2018-07-13T14:48:10-05:00 2017-08-31 952648289 VAVRINEK TRINE DAY & CO LLP 1900 S NORFOLK STREET SUITE 225 SAN MATEO CA 94403 990 2016-09-01 996014749 HAWAII LABORERS HEALTH AND WELFARE PLAN HAWA 8084418600 1440 KAPIOLANI BLVD NO 800 HONOLULU HI 96814 TRUSTEE TRUSTEE TRUSTEE 8084418600 2018-07-13 1 P00739466 9094664410 2016 2022-09-23 18:48:47Z TRUSTEE 1440 KAPIOLANI BLVD NO 800 HONOLULU HI 96814 225297559 0 X N/A X 1967 HI SEE PART III LINE 4A 10 10 1 0 0 0 0 0 34047666 34585825 1747568 4528948 316625 1307110 36111859 40421883 0 0 35560511 38957702 110479 114700 0 0 0 2868165 3103558 38539155 42175960 -2427296 -1754077 92866867 92765470 25152119 27466045 67714748 65299425 NONE 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR BENEFICIARIES ACCORDING TO THE TERMS OF THE COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE EMPLOYERS AND THE UNION. 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 1 615 0 1 1 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X PACIFIC ADMINISTRATORS INC 8084418600 1440 KAPIOLANI BLVD SUITE 800 HONOLULU HI 96814 X ALFONSO OLIVER TRUSTEE 5.00 X 0 0 0 PETER GANABAN TRUSTEE 5.00 X 0 0 0 JOBY NORTH II TRUSTEE 5.00 X 0 0 0 ANACLETO ALCANTRA TRUSTEE 5.00 X 0 0 0 RICHARD NISHIE TRUSTEE 5.00 X 0 0 0 MARK MATSUMOTO TRUSTEE 5.00 X 0 0 0 RUSSELL NONAKA TRUSTEE 5.00 X 0 0 0 MARK TAMASHIRO TRUSTEE 5.00 X 0 0 0 RON PRESCOTT TRUSTEE 5.00 X 0 0 0 MARK TAGAMI TRUSTEE 5.00 X 0 0 0 0 0 0 0 0 0 0 PACIFIC ADMINISTRATORS INC 1440 KAPIOLANI BLVD SUITE 800 HONOLULU HI 96814 PLAN ADMINISTRATION 1795529 RENALOGIC 22601 N 19TH AVE SUITE 230 PHOENIX AZ 85027 COST CONTAINMENT 266762 MILLIMAN 650 CALIFORNIA STREET 17TH FLOOR SAN FRANSISCO CA 94108 CONSULTANT 147246 HAWAII DENTAL SERVICE 700 BISHOP STREET SUITE 700 HONOLULU HI 96813 CLAIMS ADMIN 118246 DONNA ROBINSON 1454 AALAPAPA KAILUA HI 96734 NURSE 114701 5 EMPLOYER CONTRIBUTIONS 900099 33584389 33584389 PARTIC. CONTRIBUTIONS 900099 911793 911793 COBRA CONTRIBUTIONS 900099 89643 89643 34585825 2319286 2319286 187085338 184875676 2209662 2209662 2209662 STOP LOSS REIMBURSEMENT 900099 970839 970839 PREMIUM REFUNDS 900099 208236 208236 LIQUIDATED DAMAGES 900099 107497 107497 20538 20538 1307110 40421883 38102597 0 2319286 38957702 51471 9018 15682 38529 2180652 81262 41554 173206 310922 170367 14669 23508 NATIONAL HEALTH FUND 59709 ACA REINSURANCE FEE 36864 PCORI FEE 8851 OTHER 1994 42175960 11756236 5010788 2683222 3035519 24520 23413 77384937 82724687 1017952 1971063 92866867 92765470 228673 110299 24923446 27355746 25152119 27466045 X 0 0 0 0 67714748 65299425 67714748 65299425 92866867 92765470 -1754077 -661246 0 X X 0 1 X 1 0 0 CLAIMS INCURRED BUT NOT REPORTED 3024661 ACCUMULATED ELIGIBILITY CREDITS 24224553 DUE TO BROKER 106532 27355746 X 39760637 -661246 -661246 40421883 0 40421883 42175960 0 