2016-06-14T12:44:18-05:00 2015-07-31 990155373 LEMKE CHINEN & TANAKA CPA INC 210 WARD AVENUE SUITE 336 HONOLULU HI 968144012 990 2014-08-01 996009435 PAMCAH-UA LOCAL 675 HEALTH & WELFARE FUND PAMC 8085364408 1109 BETHEL ST NO 403 HONOLULU HI 96813 KENT MATSUZAKI - TRUSTEE REGINALD CASTANARES JR - TRUSTEE 8085364408 2016-06-02 1 DIANE HOSOKAWA P00922102 8085336254 2014 2016-08-17 19:52:53Z KENT MATSUZAKI - TRUSTEE 1109 BETHEL ST NO 403 HONOLULU HI 96813 28090578 0 X N/A X 1961 HI TO PROVIDE HEALTH & WELFARE BENEFITS TO PARTICIPATING EMPLOYEES AND THEIR BENEFICIARIES. 6 6 0 0 0 0 0 0 15624971 18204106 1509992 1292436 930221 55102 18065184 19551644 0 0 14143214 15471739 0 0 0 0 0 1954133 2125576 16097347 17597315 1967837 1954329 24306360 26249572 1769216 2104506 22537144 24145066 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS, THEIR DEPENDENTS, AND RETIREES. 0 0 14127888 PROVIDING SELF-INSURED BENEFITS TO ELIGIBLE PARTICIPANTS BY PAYING FOR INCURRED CLAIMS (MEDICAL CLAIMS $10,782,324, DRUG CLAIMS $1,869,425, DENTAL CLAIMS $1,233,621, VISION CLAIMS $242,518). 1343851 PROVIDING HEALTH AND WELFARE BENEFITS BY PAYING FOR MONTHLY INSURANCE PREMIUMS TO INSURANCE CARRIERS (HAWAII DENTAL SERVICE $100,306, PACIFIC GUARDIAN LIFE $442,167, EMPLOYER GROUP WAIVER PLAN (EGWP) MEDICARE PART D $231,111, INSURANCE STOP-LOSS FEES $363,933, AND HAWAII MEDICAL SERVICE ASSOCIATION $206,334). 1013998 PROVIDING SELF-INSURED BENEFITS TO ELIGIBLE PARTICIPANTS BY PAYING FOR CLAIMS ADMINISTRATIVE FEES (MEDICAL $510,268, PRESCRIPTION DRUG $360,430, DENTAL $110,979, AND VISION $32,321) 16485737 0 0 0 0 0 0 0 0 0 1 1 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 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 0 0 1 1 X PAMCAH-UA LOCAL 675 ADMINISTRATIVE 8085364408 1109 BETHEL ST 403 HONOLULU HI 96813 X REGINALD V CASTANARES JR UNION TRUSTEE 1.00 X 0 0 0 VALENTINO CERIA UNION TRUSTEE 1.00 X 0 0 0 MATTHEW BRADY UNION TRUSTEE 1.00 X 0 0 0 KENT A MATSUZAKI MANAGEMENT TRUSTEE 1.00 X 0 0 0 MARK SUZUKI MANAGEMENT TRUSTEE 1.00 X 0 0 0 SAMUEL FUJIKAWA MANAGEMENT TRUSTEE 1.00 X 0 0 0 GREGG SERIKAKU MANAGEMENT TRUSTEE (ALT) 1.00 X 0 0 0 0 0 0 0 0 0 0 NATIONAL BENEFITS ADMINISTRATORS 707 RICHARDS STREET PH6 HONOLULU HI 96813 ACTUARY/CONSULTANT/CLAIMS ADMINISTRATOR 566688 HAWAII MEDICAL SERVICE ASSOCIATION 818 KEEAUMOKU STREET HONOLULU HI 96814 MEDICAL CLAIMS ADMINISTRATOR 512775 HAWAII DENTAL SERVICE 700 BISHOP STREET 700 HONOLULU HI 96813 CLAIMS PROCESSOR 136672 3 EMPLOYER CONTRIBUTIONS 900099 16873302 16873302 RETIREE CONTRIBUTIONS 900099 1247927 1247927 LIQUIDATED DAMAGES 900099 82877 82877 18204106 471646 471646 51283 8793 42490 42490 42490 9350931 8530141 820790 820790 820790 OTHER INCOME 900099 63 63 12549 12549 12612 19551644 19037445 0 514199 15471739 73182 51309 77432 6317 31723 8938 ADMINISTRATIVE FEE - ME 510268 ADMINISTRATIVE FEE - DR 360430 ADMINISTRATIVE FEE 308438 TRANSITIONAL REINSURANC 252462 445077 17597315 