2018-07-19T17:21:24-05:00 2017-09-30 522385296 LINDQUIST LLP 600 CITY PARKWAY WEST SUITE 300 ORANGE CA 92868 990 2016-10-01 956049026 OPERATING ENGINEERS LOCAL 501 SECURITY FUND OPER 6266461079 PO BOX 990 WEST COVINA CA 91793 EDWARD CURLY CHAIRMAN 6266461079 2018-07-19 1 RICHARD G THIERMANN P00974294 7142570100 2016 2022-09-23 18:48:47Z EDWARD CURLY PO BOX 990 WEST COVINA CA 91793 45622667 0 X N/A X 1952 CA TO PROVIDE HEALTH AND WELFARE BENEFITS. 8 0 0 0 0 0 0 0 47804855 44879292 643617 742875 58977 500 48507449 45622667 0 0 33113038 34022298 0 0 0 0 0 2215931 2005351 35328969 36027649 13178480 9595018 49058038 58093638 8804430 8417477 40253608 49676161 TO PROVIDE HEALTH AND WELFARE BENEFITS. 0 0 PROVIDED HEALTH AND WELFARE BENEFITS FOR PARTICIPANTS AND THEIR DEPENDENTS. 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 1052 0 1 0 0 0 0 0 0 0 X 8 0 0 1 0 0 0 0 0 1 0 0 0 1 1 0 0 1 1 0 0 0 X BARRY OSHAROW PLAN MANAGER BENESYS ADMINISTRATORS 6266461079 PO BOX 990 WEST COVINA CA 91793 X PAUL BENSI SECRETARY - PAST 5.00 X 0 0 0 WILL WEBSTER TRUSTEE 5.00 X 0 0 0 MIKE NAREZ TRUSTEE 5.00 X 0 0 0 DENISE VUKOJEVICH VICE CHAIRMAN 5.00 X 0 0 0 EDWARD CURLY CHAIRMAN 5.00 X 0 0 0 THOMAS O'MAHAR TRUSTEE 5.00 X 0 0 0 KEVIN DEVINE TRUSTEE - PAST 5.00 X 0 0 0 ERIC FLETT ALTERNATE TRUSTEE 2.00 X 0 0 0 JEFF PALMER ASSISTANT SECRETARY 5.00 X 0 0 0 KEVIN GLEASON SECRETARY 5.00 X 0 0 0 THOMAS CROSSER TRUSTEE 0.00 X 0 0 0 SEE SCHEDULE O FOR COMPENSATION PAID BY RELATED ORGANIZATION 0.00 X 0 1 0 0 1 0 0 0 0 0 BENESYS INC 1050 LAKE DR WEST COVINA CA 91790 CONTRACT ADMINISTRATOR 741264 LINDQUIST LLP 600 CITY PARKWAY WEST SUITE 300 ORANGE CA 92868 AUDIT 402485 CORNWELL & BALDWIN 1017 EAST GRAND AVENUE ESCONDIDO CA 92025 LEGAL SERVICE 144424 ANTHEM BLUE CROSS OF CALIFORNIA 21555 OXNARD ST WOODLAND HILLS CA 91367 NETWORK ACCESS FEES 144002 MILLIMAN 650 CALIFORNIA STREET 17TH FL SAN FRANCISCO CA 941082702 ACTUARY 114775 5 EMPLOYER CONTRIBUTIONS 900099 41714340 41714340 PARTICIPANT CONTRIBUTIONS 900099 2462666 2462666 PRESCRIPTION REBATE 900099 532198 532198 STOP LOSS REIMBURSEMENT 900099 170088 170088 44879292 742875 742875 MISC. REVENUE 900099 500 500 500 45622667 44879792 0 742875 34022298 929820 137012 207686 31084 464044 103132 7864 13856 44217 ER REINSURANCE FEE 61776 MEMBERSHIP DUES 4860 36027649 13682712 22508621 4243172 3882804 10765 10413 31121389 31691800 49058038 58093638 80452 41819 396631 436712 8327347 7938946 8804430 8417477 X 0 0 0 0 40253608 49676161 40253608 49676161 49058038 58093638 9595018 -172465 0 X X 0 1 X 1 0 0 CLAIMS PAYABLE AND IBNR 2071000 ACCUMULATED ELIGIBILITY CREDITS 5585000 DUE TO RELATED PLANS 282946 7938946 X 45419118 -172465 -172465 45591583 31084 31084 45622667 35951565 0 35951565 31084 45000 76084 36027649 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE THE TAX POSITIONS TAKEN BY THE PLAN AND TO RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF SEPTEMBER 30, 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 BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL YEARS PRIOR TO 2014. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION A, LINE 3 THE PLAN HAS A CONTRACT WITH A THIRD-PARTY ADMINISTRATOR TO PROVIDE DAY TO DAY ADMINISTRATIVE SERVICES FOR THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO OTHER COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 IS REVIEWED BY THE FUND MANAGER AND THEN BY THE BOARD OF TRUSTEES. 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. 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 ADMINISTRATORS. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE ANNUAL AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THERE HAS BEEN NO CHANGE IN THIS PROCESS FROM PRIOR YEAR. INTERNATIONAL UNION OF OPERATING ENGINEERS LOCAL NO 501 2405 WEST 3RD STREET LOS ANGELES CA 90057 951751526 LABOR UNION CA 501(C)(5) N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 SEPTEMBER 30, 2017, THERE ARE 72 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. THE FEDERAL TAX CLASSIFICATION (DISREGARDED ENTITY, TAX-EXEMPT ORGANIZATION, 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. 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