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        <FormAndLineReferenceDesc>PART XII, LINE 4B - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGE IN BENEFIT OBLIGATIONS 2,910,000.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE TRUST HAS CONTRACTED WITH BENEFITS SOLUTIONS, INC. TO PROVIDE DAY-TO-DAY ADMINISTRATIVE SERVICES TO THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF TRUSTEES WAS PROVIDED A COPY OF FORM 990. THE FORM 990 IS REVIEWED BY THE ADMINISTRATOR'S MANAGEMENT AND BY THE TRUST DIRECTOR PRIOR TO FILING WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO PARTICIPANTS UPON REQUEST BUT NOT TO THE GENERAL PUBLIC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION USES THE MODIFIED CASH BASIS OF ACCOUNTING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSEEING THE ANNUAL AUDIT AND HIRING THE AUDITOR. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>OREGON HOMECARE WORKERS SUPPLEMENTAL TRUST</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>12121 HARBOUR REACH DRIVE ST 105</AddressLine1Txt>
          <CityNm>MUKILTEO</CityNm>
          <StateAbbreviationCd>WA</StateAbbreviationCd>
          <ZIPCd>98275</ZIPCd>
        </USAddress>
        <EIN>463915049</EIN>
        <PrimaryActivitiesTxt>PROVIDE ASSISTANCE REGARDING HEALTH RELATED BENEFITS TO PARTICIPANTS.</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OR</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(5)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>N/A</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SERVICE EMPLOYEES INTERNATIONAL UNION 503</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1730 COMMERCIAL STREET SE</AddressLine1Txt>
          <CityNm>SALEM</CityNm>
          <StateAbbreviationCd>OR</StateAbbreviationCd>
          <ZIPCd>97302</ZIPCd>
        </USAddress>
        <EIN>930323147</EIN>
        <PrimaryActivitiesTxt>LABOR ORGANIZATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OR</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(5)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>N/A</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>1</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>