2018-11-10T13:44:18-06:00 2017-12-31 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2017-01-01 946138741 WELFARE FUND LOCAL NO 16 IATSE WELF 9252089999 7180 KOLL CENTER PARKWAY NO 200 PLEASANTON CA 94566 STEVE LUTGE TRUSTEE 9252089999 2018-11-10 1 JASMINE S BAKER P01452246 9252779100 66.7.226.66 2018-11-10 11:44:08 PS P D85FB602DC4FA66F28A631CB81EF53DF59ECABFA 92C7F91AD246760067C653CBF66B8BF12B4D5FD1 2017 2019-02-21 02:37:17Z X IATSE LOCAL 16 HEALTH AND WELFA STEVE LUTGE 7180 KOLL CENTER PARKWAY NO 200 PLEASANTON CA 94566 17034574 0 X WWW.LOCAL16.ORG X 1965 CA TO PROVIDE HEALTH & WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 8 0 0 0 0 0 0 0 16897593 16801416 190288 233158 178 0 17088059 17034574 0 0 12438503 17974492 0 0 0 0 0 612965 839252 13051468 18813744 4036591 -1779170 12614483 12292073 41336 5978344 12573147 6313729 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 PROVIDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 1 0 0 0 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 1 464 0 1 0 0 0 0 0 0 0 X 8 0 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X BENESYS ADMINISTRATORS 9252089999 7180 KOLL CENTER PARKWAY SUITE 200 PLEASANTON CA 94566 X GREG HOLLAND TRUSTEE 1.00 X 0 0 0 DEBRA BERNARD TRUSTEE 1.00 X 0 0 0 JAMES BEAUMONTE TRUSTEE 1.00 X 0 0 0 STEVE LUTGE TRUSTEE 1.00 X 0 0 0 SCOTT A HOUGHTON TRUSTEE 1.00 X 0 0 0 KENNETH RYAN TRUSTEE 1.00 X 0 0 0 LANCE HUGHSTON JR TRUSTEE 1.00 X 0 0 0 BOB SAUTER TRUSTEE 1.00 X 0 0 0 SEE SCHEDULE O FOR COMPENSATION PAID BY RELATED ORGANIZATIONS 0.00 X 0 1 0 0 1 0 0 0 0 0 BENESYS 7180 KOLL CENTER PKWY STE 200 PLEASANTON CA 94566 THIRD PARTY ADMINISTRATOR 276916 ANTHEM BLUE CROSS 2121 N CALIFORNIA BLVD 700 WALNUT CREEK CA 94596 CLAIMS ADMINISTRATION FEES 247038 2 EMPLOYER CONTRIBUTIONS 525100 13192935 13192935 STOP LOSS REIMBURSEMENT 525100 2608742 2608742 PARTICIPANT CONTRIBUTIONS 525100 716192 716192 PRESCRIPTION REBATES 525100 192990 192990 MEDICARE PART D SUBSIDY 525100 90557 90557 16801416 233158 233158 17034574 16801416 0 233158 17974492 247958 28176 33735 12499 344262 98991 11319 62312 18813744 3930822 3329628 1974056 1877075 13735 14637 5965397 6182173 730473 888560 12614483 12292073 41336 2330344 0 3648000 41336 5978344 X 0 0 0 0 12573147 6313729 12573147 6313729 12614483 12292073 -1779170 221152 -4701400 0 X X 0 1 X 1 0 0 COLLECTIVE TRUST FUND 888560 C 888560 ACCUMULATED ELIGIBILTY CREDITS 3648000 3648000 X 17243227 221152 221152 17022075 12499 12499 17034574 17542645 0 17542645 12499 1258600 1271099 18813744 PART X, LINE 2: THE PLAN'S ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF DECEMBER 31, 2017, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN'S ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE YEARS PRIOR TO 2014. