2017-03-24T17:16:45-05:00 2016-05-31 MILLER KAPLAN ARASE LLP 600 STEWART ST STE 618 SEATTLE WA 981011261 990 2015-06-01 930478837 THE BLEDSOE HEALTH TRUST % GARTH FISHER BLED 2063294900 2323 EASTLAKE AVE E SEATTLE WA 98102 RODGER M GLOS CHAIRMAN 2063294900 2017-03-23 true Crane Curran P01499738 2065963930 2015 2021-01-29 14:40:06Z RODGER M GLOS 2323 Eastlake Ave E Seattle WA 98102 89759154 false X N/A X 1959 OR SEE SCHEDULE O 9 0 0 0 0 0 0 46526518 47428327 8012909 3487789 199 1196 54539626 50917312 0 0 56361051 51447942 0 0 0 0 0 2349777 2284341 58710828 53732283 -4171202 -2814971 121369799 111734878 14666410 13591665 106703389 98143213 ORGANIZATIONS'S MISSION IS TO PROVIDE HEALTH BENEFITS TO ELIGIBLE ACTIVE PARTICIPANTS AND THEIR COVERED DEPENDENTS. THE PLAN ALSO PROVIDES HEALTH BENEFITS TO SELF PAY PARTICIPANTS AND RETIREES FOR WHICH A CONTRIBUTION IS RECEIVED. false false ORGANIZATION'S MISSION IS TO PROVIDE HEALTH BENEFITS TO ELIGIBLE ACTIVE PARTICIPANTS AND THEIR COVERED DEPENDENTS. THE PLAN ALSO PROVIDES HEALTH BENEFITS TO SELF-PAY PARTICIPANTS AND RETIREES FOR WHICH A CONTRIBUTION IS RECEIVED. false false false false false false false false false true false false true true true false false false false false false false false false false false false false false false false false false false false false false false false true false false true 2 0 true 0 false false false false false false false X 9 0 false false false false false false false true true false false false true true true true true false X GARTH FISHER 2063294900 2323 EASTLAKE AVE E SEATTLE WA 98102 X RODGER M GLOS TRUSTEE 1.0 0.0 X 0 0 0 KEVIN PETERSON TRUSTEE 1.0 0.0 X 0 0 0 JOHN SAHLBERG TRUSTEE 1.0 0.0 X 0 0 0 KELLYE T WISE TRUSTEE 1.0 0.0 X 0 0 0 TONY HADLEY TRUSTEE 1.0 0.0 X 0 0 0 PAUL MARKS ALTERNATE TRUSTEE 1.0 0.0 X 0 0 0 CAL WELBORN SR TRUSTEE 1.0 0.0 X 0 0 0 JERRY KING TRUSTEE 1.0 0.0 X 0 0 0 TODD GORHAM TRUSTEE 1.0 0.0 X 0 0 0 0 0 0 0 false false false REGENCE BLUECROSS BLUESHIELD OF ORE PO Box 1271 PORTLAND OR 97207 ADMIN SERVICE ORG 6039514 NORTHWEST ADMINISTRATORS INC 2323 EASTLAKE AVE EAST SEATTLE WA 98102 Administrative Fees 527346 EXPRESS SCRIPTS INC 225 SUMMIT AVE MONTVALE NJ 07645 PRESC DRUG ADMIN 539343 3 0 EMPLOYER CONTRIBUTIONS 900099 40676235 40676235 SELF-PAY CONTRIBUTIONS 900099 6752092 6752092 47428327 2966466 2966466 0 0 0 0 0 39363165 38841842 521323 521323 521323 0 0 0 OTHER 900099 1196 1196 1196 50917312 47429523 3487789 0 0 0 51447942 0 0 0 0 0 0 524325 59026 73007 0 0 112169 158512 0 16150 0 0 0 0 0 12243 0 0 0 42481 NEWSLETTER EXPENSES 34368 BANK FEES 26179 ADMIN. - MEDCO 785986 ACA PCORI FEE 32925 406970 53732283 45064 0 6697093 883529 0 0 4470933 7132702 0 0 0 0 0 0 0 0 1024781 1024781 0 93253240 90409248 15878688 12284618 0 0 0 0 0 0 121369799 111734878 147817 182228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14518593 13409437 14666410 13591665 X 0 0 0 0 