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INSURANCE AND BENEFITS TR OF PEACE OFFICERS RESEARCH ASSOC OF CA: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
INSURANCE AND BENEFITS TR OF PEACE OFFICERS RESEARCH ASSOC OF CA (EIN 68-6068469)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-11-14
IRS object ID
202143189349300799
Schema version
2020v4.1
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)
Return2021-11-14T12:58:13-06:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110681 FOOTHILL BLVD STE 300AddressLine1Txt
CityRANCHO CUCAMONGACityNm
State AbbreviationCAStateAbbreviationCd
ZIP917303831ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN686068469EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1INSURANCE AND BENEFITS TRUST OF THEBusinessNameLine1Txt
Business Name Line2PEACE OFFICERS RESEARCH ASSOC OF CABusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlINSUBusinessNameControlTxt
Phone9169283777PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14010 TRUXEL ROADAddressLine1Txt
CitySACRAMENTOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95834ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonFRANCO VADOPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone9169283777PhoneNum
Signature2021-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstFRANCOPersonFirstNm
Person LastVADOPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCATHERINE L GRAYPreparerPersonNm
PTINP01294460PTIN
Phone9094664410PhoneNum
Preparation2021-11-14PreparationDt

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)
Principal OfficerFRANCO VADOPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line14010 TRUXEL ROADAddressLine1Txt
CitySACRAMENTOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95834ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$196,201,845GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1991FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionTO PROVIDE DISABILITY, LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT, CANCER, ACCIDENT AND HOSPITAL BENEFITS TO MEMBERS.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee12TotalEmployeeCnt
Total Volunteers11TotalVolunteersCnt
Total Gross UBI$2,959,415TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$175,111,776PYProgramServiceRevenueAmt
CY Program Service Revenue$174,070,403CYProgramServiceRevenueAmt
PY Investment Income$2,180,336PYInvestmentIncomeAmt
CY Investment Income$2,959,415CYInvestmentIncomeAmt
PY Other Revenue$28,611,314PYOtherRevenueAmt
CY Other Revenue$18,926,139CYOtherRevenueAmt
PY Total Revenue$205,903,426PYTotalRevenueAmt
CY Total Revenue$195,955,957CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$192,554,828PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$158,302,520CYBenefitsPaidToMembersAmt
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$11,523,802PYOtherExpensesAmt
CY Other Expenses$11,389,220CYOtherExpensesAmt
PY Total Expenses$204,078,630PYTotalExpensesAmt
CY Total Expenses$169,691,740CYTotalExpensesAmt
PY Revenues Less Expenses$1,824,796PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$26,264,217CYRevenuesLessExpensesAmt
Total Assets BOY$98,196,410TotalAssetsBOYAmt
Total Assets EOY$132,160,569TotalAssetsEOYAmt
Total Liabilities BOY$30,034,115TotalLiabilitiesBOYAmt
Total Liabilities EOY$19,229,357TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$68,162,295NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$112,931,212NetAssetsOrFundBalancesEOYAmt
MissionNONEMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescTO PROVIDE DISABILITY, LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT, CANCER, ACCIDENT AND HOSPITAL BENEFITS TO APPROXIMATELY 60,000 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.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 EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
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 RequiredYes (1)ScheduleJRequiredInd
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 Document22IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee12EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
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 Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
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 Line1PORACBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9169283777PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14010 TRUXEL ROADAddressLine1Txt
CitySACRAMENTOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95834ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
MARIA JIMENEZ
CHIEF OPERATIONS OFFICER40.00Yes (X)$201,741$0$12,269
FRANCO VADO
CHAIRMAN5.00Yes (X)$0$0$0Yes (X)
RICHARD BUSS
VICE-CHAIRMAN5.00Yes (X)$0$0$0Yes (X)
ISRAEL REYES
TREASURER5.00Yes (X)$0$0$0Yes (X)
RUSTY REA
SECRETARY5.00Yes (X)$0$0$0Yes (X)
DAMON KURTZ
TRUSTEE5.00$0$0$0Yes (X)
BRYAN HUBBARD
TRUSTEE5.00$0$0$0Yes (X)
PATRICK MARTIN
TRUSTEE5.00$0$0$0Yes (X)
CODY GREEN
TRUSTEE5.00$0$0$0Yes (X)
GARY FRACE
TRUSTEE5.00$0$0$0Yes (X)
ROGER GARCIA
TRUSTEE5.00$0$0$0Yes (X)
SHANE TALBOT
TRUSTEE5.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$201,741TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$12,269TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ANTHEM BLUE CROSS
11030 WHITE ROCK ROADRANCHO CORDOVACA95670ADMINISTRATOR$5,939,639
MEDICARE
11030 WHITE ROCK ROADRANCHO CORDOVACA95670ADMINISTRATOR$1,348,237
INSURANCE BENEFIT TRUST OF PORAC
4010 TRUXEL ROADSACRAMENTOCA95834ADMINISTRATOR$793,689
MYER-STEVENS TOOHEY
26101 MARGUERITE PARKWAYMISSION VIEJOCA92692PROVIDER$580,607
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PARTICIPANT CONTRIBUTIONS900099$165,151,298$165,151,298
PREMIUM CONTRIBUTIONS REVENUE900099$8,919,105$8,919,105
FieldValueIRS element (for citing)
Total Program Service Revenue$174,070,403TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,144,302TotalRevenueColumnAmt
Unrelated Business Revenue$2,144,302UnrelatedBusinessRevenueAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,061,001SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$245,888SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$815,113SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$815,113TotalRevenueColumnAmt
Unrelated Business Revenue$815,113UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
OTHER900099$16,781,720$16,781,720
LTD CLAIMS RECOVERIES900099$1,116,707$1,116,707
ADMIN FEE REVENUE900099$1,027,312$1,027,312

