiscal 2017. Form 990, Part VI, Section A, line 2 Trustee Subiono is an employee of a sister Roofers Trust Fund that has common trustees with this Fund, and thus has a business relationship, as defined in the instructions to form 990, with those trustees. Form 990, Part VI, Section A, line 7a The governing board is appointed by the Local Union No. 221 of the United Union of Roofers, Waterproofers and Allied Workers; and the Roofing Contractors Association of Hawaii. Form 990, Part VI, Section B, line 11b Form 990 is provided to the Trustees for their review prior to filing. Form 990, Part VI, Section B, line 12c The trustees report annually on any instances that could give rise to conflict of interest. Form 990, Part VI, Section C, line 19 The Plan does not make its governing documents, conflict of interest policy or financial statements available to the public. Form 990 Part XII, Line 2c The process for hiring the independent auditor and reviewing the results of the annual audit has not changed from the prior year. Form 990 Part VI, line 3 The board of trustees retains management control over the Fund. The organization utilizes the services of a third party administrator to provide certain administrative services. Roofers Union Local 221 Training Plan 200 N Vineyard Blvd Honolulu HI 96817 237152750 Provides training benefits to unionized employees. HI 501(c)(5) None 0 Roofers Union Local 221 Vacation & Health Trust Fund 200 N Vineyard Blvd Honolulu HI 96817 996005504 Provides vacation & holiday benefits to unionized employees HI 501(c)(9) None 0 Roofers Union Local 221 Pension Plan 200 N Vineyard Blvd Honolulu HI 96817 990208117 Provides retirement benefits to unionized employees HI None 0 Roofers Union Local 221 Annuity Plan 200 N Vineyard Blvd Honolulu HI 96817 990174607 Provides retirement benefits to unionized employees HI None 0 BEACHSIDE ROOFING LLC 91-571 NUKUAWA ST KAPOLEI HI 96707 PAC ROOFING LLC PO BOX 2608 Wailuku HI 96793 OMEGA ROOFING LLC 4321 LIKINI STREET HONOLULU HI 96818 PROTECH ROOFING LLC PO BOX 31226 HONOLULU HI 96820 HEADED HOME ROOFING LLC 96-1173 WAIHONA STREET UNIT A8 Pearl City HI 96782 Leeward Construction LLC PO Box 886 Waianae HI 96792 A TEAM PACIFIC ROOFING 3790 SCHACHT ST FAIRBANKS AK 99701 ALCAL SPECIALTY 946 N MARKET BLVD SACRAMENTO CA 95834 BUCK ROOFING CO INC 47-609 HUI ULILI ST KANEOHE HI 96744 LAULIMA ROOFING & WATER 590 FARRINGTON HWY 210-187 KAPOLEI HI 96707 HAAS INSULATION INC 94-1388 MOANIANI ST 111 WAIPAHU HI 96797 HONOLULU ROOFING COMPANY 2004 KAHAI ST HONOLULU HI 96819 Western Roofing Service 15002 Wicks Blvd San Leandro CA 94577 ROOFERS TRAINING OFFICE PO BOX 17250 HONOLULU HI 96817 ROOFERS UNION LOCAL 221 PO BOX 17250 HONOLULU HI 96817 TYSON'S INC 533 ONEAWA STREET KAILUA HI 96734 ULTIMATE ROOFING INC 519 MANONO ST HILO HI 96720 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0