42175960 0 42175960 PART X, LINE 2: THE PLAN HAS ADOPTED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR FISCAL YEARS PRIOR TO AUGUST 31, 2014. FORM 990, PART VI, SECTION B, LINE 11B THE CHAIR AND CO-CHAIR REVIEW THE FORM; THE TRUSTEES ARE PROVIDED A COPY OF THE FORM 990 FOR THEIR REVIEW PRIOR TO SIGNING AND FILING. FORM 990, PART VI, SECTION B, LINE 12C DURING EACH REGULARLY SCHEDULED BOARD OF TRUSTEE MEETING, THE CONSULTANTS GIVE DETAILED REPORTS ON VARIOUS ASPECTS OF THE FUND'S ACTIVITIES. IN THE COURSE OF THESE REPORTS, POTENTIAL OR ACTUAL CONFLICTS OF INTEREST MAY BE REVEALED. EVERY SITUATION, SHOULD THEY ARISE, IS DEALT WITH IN THE APPROPRIATE MANNER BASED ON THE GUIDELINES SET FORTH IN THE POLICY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL INFORMATION ARE AVAILABLE UPON REQUEST AS STATED IN THE SUMMARY ANNUAL REPORTS THAT ARE DISTRIBUTED EACH PLAN YEAR TO ALL PLAN PARTICIPANTS. FORM 990, PART XI, 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. HAWAII LABORERS ANNUITY FUND 1440 KAPIOLANI BLVD STE 800 KAPOLEI HI 96814 990322478 TO PROVIDE AND MAINTAIN AN ANNUITY FUND FOR THE ELIGIBLE PARTICIPANTS HI 501(C)(9) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FORM 990, PART IV, LINE 34 THE FILING ENTITY IS A 501(C)(9) VEBA WHO MUST LIST CONTRIBUTING EMPLOYERS ON SCHEDULE R. THE ADMINISTRATIVE OFFICE MAINTAINS A LIST OF CONTRIBUTING EMPLOYERS, HOWEVER, THAT LIST DOES NOT INCLUDE FEDERAL TAX CLASSIFICATION. THEREFORE, THE LIST OF CONTRIBUTING EMPLOYERS IS REPORTED ON PART VII, SUPPLEMENTAL INFORMATION. 808 UNDERGROUND UTILITIES, INC. AALBERTS RELIABLE CLEANING CO. ACCESS LIMITED CONSTRUCTION ADVANCED FENCE SOLUTIONS, LLC ADVANTAGE LANDSCAPE HAWAII, INC. AFFILIATED CONSTRUCTION, LLC AKAMAI BUILDERS, INC. ALAN SHINTANI, INC. ALBERT C. KOBAYASHI, INC. A-LEGACY CONSTRUCTION LLC ALL POOL & SPA WATERSCAPE ALLIED CONSTRUCTION INC. ALLIED SECURTIY FENCE COMPANY, LLC. AMERICAN CIVIL CONSTRUCTORS WEST COAST, INC. AMERICAN PIPING & BOILER CO INC AMG SERVICES APEX CLEANING, INC. ARTECH CONSTRUCTION GROUP, INC. B & C MASONRY BAUSKE ENVIRONMENTAL INC DBA BENDCO BEST VINYL FENCE & DECK, LLC. BLACKBURN CLEANING SERVICES BLACKMORE BRADY HAWAII LLC BLASTING TECHNOLOGY, INC BRIAN'S CONTRACTING BURNETT'S TERMITE & PEST CONTROL C.J. PETERSON SERVICES INC. CENTRAL CONSTRUCTION CHARLES PANKOW BUILDERS, LTD. CHOICE FENCE, INC. CHRIS CURTIS LANDSCAPE CO CJA-HDCC JV CLEANING SPECIALISTS OF HONOLULU CLOSE CONSTRUCTION, INC. CMZ OF HAWAII INC. COASTAL CONSTRUCTION CO COLUCCIO FRANK CONSTRUCTION COMMERCIAL ELECTRIC INC CONDON-JOHNSON ASSOCIATES, INC. CONSTRUCTORS HAWAII, INC. CONTECH SERVICES, INC. CORALCO CORPORATION CREDO CONSTRUCTION, INC. D & C PLUMBING INC. D.Y. MIKAMI CONSTRUCTION DAVID'S FENCING, INC. DAVIDSON'S MASONRY, INC. DCK PACIFIC CONSTRUCTION, LLC. DE LIMA'S