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION A, LINE 3 THE TRUST HAS CONTRACTED WITH BENESYS ADMINISTRATORS TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE 990 IS PROVIDED TO THE BOARD OF TRUSTEES FOR APPROVAL PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT-OF-INTEREST POLICY BY COMPLYING WITH ALL APPLICABLE PROVISIONS OF ERISA, INCLUDING PART-IN-INTEREST AND CONFLICT-OF-INTEREST PROVISIONS OF ERISA SECTION 406. ANY CONFLICTS OR POTENTIAL CONFLICTS ARE REPORTABLE TO THE CHAIRMAN OF THE BOARD OF TRUSTEES AND LEGAL COUNSEL FOR THE PLAN. 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, LINE 1A TRUSTEES ARE NOT COMPENSATED BY THE TRUST. COMPENSATION PAID TO TRUSTEES EMPLOYED BY OTHER RELATED ORGANIZATIONS IS REPORTED ON THE FORM 990 FILED WITH THE INTERNAL REVENUE SERVICE BY THE RELATED TAX-EXEMPT ORGANIZATION. IF YOU WOULD LIKE ADDITIONAL INFORMATION, PLEASE CONTACT THE THIRD PARTY ADMINISTRATOR, BENESYS, INC. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A BOARD OF TRUSTEES THAT ASSUMES RESPONSIBILTY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED, IATSE LOCAL 16 PENSION PLAN 240 2ND STREET SAN FRANCISCO CA 94105 946296420 PENSION PLAN CA 501(A) N/A N/A 0 IATSE LOCAL 16 TRAINING TRUST FUND 240 2ND STREET SAN FRANCISCO CA 94105 616335362 TRAINING FUND CA 501(C)(9) N/A N/A 0 INTERNATIONAL ALLIANCE OF THEATRICAL STAGE EMPLOYEES LOCAL 16 240 2ND STREET SAN FRANCISCO CA 94105 940921920 LOCAL UNION CA 501 (C) (5) N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF DECEMBER 31, 2017, THERE ARE APPROXIMATELY 221 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATBASE OF THESE CONTRIBUTING EMPLOYERS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. THE FEDERAL TAX CLASSIFICATION (DISREGARDED ENTITY, TAX EXEMPT ORANIZATION, PARTNERSHIP, TAXABLE CORPORATION OR TRUST) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT THE NAMES OF THE CONTRIBUTING EMPLOYERS ARE LISTED ON PART VII BELOW AND NOT ON PARTS II THROUGH IV BY FEDERAL TAX CLASSIFICATION. 1540 PRODUCTIONS/CONCEPT SERVICES 20TH CENTURY FOX TELEVISION/EP 32TEN KERNER BOULEVARD STUDIOS, INC/CAPS 32TEN STUDIOS / CAPS A TRIVISION PRODUCTION/THE TALENT FUND PC-80 - ACADEMY THEATRICAL LIGHTING, INC. ACME SCENERY COMPANY ADAM BOMB PRODUCTIONS AEG MANAGEMENT OAKLAND, LLC AESTHETIC VISUAL SOLUTIONS/THE TALENT FUND ALL STAR GROUP/ THE TALENT FUND ALLIANT EVENT SERVICES/THE TALENT FUND AMERICAN AUDIO-VISUAL CENTER AMERICAN CONSERVATORY THEATER ANDERSON AV RENTALS/THE TALENT FUND ANOTHER PLANET ENTERTAINMENT/TALENT FUND ASCE/ SF PERFORMING ARTS ASSEMBLY FILMS, INC. ATL (ACADEMY THEATRICAL LIGHTING) EVENTS AUDIO VISUAL SERVICES UNLIMITED AUDIO XL/THE TALENT FUND AV DIMENSIONS/THE TALENT FUND AVX AUDIO VISUAL/THE TALENT FUND AXS TV (AKA -HDNET LLC)- THE TALENT FUND B-REEL FILMS, INC BBI ENGINEERING, INC. BELIEVE