4910848 5574533 2115682 2171998 14745 18216 107325 27301 87347 80024 14525351 15606937 2452004 2590711 200383 207153 24306360 26249572 1769216 2104506 1769216 2104506 X 22537144 24145066 0 0 0 0 22537144 24145066 24306360 26249572 1954329 -346407 0 X X 0 1 X 1 0 107325 27301 80024 80024 REAL ESTATE - IWILEI PROPERTY 1436240 F REAL ESTATE - KAPOLEI PROPERTY 633200 F PLAZA AT MOANALUA 258771 F PLAZA AT PEARL CITY 262500 F 2590711 BANK OVERDRAFT 2092453 SECURITY DEPOSIT 12053 2104506 X 19087985 -346407 -346407 19434392 117252 117252 19551644 17480063 0 17480063 117252 117252 17597315 PART X, LINE 2: THE AUDITED FINANCIAL STATEMENTS CONTAIN THE FOLLOWING DISCLOSURE PERTAINING TO FIN 48 (ASC 740): "THE TRUST FUNDING CERTAIN BENEFITS OF THE PLAN RECEIVED AN EXEMPTION LETTER FROM THE IRS DATED MARCH 14, 1983, STATING THAT THE TRUST IS TAX-EXEMPT UNDER THE PROVISIONS OF SECTION 501(C)(9) OF THE IRC. HOWEVER, AS A RESULT OF THE PLAN'S FUNDING POLICY, FROM TIME TO TIME THE TRUST MAY BE SUBJECT TO INCOME TAXES. NO FEDERAL OR STATE INCOME TAXES HAVE BEEN RECORDED IN 2015 AND 2014 FOR UNRELATED BUSINESS TAXABLE INCOME. IN ADDITION, THE PLAN AND THE TRUST ARE REQUIRED TO OPERATE IN CONFORMITY WITH THE IRC TO MAINTAIN THE TAX-EXEMPT STATUS OF THE TRUST. THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC AND, THEREFORE, BELIEVES THAT THE RELATED TRUST IS TAX-EXEMPT. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY IF IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR PLAN YEARS PRIOR TO 2012." FORM 990, PART VI, SECTION B, LINE 11 ALL DOCUMENTS ARE REVIEWED BY UNION AND MANAGEMENT TRUSTEE REPRESENTATIVES BEFORE SIGNING AND FILING. FORM 990, PART VI, SECTION B, LINE 12C POLICY IS REVIEWED BY THE BOARD OF TRUSTEES ANNUALLY FORM 990, PART VI, SECTION C, LINE 19 POLICIES ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART VII REGINALD V. CASTANARES JR. - 1109 BETHEL ST BASEMENT, HONOLULU, HI 96813. VALENTINO CERIA - 1109 BETHEL ST BASEMENT, HONOLULU, HI 96813. MATTHEW BRADY - 1109 BETHEL ST BASEMENT, HONOLULU, HI 96813. KENT A. MATSUZAKI - 1029 ULUPONO STREET, HONOLULU, HI 96819. MARK SUZUKI - 1820 COLBURN STREET, HONOLULU, HI 96819. SAMUEL FUJIKAWA - 2149 PUUHALE PLACE, HONOLULU, HI 96819. GREGG SERIKAKU - 1314 S KING STREET #961, HONOLULU, HI 96814. FORM 990, PART X11, LINE 2C: BOARD OF TRUSTEES SELECT AN INDEPENDENT AUDITOR. THE ADMINISTRATOR AND MANAGEMENT AND UNION TRUSTEE REPRESENTATIVES REVIEW AND APPROVE THE FINANCIAL STATEMENTS. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. PAMCAH-UA LOCAL 675 ANNUITY PLAN 1109 BETHEL STREET 403 HONOLULU HI 96813 990221545 TO PROVIDE ANNUITY BENEFITS TO ELIGIBLE MEMBERS HI 401(A) N/A 0 PAMCAH-UA LOCAL 675 COOPERATION FUND 1109 BETHEL STREET 403 HONOLULU HI 96813 990266164 TO PROMOTE THE INDUSTRY AND IMPROVE RELATIONSHIPS BETWEEN LABOR AND MGMT. HI 501(C)(5) N/A 0 PAMCAH-UA LOCAL 675 TRAINING PLAN 1109 BETHEL STREET 403 HONOLULU HI 96813 996009433 TO PROVIDE