2019-04-30T18:14:21-05:00 2018-06-30 952648289 VAVRINEK TRINE DAY & CO LLP 1900 S NORFOLK STREET SUITE 225 SAN MATEO CA 94403 990 2017-07-01 916034674 ALASKA TEAMSTER EMPLOYER WELFARE TRUST ALAS 9075658310 520 EAST 34TH AVENUE NO 107 ANCHORAGE AK 99503 TRUSTEE TRUSTEE TRUSTEE 9075658310 2019-04-30 1 JENNIFER SNOW P01882015 9094664410 69.170.7.86 2019-04-30 18:13:43 PD P A8923EACCE2D6A4F1290DCBC04922AB836540ED7 79ACAE867A9DB9871DCF109F9EDC9C017100E02E 2017 2019-02-21 02:37:17Z 520 EAST 34TH AVENUE NO 107 ANCHORAGE AK 99503 37006064 0 X N/A X 1964 AK SEE PART III(A) 8 8 0 0 0 0 0 0 35387567 33462525 312596 448983 1638487 1686857 37338650 35598365 0 0 31161954 31172669 0 0 0 0 0 2609364 2419402 33771318 33592071 3567332 2006294 13003795 15492135 14722797 15293899 -1719002 198236 NONE 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE UNION AND THE EMPLOYERS 0 0 0 0 0 0 0 0 0 0 0 0 1 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 15 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X ALASKA TEAMSTER EMPLOYER SERVICE CO 9077519700 520 E 34TH AVE ANCHORAGE AK 99503 X KENNY GILL TRUSTEE 5.00 X 0 0 0 RICK BOYLES TRUSTEE 5.00 X 0 0 0 DEREK MUSTO TRUSTEE 5.00 X 0 0 0 EILEEN WHITMER TRUSTEE 5.00 X 0 0 0 SCOTT DEPAEPE TRUSTEE 5.00 X 0 0 0 TODD HENDERSON TRUSTEE 5.00 X 0 0 0 BARBARA HUFF-TUCKNESS TRUSTEE 5.00 X 0 0 0 FRANK MONFREY TRUSTEE 5.00 X 0 0 0 0 0 0 0 0 0 0 BENESYS 1220 SW MORRISON AVE SUITE 300 PORTLAND OR 97205 ADMINSTRATOR 540975 ALASKA TEAMSTERS EMPLOYER SERVICE CORPOR 520 E 34TH STREET SUITE 107 ANCHORAGE AK 99503 THIRD PARTY ADMINISTRATOR 540847 AETNA 151 FARMINGTON AVE 107 HARTFORD CT 06156 CLAIMS ADMINISTRATION 455704 OPTUM RX 2300 MAIN STREET IRVINE CA 92614 CLAIMS ADMINISTRATION 112619 HEALTHCARE STRATEGIES INC 5746 MARLIN ROAD SUITE 600 CHATTANOOGA TN 37411 CLAIMS ADMINISTRATION 107565 7 EMPLOYER CONTRIBUTIONS 900099 30223652 30223652 PARTICIPANT 900099 3238873 3238873 33462525 167855 167855 1688827 1407699 281128 281128 281128 EXPERIENCE REFUNDS 900099 1587402 1587402 MISCELLANEOUS 900099 99455 99455 1686857 35598365 35430510 0 167855 31172669 1535050 76636 79036 33409 61936 18602 23514 MEDICAL NETWORK 455704 CONSULTANT 126466 PATIENT CARE OUTCOME RE 7758 MISCELLANEOUS 1291 33592071 1384196 2993627 212358 269261 2780096 2552327 428795 415092 6896289 7734326 1302061 1527502 13003795 15492135 165918 246825 14556879 15047074 14722797 15293899 X 0 0 0 0 -1719002 198236 -1719002 198236 13003795 15492135 2006294 -89056 0 X X 0 1 X 1 0 0 PRESCRIPTION REBATE 236214 ULLICO DIVIDEND RECEIVABLE 359 STOP LOSS RECEIVABLE 1290929 1527502 CONTRIBUTIONS ADVANCED BY RETIREES 12798 GROUP INSURANCE PREMIUMS 264696 SELF-FUNDED BENEFIT CLAIMS 10098779 DOLLAR BANK RESERVE 4670000 DUE TO AFFILIATES 801 15047074 X 35509309 -89056 -89056 35598365 0 35598365 33592071 0 33592071 0 33592071 PART X, LINE 2: THE TRUST HAS ADOPTED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD. THE PLAN MANAGEMENT BELIEVES THAT THE TRUST HAS NOT TAKEN UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS AS A TAX LIABILITY. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS DELEGATED CONTROL OVER MANAGEMENT DUTIES CUSTOMARILY PERFORMED BY OR UNDER THE DIRECT SUPERVISION OF OFFICERS, DIRECTORS, TRUSTEES, OR KEY EMPLOYEES TO A CONTRACT ADMINISTRATOR. FORM 990, PART VI, SECTION B, LINE 11B THE TRUSTEES DESIGNATE THE ADMINISTRATOR TO REVIEW THE FORM 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY THE TRUSTEES SIGNING A FORM ANNUALLY. FORM 990, PART VI, SECTION C, LINE 18 THE ENTITY IS NOT A 501(C)(3) PLAN, AND IS THEREFORE NOT REQUIRED TO MAKE ITS FORM 990 AVAILABLE TO THE PUBLIC. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES IT'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON WRITTEN REQUEST. 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. ALASKA TEAMSTER EMPLOYER PENSION TRUST 520 EAST 34TH AVE SUITE 107 ANCHORAGE AK 99503 926003463 TO PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS. CA N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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.