2017-07-28T15:07:25-05:00 2016-09-30 522385296 LINDQUIST LLP 600 CITY PARKWAY WEST SUITE 300 ORANGE CA 92868 990 2015-10-01 956049026 OPERATING ENGINEERS LOCAL 501 SECURITY FUND OPER 6266461079 PO BOX 990 WEST COVINA CA 91793 EDWARD CURLY CHAIRMAN 6266461079 2017-07-28 1 RICHARD G THIERMANN P00974294 7142570100 2015 2021-01-29 14:40:06Z EDWARD CURLY PO BOX 990 WEST COVINA CA 91793 48507449 0 X N/A X 1952 CA TO PROVIDE HEALTH AND WELFARE BENEFITS. 10 0 0 0 0 0 0 0 47607631 47804855 331699 643617 85579 58977 48024909 48507449 0 0 34764382 33113038 0 0 0 0 0 2175870 2215931 36940252 35328969 11084657 13178480 34580326 49058038 8317075 8804430 26263251 40253608 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 10 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 PAUL BENSI SECRETARY 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 SHELLI LEES MAHAN TRUSTEE-PAST 5.00 X 0 0 0 KEVIN DEVINE ASSISTANT SECRETARY 5.00 X 0 0 0 ERIC FLETT ALTERNATE TRUSTEE 2.00 X 0 0 0 JEFF PALMER ALTERNATE TRUSTEE 2.00 X 0 0 0 KEVIN GLEASON TRUSTEE 5.00 X 0 0 0 JIM JOHNSON ALTERNATE TRUSTEE - PAST 2.00 X 0 0 0 MIKE LATHAM TRUSTEE - PAST 5.00 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 ASSOCIATED THIRD PARTY ADMINISTRATORS 1640 SOUTH LOOP RD ALAMEDA CA 94502 CONTRACT ADMINISTRATOR 224431 LINDQUIST LLP 600 CITY PARKWAY WEST SUITE 300 ORANGE CA 92868 AUDIT 199571 ANTHEM BLUE CROSS OF CALIFORNIA 21555 OXNARD ST WOODLAND HILLS CA 91367 NETWORK ACCESS FEES 149513 CORNWELL & BALDWIN 1017 EAST GRAND AVENUE ESCONDIDO CA 92025 LEGAL SERVICE 118725 MILLIMAN 650 CALIFORNIA STREET 17TH FL SAN FRANCISCO CA 941082702 ACTUARY 100542 5 EMPLOYER CONTRIBUTIONS 900099 43654864 43654864 PARTICIPANT CONTRIBUTIONS 900099 2579996 2579996 PRESCRIPTION REBATE 900099 1075309 1075309 STOP LOSS REIMBURSEMENT 900099 494686 494686 47804855 643617 643617 OTHER REVENUE 900099 58977 58977 58977 48507449 47863832 0 643617 33113038 874185 129304 302827 56677 489128 166130 13936 39299 TRANSITIONAL REINSURANC 136973 MEMBERSHIP DUES 7472 35328969 8380325 13682712 5454836 4243172 79282 10765 20665883 31121389 34580326 49058038 121598 80452 226779 396631 7968698 8327347 8317075 8804430 X 0 0 0 0 26263251 40253608 26263251 40253608 34580326 49058038 13178480 811877 0 X X 0 1 X 1 0 0 CLAIMS PAYABLE AND IBNR 2164000 ACCUMULATED ELIGIBILITY CREDITS 5447000 DUE TO RELATED PLANS 716347 8327347 X 49262649 811877 811877 48450772 56677 56677 48507449 34877292 0 34877292 56677 395000 451677 35328969 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, 2016, 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 2013. 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 11 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. 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. 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. 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, 2016, THERE ARE 90 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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