106703389 98143213 106703389 98143213 121369799 111734878 -2814971 -5745205 X false true X true GROSVENOR INSTITUTIONAL 0 F PARTNER 10789981 F MFS INTERNATIONAL GROWTH LLC 1494637 F 12284618 0 BENEFIT OBLIGATIONS 13409437 13409437 X 45059938 -5745205 -5745205 50805143 112169 112169 50917312 54729270 54729270 112169 -1109156 -996987 53732283 PART X, LINE 2: Accounting principles generally accepted in the United States of America require management to evaluate tax positions taken by the Plan and recognize a tax liability if the Plan has taken a tax position that more likely than not would not by sustained upon examination by a tax authority. The Plan is subject to routine audits by jurisdictions; however, there are currently no audits for any tax periods in progress. PART XII, LINE 4b: Change in Benefit Obligations. PART I, LINE 1 AND PART III, LINES 1 AND 4A - ORGANIZATION'S MISSION: TO PROVIDE HEALTH BENEFITS TO ELIGIBLE ACTIVE PARTICIPANTS AND THEIR COVERED DEPENDENTS. THE PLAN ALSO PROVIDES HEALTH BENEFITS TO SELF-PAY PARTICIPANTS AND RETIREES FOR WHICH A CONTRIBUTION IS RECEIVED. PART VI, LINE 11B: FORM 990 IS REVIEWED BY THE ADMINISTRATIVE OFFICE PRIOR TO BEING FILED. THE ADMINISTRATIVE OFFICE NOTIFIES THE BOARD OF TRUSTEES OF UNUSUAL OR SIGNIFICANT ITEMS, IF NOTED. PART VI, LINE 12C: TRUSTEES ARE REQUIRED TO NOTIFY THE TRUST OF ANY CHANGES IN INTERESTS THAT COULD GIVE RISE TO CONFLICTS. PART VI, LINE 19: THE PLAN'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MAINTAINED AT THE ADMINISTRATIVE OFFICE AND ARE AVAILABLE UPON REQUEST. PART VII - SECTION A: MEMBERS OF THE BOARD OF TRUSTEES SERVE FOR NO COMPENSATION. COMPENSATION PAID TO TRUSTEES BY THEIR EMPLOYERS IS REPORTED ON THE EMPLOYERS' ANNUAL TAX FILINGS. THIS INFORMATION IS UNKNOWN TO THE PLAN ADMINISTRATOR. CIC-TOC PENSION PLAN 2323 EASTLAKE AVE E SEATTLE WA 98102 456909074 PENSION BEN. WA 1.401-1(B)3 NA false LUMBER INDUSTRY PENSION PLAN 2323 EASTLAKE AVE E SEATTLE WA 98102 456909074 PENSION BEN. WA 1.401-1(B)3 NA false CIC DEFINED CONTRIBUTION RETIREMENT PLAN 2323 EASTLAKE AVE E SEATTLE WA 98102 456909074 PENSION BEN. WA 1.401-1(B)3 NA false CARPENTERS INDUSTRIAL COUNCIL 12788 SE STARK ST PORTLAND OR 97233 421693707 LABOR ORG. OR 501(C)5 NA false see supplemental information na see supplemental information na false false false false false false false false false false false false false false false false false false true PARTS II, III AND IV - IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS AND RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP, CORPORATION OR TRUST: A CONTRIBUTING EMPLOYER IS A RELATED ORGANIZATION SOLELY TO THE EXTENT THAT THE EMPLOYER IS SIGNATORY TO A COLLECTIVE BARGAINING AGREEMENT OR PARTICIPATION AGREEMENT REQUIRING CONTRIBUTIONS TO THE TRUST. THE PLAN ADMINISTRATOR DOES NOT MAINTAIN INFORMATION CONCERNING THE ENTITY TYPE OF EACH OF THE TRUST'S 30 CONTRIBUTING EMPLOYERS.