2017-05-11T16:35:25-05:00 2016-06-30 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2015-07-01 936029224 UMTA TRUST UMTA 5032358363 1919 NE PACIFIC STREET NO 200 PORTLAND OR 97232 MARTHA COX TRUSTEE 5032358363 2017-05-11 1 JAMES N BROWNING P01451906 9252779100 2015 2021-01-29 14:40:06Z X MARTHA COX 1919 NE PACIFIC ST STE 200 PORTLAND OR 97232 57491767 0 X N/A X 1950 OR TO ENABLE THE ASSOCIATION, ITS MEMBERS AND AFFILIATES TO MAKE AVAILABLE TO THEIR INTERESTED EMPLOYEES, OFFICERS AND THEIR DEPENDENTS SUCH GROUP BENEFIT PROGRAMS AS MAY BE ESTABLISHED, REQUIRED OR MAINTAINED PURSUANT TO COLLECTIVE BARGAINING OR OTHERWISE DESIRED FROM TIME TO TIME. 4 1 0 0 0 0 0 0 35652862 31457931 1656146 1205503 19659 29165 37328667 32692599 0 0 30423839 24506047 0 0 0 0 0 2690781 2742175 33114620 27248222 4214047 5444377 35105522 39735176 6577151 5626376 28528371 34108800 TO PROVIDE PARTICIPATING EMPLOYER'S EMPLOYEES WITH HEALTH, LIFE, AND DISABILITY BENEFITS AND WELLNESS AND CLINICAL TESTING PROGRAMS. 0 0 PROVIDED DEATH, SICKNESS AND HOSPITALIZATION BENEFITS TO COVERED MEMBERS 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1512 0 1 0 0 0 0 0 0 0 X 4 1 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0 X REBECCA ANDERSON 5035952163 1919 NE PACIFIC ST STE 200 PORTLAND OR 97232 X KURT ZETZSCHE TRUSTEE 0.30 X 0 0 0 REX SMITH TRUSTEE - PAST 0.30 X 0 0 0 MIKE ECKSTEIN TRUSTEE 0.30 X 0 0 0 MARTHA COX TRUSTEE 0.42 X 0 0 0 STEVE FUGATE TRUSTEE 0.42 X 0 0 0 0 0 0 0 0 0 0 US BENEFITS INC 1919 NE PACIFIC ST STE 100 PORTLAND OR 97232 CLAIMS ADMINISTRATION 1207200 UEA INC 1919 NE PACIFIC ST STE 200 PORTLAND OR 97232 CONTRACT ADMINISTRATION 503946 ZELIS CLAIMS INTEGRITY 2 CROSSROADS DRIVE BEDMINSTER NJ 07921 CLAIMS EDITING AND COST MANAGEMENT 361519 3 EMPLOYER CONTRIBUTIONS 900099 31362126 31362126 PARTICIPANT CONTRIBUTIONS 900099 95805 95805 31457931 834986 834986 25169685 24799168 370517 370517 370517 PROCESSING FEES & FINANCE INCOME 900099 29165 29165 29165 32692599 31487096 0 1205503 X 24506047 60000 38178 45128 100028 2420570 656 22680 8069 2470 13882 MISCELLANEOUS 16815 PCORI FEE 13699 27248222 3982431 7052789 1567237 425016 482414 189353 28913540 32010620 217298 35105522 39735176 3782249 268631 2794902 2567761 0 2789984 6577151 5626376 X 0 0 0 0 28528371 34108800 28528371 34108800 35105522 39735176 5444377 404553 -268501 0 X X 0 1 X 1 0 0 CLAIMS PAYABLE AND INCURRED BUT NOT REPORTED 2730157 INSURANCE PREMIUMS PAYABLE 59827 2789984 X 32997124 404553 404553 32592571 100028 100028 32692599 27634340 0 27634340 100028 -486146 -386118 27248222 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 NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF JUNE 30, 2016, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED 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: CHANGES IN BENEFIT OBLIGATIONS -486,146. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE DIRECTOR OF OPERATIONS REVIEWS THE FORM 990 WITH THE TRUSTEES PRIOR TO FILING THE FORM. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONSOLIDATED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST FOR SUCH INFORMATION. FORM 990, PART IX, LINE 11G: PLAN ADMINISTRATION $1,703,196 PHARMACY ADMINISTRATION 130,894 CLAIMS EDITING AND COST CONTAINMENT 535,780 CONSULTING AND ACTUARIAL 50,700 TOTAL $2,420,570 FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES HAS RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT AUDITOR. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. UMTA TRUST CAPTIVE LLC 906 NE 19TH AVENUE PORTLAND OR 97232 472319691 CAPTIVE INSURANCE MT 2485270 1512341 UMTA TRUST RETIREMENT PLAN FOR THE EMPLOYEES OF THE UMTA & ITS AFFILIATES 906 NE 19TH AVENUE PORTLAND OR 97232 930302009 DEFINED BENEFIT PENSION PLAN OR 501(A) UNITED METAL TRADES ASSOCIATION 0 UNITED METAL TRADES ASSOCIATION 906 NE 19TH AVENUE PORTLAND OR 97232 930302009 LABOR RELATIONS OR 501(C) NOT APPLICABLE 0 401(K) PLAN OF THE UNITED METAL TRADES ASSOCIATION & ITS AFFILIATES 906 NE 19TH AVENUE PORTLAND OR 97232 930302009 DEFINED CONTRIBUTION PENSION PLAN OR 501(A) UNITED METAL TRADES ASSOCIATION 0 UEA INC 1919 NE PACIFIC STREET SUITE 200 PORTLAND OR 97232 930991444 CONTRACT ADMINISTRATION OR UNITED METAL TRADES ASSOCIATION C 0 US BENEFITS INC 1919 NE PACIFIC STREET SUITE 100 PORTLAND OR 97232 930929070 CLAIMS ADMINISTRATION OR UNITED METAL TRADES ASSOCIATION C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 FORM 990, SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS: THE FILING ORGANIZATION IS A MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF JUNE 30, 2016, THERE ARE APPROXIMATELY 44 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 NAME OF THE CONTRIBUTING EMPLOYERS ARE LISTED ON PART VII BELOW AND NOT ON PARTS II THROUGH IV BY FEDERAL TAX CLASSIFICATION. GMP LOCAL #139 WEBSTER IRONWORKERS SHOPMEN GILBERTSON MACHINE TOM STEVENS BOILER REPAIR WAYRON, INC. OCHOCO MANUFACTURING HOGAN FAB INC INTERSTATE MANUFACTURING PEERLESS PATTERN WORKS KACH MACHINE WORKS WILLAMETTE PATTERN WORKS OREGON AUTO SPRING PAUL BRONG MACHINE PULL IT CORPORATION INTEGRATED POWER SERVICES RIVER CITY PATTERN PENINSULA IRON WORKS ROEMER ELECTRIC PORTLAND PATTERN WORKS UEA INC. TIDLAND CORPORATION PREMIER GEAR & MACHINE GTE METAL FABRICATORS SMALL PARTS MANUFACTURING DEPENDABLE PATTERN WORKS PACKAGE CONTAINERS PORTLAND BOLT & MFG CO. THOMPSON METAL FAB GALVANIZERS COMPANY VANCOUVER IRON & STEEL THE WESTERN GROUP RUAN TRANSPORTATION VOITH PAPER ROLLS SOUTH INC ROCKMORE INTERNATIONAL PIERCE PACIFIC FOUGHT & COMPANY INC. ZIMMERMAN METALS CANRON WESTERN HARDER MECHANICAL ALLIED SYSTEMS OREGON IRON WORKS COLUMBIA STEEL CASTING CASCADE STEEL MILLS