DRILLING, INC. DELTA CONSTRUCTION CO DENNIS HIEBERT DESIGNER BUILT SYSTEMS, INC. DIANE'S CLEANING CONTRACTOR, LLC DME CONCRETE & MASONRY, INC. DURA CONSTRUCTORS, INC DYK INCORPORATED EARTHWORKS PACIFIC INC. EDWARDS & SANDS CONSTRUCTION CO ELECTRICAL CONTRACTORS HAWAII, INC. ELITE CONCRETE LLC ENVIRONMENTAL CONTROL SPECIALIST, INC. EXCAVATION HAWAII, INC. EXCAVATIONS ETC., INC. F & H CONSTRUCTION FIBRWRAP CONSTRUCTION SERVICES USA FINISHING EDGE CURB & SIDEWALK INC. FONG CONSTRUCTION COMPANY FOUNDATION INTERNATIONAL FOUNDATIONS HAWAII INC FRED LAU/HAWN LANDSCAPE CO GARNER CONSTRUCTION, INC. GENTRY BUILDERS, LLC GIMA PEST CONTROL, INC. GLAD'S LANDSCAPING & TREE TRIMMING GOODFELLOW BROS INC GP ROADWAY SOLUTIONS, INC. GPRM PRESTRESS, LLC GRAMERCY GROUP, INC. GRANITE CONSTRUCTION COMPANY GREEN THUMB INC GROUP BUILDERS, INC HALLER NURSERY INC HAMON CUSTODIS HARON CONSTRUCTION INC HAWAII LABORERS HEALTH & WELFARE TRUST FUND HAWAII LABORERS LECET HAWAII LABORERS TRAINING HAWAII MASONRY & DEVELOPMENT CORP HAWAII MVCC, LLC. HAWAII PACIFIC CONCRETE & PAVING INC. HAWAIIAN CRUSH INC. DBA HAWAIIAN CRUSH CLEANING SERVICES HAWAIIAN SIGN & DESIGN HAWAIYA TECHNOLOGIES, INC. HAWN DREDGING CONSTRUCTION CO HAYWARD BAKER, INC. HEALY TIBBITTS BUILDERS INC HENSEL PHELPS CONSTRUCTION CO. HIGHWAY CONSTRUCTION CO HI'ILAWE CONSTRUCTION, LLC HI-TECH ROCKFALL CONSTRUCTION, INC. HK FENCE, LLC HO'ONANI LANDSCAPING, LTD. HYDROSEEDING HAWAII, LLC. IDEAL CONSTRUCTION, INC IIDA T CONTRACTING COMPANY IMPACT ENVIRONMENTS INDUSTRIAL RESOURCES INC INDUSTRIAL SOLUTIONS & SERVICES, INC. INOUYE RALPH S INTEGRATED CONSTRUCTION INC ISEMOTO CONTRACTING CO ISLAND LANDSCAPE & MAINTENANCE, INC. ISLANDWIDE FENCING, INC. ITC WATER MANAGEMENT, INC. J & J WORLDWIDE SERVICES J. TAMASHIRO INC. JAMES W FOWLER CO JAYAR CONSTRUCTION, INC JDH CONSTRUCTION LTD JDS CONSTRUCTION JJS CONSTRUCTION INC JOHNSON BROS. CORPORATION, A SOUTHLAND CO KAIKOR CONSTRUCTION COMPANY, INC KAILUA ELECTRIC SERVICE KAMALI'I TRUCKING & RENTALS, INC. KAPOLEI GOLF COURSE KAUAI BUILDERS, LTD. KAYA ROBERT BUILDERS KELIKAI INC. KELIKAI PACIFIC FOUNDATION KIEWIT BUILDING GROUP, INC. KIEWIT INFRASTRUCTURE WEST CO. KIEWIT/KOBAYASHI JOINT VENTURE KIHEI GARDENS & LANDSCAPING CO., LLP KLEEN RITE OF KONA KOGA ENGINEERING & CONSTRUCTION KONA COUNTRY CLUB INC LABORERS UNION LOCAL 368 LANDAN CONSTRUCTION, INC. LANDSCAPE CONCEPTS INC LANGOIA NISA DBA NISA CONTRACTOR LAYTON CONSTRUCTION COMPANY, LLC. LEDCOR CONSTRUCTION HAWAII, LLC LEE RICHARD H S INC LEEWARD LANDSCAPE, INC LEIGH DIVERSIFIED CONSTRUCTION INC. LEND LEASE (US) PUBLIC PARTNERSHIP, LLC LESLIE'S DRILLING LLS PACIFIC LTM EXECUTIVE CLEANING, INC. M E I CORPORATION M. SHIROMA CONSTRUCTION CO. MALACHI CLEANING MALCOLM DRILLING CO OF HAWAII MARYL PACIFIC CONSTRUCTORS MASONRY SYSTEMS HAWAII, INC. MAUI WATERSCAPES, LLC