MEDIA/CAPS UNIVERSAL BEYOND PIX/ THE TALENT FUND BIG INDIE - BEAUTIFUL BOY/EP BISCUIT FILLMWORKS LLC/CAPS BLACK POINT PROD/ TALENT FUND BRIGHTSOURCE/THE TALENT FUND BUTLER & ASSOC/THE TALENT FUND CADMIUM CD CAPS INC DBA UNIVERSAL PAYMENT DBA OLYMPIC PARTNER CAST AND CREW CAVIAR CONTENT/CAPS CHARLIE COMPANY CORP/CAPS CIRQUE DU SOLEIL AMERICA, INC CITY ARTS/THE TALENT FUND CITY BALLET SCHOOL, LLC/PATSEL, KENNETH CLARITY TECH SOLUTIONS/ THE TALENT FUND CLOSE UP PRODUCTIONS/THE TALENT FUND CMI COMMUNICATIONS / UNION PAYROLL CMS PRODUCTIONS/CAPS COAST TO COAST PRODUCTION MGMT COLOSSAL CLUSTERFEST/ THE TALENT FUND COMPANY FILMS/FSI CONCEPT SERVICES LLC CORPORATE AV PRODUCTIONS/ THE TALENT FUND CORPORATE MANAGEMENT SOLUTIONS INC/FORWARD PCA COW PALACE/#1A DIST AGRI ASSN CREATIVE TECHNOLOGY GROUP/DBA AVTS CURRAN LIVE/ CONCEPT SERVICES DC INTERPRETATION/THE TALENT FUND DIVERSIFIED STAGE DODD TECHNOLOGIES DOOMSDAY ENTERTAINMENT/CAPS DTC GRIP & ELECTRIC, INC. E2 OPEN, LLC - THE TALENT FUND ECLIPSED SF, LLC EMOTION STUDIOS INC. EMPLOYEE LEASING SOLUTIONS INC/TEAM ENCORE EVENT TECHNOLOGIES INC FKA AVT EVENT ENHANCED LIGHTING/ THE TALENT FUND ENTERTAINMENT PARTNERS EVENT PRODUCTIONS INC EVENT TECHNOLOGIES EXTREME REACH TALENT, INC FILM 49 PRODUCTIONS / EP FILM COMMERCIAL CA INC FILM STAGE & SHOWBIZ EXPO/THE TALENT FUND FLEXVISUAL INC/THE TALENT FUND FMAV/THE TALENT FUND FORT MASON CENTER FORWARD PROCESSING CA INC FOUR MOON PRODUCTIONS/THE TALENT FUND FREEMAN AUDIO VISUAL SOLUTIONS INC. FRISCHKORN AUDIO VISUAL FULL MOON FILMS INC/NCI PROCESSING GES - GLOBAL EXPERIENCE SPECIALISTS, INC. GLP CREATIVE/MAIN PROCESSING INC. GOLDEN STATE SOUND HALLWAY PRODUCTIONS/UNION PAYROLL HARTMANN STUDIOS, INC. HOLZMUELLER CORPORATION HORIZON SCRIPTED TELEVISION/C&C HUGHSTON ENGINEERING ICONOCLAST CONTENT, INC/CAPS IDEAS SPECIAL EVENTS CO. IMAGES AUDIOVISUALS/THE TALENT FUND IMMERSIVE ENVIRONMENTS/CONCEPT SERVICES INC IMPACT ENTERTAINMENT/ TALENT FUND IMPACT LIGHTING INC IMPERIAL WOODPECKER/CAPS INDIEPAY, LLC. INTO THE WOODS ISLAND CREATIVE MANAGEMENT JCD ATMOSPHERICS, INC/CONCEPT SERVICES INC JHE PRODUCTION GROUP/ THE TALENT FUND JSTRYKER/THE TALENT FUND JUST HAPPY DBA CARUSO COMPANY/THE TALENT FUND KALEIDOSCOPE PRODUCTIONS KFJ PRODS LLC/UNTITLED OAKLAND PROJECT/ C&C KONTENT FILMS L.O.Z. PRODUCTIONS, INC. / C&C LABOR RESOURCE MANAGEMENT INC. LIGHTSWITCH/CONCEPT SERV. PAYROLL LIVE BOX DIGITAL LLC LIVE NATION LIVE NATION/FILLMORE LMG TECHNICAL SERVICES, LLC LOGIC SYSTEMS PROD/THE TALENT FUND LUCKY FOOT PRODUCTIONS/MAIN PROCESSING INC LUMENS/THE TALENT FUND MAC PRODUCTIONS/THE TALENT FUND MACRO PRODUCTIONS / UNION PAYROLL MAGNETIC IMAGE VIDEO MAIN PROCESSING INC. MARIN SYMPHONY ASSOCIATION MARINES MEMORIAL THEATRE MC CUNE AUDIO VISUAL/SHEPARD AV MEETING SERVICES INC MEETING SERVICES