INSURANCE AND BENEFITS TR OF PEACE OFFICERS RESEARCH ASSOC OF CA: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
INSURANCE AND BENEFITS TR OF PEACE OFFICERS RESEARCH ASSOC OF CA (EIN 68-6068469)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-16
IRS object ID
202033219349314113
Schema version
2019v5.1
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)
Return2020-11-16T14:22:01-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

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 Line13130 CROW CANYON PL STE 300AddressLine1Txt
CitySAN RAMONCityNm
State AbbreviationCAStateAbbreviationCd
ZIP945831386ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

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
Signature2020-11-16SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTHERESA MONTGOMERY CPAPreparerPersonNm
PTINP00232100PTIN
Phone9254804000PhoneNum
Preparation2020-11-09PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address99.110.55.147IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-11-16IPDt
IP Tm14:21:48IPTm
IP TimezonePSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id327E456370A643C83A1BB4325D39191A230D016AAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-04-22 16:20:28ZBuildTS

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$232,687,305GrossReceiptsAmt
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$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$192,693,017PYProgramServiceRevenueAmt
CY Program Service Revenue$175,111,776CYProgramServiceRevenueAmt
PY Investment Income$1,574,847PYInvestmentIncomeAmt
CY Investment Income$2,180,336CYInvestmentIncomeAmt
PY Other Revenue$52,040,105PYOtherRevenueAmt
CY Other Revenue$28,611,314CYOtherRevenueAmt
PY Total Revenue$246,307,969PYTotalRevenueAmt
CY Total Revenue$205,903,426CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$171,349,040PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$192,554,828CYBenefitsPaidToMembersAmt
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$14,856,702PYOtherExpensesAmt
CY Other Expenses$11,523,802CYOtherExpensesAmt
PY Total Expenses$186,205,742PYTotalExpensesAmt
CY Total Expenses$204,078,630CYTotalExpensesAmt
PY Revenues Less Expenses$60,102,227PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,824,796CYRevenuesLessExpensesAmt
Total Assets BOY$83,565,966TotalAssetsBOYAmt
Total Assets EOY$98,196,410TotalAssetsEOYAmt
Total Liabilities BOY$20,213,774TotalLiabilitiesBOYAmt
Total Liabilities EOY$30,034,115TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$63,352,192NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$68,162,295NetAssetsOrFundBalancesEOYAmt
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 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 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 Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document13IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee12EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
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

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
FRANCO VADO
CHAIRMAN5.00Yes (X)Yes (X)$0$0$0
RICHARD BUSS
VICE-CHAIRMAN5.00Yes (X)Yes (X)$0$0$0
ISRAEL REYES
TREASURER5.00Yes (X)Yes (X)$0$0$0
RUSTY REA
SECRETARY5.00Yes (X)Yes (X)$0$0$0
JOEY SCHLEMMER
TRUSTEE5.00Yes (X)$0$0$0
DAMON KURTZ
TRUSTEE5.00Yes (X)$0$0$0
PATRICK MARTIN OCT-DEC
TRUSTEE5.00Yes (X)$0$0$0
CODY GREEN
TRUSTEE5.00Yes (X)$0$0$0
GARY FRACE
TRUSTEE5.00Yes (X)$0$0$0
ROGER GARCIA
TRUSTEE5.00Yes (X)$0$0$0
SHANE TALBOT
TRUSTEE5.00Yes (X)$0$0$0
MARIA JIMENEZ
CHIEF OPERATIONS OFFICER40.00Yes (X)$0$155,764$8,012
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$155,764TotReportableCompRltdOrgAmt
Total Other Compensation$8,012TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ANTHEM BLUE CROSS
11030 WHITE ROCK ROADRANCHO CORDOVACA95670ADMINISTRATOR$6,140,250
MEDICARE
11030 WHITE ROCK ROADRANCHO CORDOVACA95670ADMINISTRATOR$1,787,125
PORAC
4010 TRUXEL ROADSACRAMENTOCA95834ADMINISTRATOR$908,798
INSURANCE BENEFIT TRUST OF PORAC
4010 TRUXEL ROADSACRAMENTOCA95834ADMINISTRATOR$669,896
MYER-STEVENS TOOHEY
26101 MARGUERITE PARKWAYMISSION VIEJOCA92692PROVIDER$511,876
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PARTICIPANT CONTRIBUTIONS900099$166,865,714$166,865,714
PREMIUM CONTRIBUTIONS REVENUE900099$8,246,062$8,246,062
FieldValueIRS element (for citing)
Total Program Service Revenue$175,111,776TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,911,496TotalRevenueColumnAmt
Exclusion$1,911,496ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$27,052,719SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$26,783,879SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$268,840SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$268,840TotalRevenueColumnAmt
Exclusion$268,840ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
OTHER900099$27,143,600$27,143,600
ADMIN FEE REVENUE900099$867,195$867,195
LTD CLAIMS RECOVERIES900099$600,219$600,219

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$300TotalRevenueColumnAmt
Related Or Exempt Func Income$300RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$28,611,314OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$205,903,426TotalRevenueColumnAmt
Related Or Exempt Func Income$203,723,090RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,180,336ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$192,554,828TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,090,570TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$174,933TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$33,509TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$267,984TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,568,247TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$52,466TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$75,836TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$9,356TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$73,429TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmt
ACA INSURER$79,546
PCORI FEE$41,557
SUPPLIES AND TELEPHONE$37,945
PRINTING$9,330

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$9,094TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$204,078,630TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$15,236,574BOYAmt
EOY$11,913,175EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$103,058BOYAmt
EOY$5,649,972EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$14,011,826BOYAmt
EOY$13,781,534EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$79,658BOYAmt
EOY$89,953EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$136,809LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$21,262LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$15,714BOYAmt
EOY$115,547EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$47,944,838BOYAmt
EOY$65,098,664EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$6,174,298BOYAmt
EOY$1,547,565EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$83,565,966BOYAmt
EOY$98,196,410EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,111,375BOYAmt
EOY$12,898,767EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,102,399BOYAmt
EOY$17,135,348EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$20,213,774BOYAmt
EOY$30,034,115EOYAmt
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$63,352,192BOYAmt
EOY$68,162,295EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$63,352,192BOYAmt
EOY$68,162,295EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$83,565,966BOYAmt
EOY$98,196,410EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,824,796ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$2,985,307NetUnrlzdGainsLossesInvstAmt
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$103,419OtherCostOrOtherBasisAmt
Book Value$103,419BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$33,390OtherCostOrOtherBasisAmt
Depreciation$21,262DepreciationAmt
Book Value$12,128BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$115,547TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
ACCRUED VACATION/PAYROLL TAXES$43,968
GROUP INSURANCE PREMIUMS PAYABLE$2,956,244
SELF-FUNDED BENEFITS CLAIMS PAYABLE$1,341,386
INCURRED BUT NOT REPORTED CLAIMS$12,779,000
DUE TO OTHER TRUST$14,750
FieldValueIRS element (for citing)
Total Liability$17,135,348TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$208,620,749TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$2,985,307NetUnrealizedGainsInvstAmt
Revenue Not Reported$2,985,307RevenueNotReportedAmt
Revenue Subtotal$205,635,442RevenueSubtotalAmt
Investment Expenses Not Incld$267,984InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$267,984RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$205,903,426TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$202,310,394TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$202,310,394ExpensesSubtotalAmt
Investment Expenses Not Incld2$267,984InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$1,500,252OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$1,768,236ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$204,078,630TotalExpensesPerForm990Amt

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 1,500,252.

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$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$155,764CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$8,012NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$163,776TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 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 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

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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