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$400TotalRevenueColumnAmt
Related Or Exempt Func Income$400RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$18,926,139OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$195,955,957TotalRevenueColumnAmt
Related Or Exempt Func Income$192,996,542RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$2,959,415UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$158,302,520TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,383,672TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$113,922TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$58,800TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$408,609TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,115,952TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$57,842TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$15,548TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$32,752TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$8,396TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$102,242TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmt
SUPPLIES AND TELEPHONE$41,125
PCORI FEE$26,279
MISCELLANEOUS$8,920
ACA INSURER$8,004

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$7,157TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$169,691,740TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$11,913,175BOYAmt
EOY$17,781,470EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$5,649,972BOYAmt
EOY$433,028EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$13,781,534BOYAmt
EOY$13,360,355EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$89,953BOYAmt
EOY$69,894EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$5,783,617LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,600LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$115,547BOYAmt
EOY$5,778,017EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$65,098,664BOYAmt
EOY$86,639,900EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,547,565BOYAmt
EOY$8,097,905EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$98,196,410BOYAmt
EOY$132,160,569EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$12,898,767BOYAmt
EOY$4,311,013EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$17,135,348BOYAmt
EOY$14,918,344EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$30,034,115BOYAmt
EOY$19,229,357EOYAmt
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$68,162,295BOYAmt
EOY$112,931,212EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$68,162,295BOYAmt
EOY$112,931,212EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$98,196,410BOYAmt
EOY$132,160,569EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$26,264,217ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$4,702,224NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments$13,802,476PriorPeriodAdjustmentsAmt
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

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,624,285OtherCostOrOtherBasisAmt
Book Value$5,624,285BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$159,332OtherCostOrOtherBasisAmt
Depreciation$5,600DepreciationAmt
Book Value$153,732BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,778,017TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDescBook ValueBookValueAmt
ESTIMATED RECOVERABLE CLAIMS RECEIVABLE$1,270,476
ADMINISTRATIVE FEE RECEIVABLE$343,996
DUE FROM OTHER TRUSTS$281,429
ACCRUED INTEREST AND DIVIDENDS$172,836
STOP LOSS RECEIVABLE$529,168
PRESCRIPTIONS REBATES RECEIVABLE$5,500,000
FieldValueIRS element (for citing)
Total Book Value Other Assets$8,097,905TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
ACCRUED VACATION/PAYROLL TAXES$73,147
GROUP INSURANCE PREMIUMS PAYABLE$405,611
SELF-FUNDED BENEFITS CLAIMS PAYABLE$1,536,386
INCURRED BUT NOT REPORTED CLAIMS$12,779,000
DUE TO OTHER TRUST$124,200
FieldValueIRS element (for citing)
Total Liability$14,918,344TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$200,249,572TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$4,702,224NetUnrealizedGainsInvstAmt
Revenue Not Reported$4,702,224RevenueNotReportedAmt
Revenue Subtotal$195,547,348RevenueSubtotalAmt
Investment Expenses Not Incld$408,609InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$408,609RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$195,955,957TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$171,638,764TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$171,638,764ExpensesSubtotalAmt
Investment Expenses Not Incld2$408,609InvestmentExpensesNotIncld2Amt
Other Expenses Not Included-$2,355,633OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt-$1,947,024ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$169,691,740TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 -2,355,633.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonMARIA JIMENEZPersonNm
TitleCHIEF OPERATIONS OFFICERTitleTxt
Base Compensation Filing Org$201,741BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$500DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$11,769NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$214,010TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 7ATHE 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 11BTHE TRUSTEES ARE PROVIDED THE TAX RETURNS AND ASKED TO REMARK IF THEY HAVE ANY CHANGES.
FORM 990, PART VI, SECTION B, LINE 12CNEW TRUSTEES ARE REQUIRED TO ATTEND ANNUAL TRAINING.
FORM 990, PART VI, SECTION C, LINE 19THE 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 FALL 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 2CTHE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE PLAN'S FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT AUDITOR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (184 entries)

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
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 SharingYes (1)PaidEmployeesSharingInd
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 ReferencePARTS II, III, AND IV - IDENTIFICATION OF RELATED TAX ORGANIZATIONSFormAndLineReferenceDesc
ExplanationIN 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.ExplanationTxt

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