INC/UNION PAYROLL MODOP FILMS/EP MORTIN, JANKEL, ZANDER/FPS MOXIE PICTURES INC/CAPS UNIVERSAL MPG-MULTIMEDIA PR/THE TALENT FUND MUNDAY AND COLLINS/THE TALENT FUND MUSE MEDIA CENTER, INC. MUSSON THEATRICAL NMR, INC. / CAPS OAKLAND MOVING PICTURES, LLC/C&C ON SERVICES, A GES COMPANY OUTSIDE LANDS/THE TALENT FUND PAEINC CORP PALACE FINE ARTS LEAGUE, INC. PARADIGM PROD GROUP/THE TALENT FUND PARADIGM STUDIOS, INC. PARAMOUNT PICTURES/C&C PARK PICTURES LLC/CAPS PECUBU PRODUCTIONS, INC./CAPS PLAN - IT INTERACTIVE PLEIN SOLEIL INC/NCI PROCESSING INC PRESENTATION SERVICES PRO AUDIO VIDEO RENT PRO PROD. PRO AV/ UNION PAYROLL AGENCY PRO HOME SYSTEMS PRO MEDIA/SERB SYSTEMS, INC. PRODUCTION ALLIANCE GRP/THE TALENT FUND PRODUCTION PLUS TECHNOLOGIES/UNION PAYROLL PRODUCTION RESOURCE GROUP/CONCEPT SERVICES PRODUCTION SUPPORT SERVICES PROFESSIONAL SOUND PROD/THE TALENT FUND PROJECTION PRESENTATION TEC PYM PARTICLES PRODUCTIONS II, LLC/C&C RENT-A-COMPUTER DBA CCT TECH/MENLO EVENT SERVICES RICK HERNS PRODUCTIONS/THE TALENT FUND RIVERVIEW SYSTEMS GROUP ROCKET SCIENCE ROMAN HOLIDAY SAN MATEO COUNTY EXPO CENTER SANCTUARY CONTENT INC/ CAPS SANTA ROSA SYMPHONY SATIS & FY LLC/UNION PAYROLL AGENCY SCIENCE NORTH/EP SEAMLESS SHOW/ THE TALENT FUND SF BALLET ASSOCIATION SF OPERA ASSOCIATION SF PERFORMING ARTS CENTER SF SYMPHONY ASSOCIATION SHORENSTEIN HAYS-NEDERLANDER SHOW GEAR PRODUCTIONS/THE TALENT FUND SHOWTIME PICTURES DEVELOPMENT/EP SIDESTREET ENTERTAINMENT INC/C&C SLIM PICTURES/CAPS SMART SOURCE RENTALS/ THE TALENT FUND SMARTSOURCE/THE TALENT FUND SMG FACILITY SERVICES LLC SOMETHING DEAL, INC DBA M SS NG P ECES/CAPS SONIC FOUNDRY/THE TALENT FUND SOUND ON STAGE, INC. STAGE CALL, INC. STANFORD/CONCEPT SERVICES STATION FILM/CAPS STREAM VPG/THE TALENT FUND STUN CREATIVE/TEAM SERVICES ENTERTAINMENT & MEDIA SULLIVAN PRODUCTIONS/THE TALENT FUND TAYLOR STREET PRODUCTION/ TALENT FUND TELEPROS/THE TALENT FUND TERRAMAR CREATIVE/THE TALENT FUND THE ADMIN AWARDS/THE TALENT FUND THE AV GUYS/THE TALENT FUND THE BIG PICTURE FILM & VIDEO THE LITTLE GIANT LIGHTING & GRIP CO THE TALENT FUND THEATRICAL RESOURCES/C&C TOOL OF NO AMERICA/CAPS TREASURER COUNTY OF MARIN TREEHOUSE DESIGN/ISLAND CREATIVE MANAGEMENT TS PRODUCTIONS/THE TALENT FUND TVM PRODUCTIONS / EP TWIGHLIGHT DESIGN LLC/THE TALENT FUND TWILIGHT DESIGN/MILLS, JEFFRY TWILIGHT DESIGN/THE TALEN FUND UNPRONOUNCEABLE PRODUCTIONS, LLC / C&C UTP PRODUCTIONS, INC. VAI DBA WORLDSTAGE/ TEAM VCI EVENT TECHOLOGY/THE TALENT FUND VIDEOLOGY/THE TALENT FUND VILLAN DESIGN STUDIOS VILLAN PRODUCTIONS VIVID LIFE PRODUCTIONS/THE TALENT FUND WALK DON'T RUN PRODUCTIONS LLC/EP WELLS FARGO CENTER WONDROS/AKA HUNGRY HEART/CAPS WOODBRIDGE PRODUCTIONS LTD WORLD WAR SEVEN STUDIOS/CAPS WORRY FREE, LLC/ GREENSLATE, LLC YARD DOG TV / CAPS YERBA BUENA CENTER FOR THE ARTS