MCCLONE CONSTRUCTION COMPANY MEGA CONSTRUCTION INC MICHELS CORPORATION MIRA IMAGE CONSTRUCTION, LLC MITSUNAGA CONSTRUCTION, INC MK ELECTRIC LLC MOCON CORPORATION MORT DRILLING SERVICES, INC. MYERS & SONS CONSTRUCTION, LP NAKAMURA TAKANO LANDSCAPING NAN, INC. NATIONAL CONCRETE SAWING NEW TRANSFORMATION, LLC NORDIC PCL CONSTRUCTION, INC. NORTHSTAR CONTRACTING GROUP, INC. OKADA TRUCKING ONO CONSTRUCTION, LLC. PACIFIC AQUASCAPES, INC. PACIFIC CONCRETE CUTTING & CORING, INC. PACIFIC CONCRETE WORKS PACIFIC DECORATIVE CONCRETE, INC. PACIFIC FOUNDATION, INC. PARADIGM CONSTRUCTION LLC PARADISE LANDSCAPE MAINTENANCE, INC PARSONS RCI INC. PAUL'S ELECTRICAL SERVICE INC PENHALL COMPANY PERFORMANCE MECHANICAL, INC. PETERSON BROS. CONSTRUCTION INC. PINEBACK LANDSCAPING, INC. PRECISION GUNITE INC PREMIERE GREENS PRIME CLEAN, INC. PROGRESSIVE LANDSCAPING INC PROMETHEUS CONSTRUCTION QUALITY GENERAL, INC. R & D TECHNOLOGIES INC R K IIDA, LLC R5 FENCING, LLC. RAINMAKER, INC. RAMBAUD ELECTRIC, LLC REEF DEVELOPMENT OF HAWAII, INC. REISOC CONSTRUCTION CORP. RESORT MANAGEMENT GROUP, LLC RESORT MANAGEMENT GROUP-MAUI RIVIERA JRC HAWAII, LLLP RMY CONSTRUCTION INC ROAD AND HIGHWAY BUILDERS, LLC. ROAD BUILDERS ROAD SAFETY SERVICE & DESIGN ROBERT A. BOTHMAN, INC. ROJAC CONSTRUCTION, INC. RON D ELECTRICAL SERVICE, LLC. RON'S CONCRETE SPECIALISTS LTD RONS CONSTRUCTION COMPANY ROYAL CONTRACTING CO LTD ROYAL ELECTRIC COMPANY ROYAL PALM CONSTRUCTION & LANDSCAPING ROYAL PALM MAINTENANCE SERVICE S & M SAKAMOTO, INC. S.A. HEALY CO. S.J. GENERAL BUILDING MAINTENANCE, INC. SAFETY SYSTEMS AND SIGNS HAWAII, INC. SALINAS CONSTRUCTION, INC. SCHNABEL FOUNDATION COMPANY SEA ENGINEERING, INC. SERVICE CONTRACTING SF MASONRY SHIMMICK/TRAYLOR/GRANITE JV SHIOI CONSTRUCTION INC SITE ENGINEERING INC. SKY HIGH CLEANING, LLC. SKYLANI CLEANING CONTRACT SOUTHEAST DIRECTIONAL DRILLING SOUTHLAND MOLE JV ST RHOADES CONSTRUCTION, INC. STRUCTURAL DYNAMICS INC. STRUCTURAL PEST CONTROL, INC. SUMMIT CLEANING SUNRISE TO SUNSET, LLC SUPERIOR CONCRETE SERVICES, INC. SWINERTON BUILDERS T. MASANIAI CONTRACTOR TAJIRI RECYCLING & DEMOLITION LLC TAU MASONRY, LLC TAUFATOFUA MASONRY CONTRACTOR TECK, INC TESTRON LOGISTICS THE NAKOA COMPANIES, INC. TILECO, INC. TKH CONSTRUCTION, LLC TOKUNAGA MASONRY, INC TOMCO CORPORATION TOMMY S. TOMA CONTRACTOR, INC. TRANSPACIFIC INNOVATORS, LLC TRAYLOR BROS. INC. UNITED PATRIOT ABATEMENT SERVICES, LLC UNITEK INSULATION, LLC UNLIMITED CONSTRUCTION SERVICES VALLEY ISLE FENCING VINYL TECH & MASONRY INC. W.W. CLYDE & CO. WAIALUA PLUMBING & MECHANICAL, INC. WALKER-MOODY ASPHALT MAINTENANCE WALSH CONSTRUCTION COMPANY WATTS CONSTRUCTORS, INC. WDI COMPANIES, INC. WESTERN WATER FEATURES, INC. YHB HI KAI GC DBA HAWAII KAI GOLF COURSE YHB MILILANI GC, LLC. YOSHIMURA T CONTRACTING INC ZELINSKY COMPANY ZOE BUILDERS, INC.