EDUCATIONAL BENEFITS TO ELIGIBLE MEMBERS AND EMPLOYERS HI 501(C)(5) N/A 0 PAMCAH-UA LOCAL 675 VACATION & HOLIDAY PLAN 1109 BETHEL STREET 403 HONOLULU HI 96813 996009438 TO PROVIDE VACATION AND HOLIDAY BENEFITS TO ELIGIBLE MEMBERS HI 501(C)(9) N/A 0 PAMCAH-UA LOCAL 675 PENSION PLAN 1109 BETHEL STREET 403 HONOLULU HI 96813 996024083 TO PROVIDE PENSION BENEFITS TO ELIGIBLE MEMBERS HI 401(A) N/A 0 PAMCAH-UA LOCAL 675 ADMINISTRATIVE OFFICE 1109 BETHEL STREET 403 HONOLULU HI 96813 990110375 TO ALLOCATE COMMON EXPENSES AMOUNG THE PAMCAH TRUST FUNDS HI N/A C 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 PAMCAH-UA LOCAL 675 ADMINISTRATIVE OFFICE P 437361 PERCENTAGE ALLOCATION FORM 990, SCHEDULE R, PARTS II, III, IV THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER PLAN THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS INCLUDING THE NAMES, ADDRESSES, AND OTHER CONTACT INFORMATION. HOWEVER, THE LEGAL STRUCTURE (CORPORATION, PARTNERSHIP, ETC) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND COULD NOT BE REASONABLY OBTAINED. AS A RESULT, THE CONTRIBUTING EMPLOYERS COULD NOT BE SEPARATED BY TYPE OF ORGANIZATION. HOWEVER THEY ARE LISTED BELOW: 1. A & I REFRIGERATION , INC. 2. ACME MECHANICAL 3. ADVANCE PLUMBING SYSTEMS CORP. 4. AIR CENTRAL, INC. 5. AIR ENGINEERING CO. 6. AKIYAMA - K. AKIYAMA PLUMBING 7. AKUA AIR CONDITIONING LLC 8. ALAKA'I MECHANICAL CORPORATION 9. ALCO MECHANICAL, INC. 10. ALOHA FIRE SYSTEMS, L.L.C. 11. AMERICAN PIPING & BOILER COMPANY 12. B'S AIR CONDITIONING & REFRIGERATION SERVICE 13. C & W PLUMBING, INC. 14. C S MECHANICAL 15. CARRIER BUILDING SERVICES 16. CENTRAL AIR SYSTEMS, INC. 17. CHAD'S PLUMBING, INC. 18. CHECKPOINT FIRE SERVICE, LLC 19. CLIMATE PROS 20. CLYDE'S PLUMBING 21. COMFORT COOLING HAWAII 22. COMMERCIAL AIRE, INC. 23. COMMERCIAL PLUMBING, INC. 24. CONTINENTAL MECHANICAL OF THE PACIFIC 25. COOL AIR, INC. 26. CREATIVE PLUMBING, INC. 27. CRITCHFIELD PACIFIC INC. 28. D & C PLUMBING, INC. 29. DELIMA'S PLUMBING 30. DELTA PLUMBING 31. DIAMOND PLUMBING, INC. 32. DLD MECHANICAL, INC. 33. DORVIN D. LEIS COMPANY, INC. 34. DYNAMIC AIR, INC. 35. ECONOMY PLBG & SHEETMETAL, INC. 36. EKAHI FIRE PROTECTION, LLC 37. ELITE MECHANICAL, INC. 38. HAGIO PLUMBING, LLC 39. HAKO PLUMBING, INC. DBA HAKO CONSTRUCTION 40. HAWAII SHEETMETAL & MECHANICAL, INC. 41. HAWAIIAN DREDGING CONSTRUCTION CO., INC. 42. HEIDE & COOK, LLC 43. HILO AIR A/C & REFRIGERATION, LLC 44. HILO MECHANICAL, INC. 45. HI-TECH PLUMBING CORPORATION 46. HMS CONSTRUCTION, INC. 47. HONEYWELL, INC. 48. HONOLULU FIRE PROTECTION L.L.C. 49. HONOLULU PLUMBING COMPANY, LTD. 50. HSI AIR CONDITIONING & MECHANICAL 51. HUALALAI MECHANICAL, LLC 52. INNOVATIVE PLUMBING LLC 53. INTER ISLAND CONSTRUCTION, INC. 54. ISLAND CONTROLS, INC. 55. ISLAND WIDE A/C SERVICE, LLC 56. JEBSCO MECHANICAL INC. 57. JOHNSON CONTROLS, INC. 58. J'S PLUMBING 59. K & R PLUMBING 60. KAUAI AIR CONDITIONING 61. LEND LEASE (US) PUBLIC PARTNERSHIP LLC 62. MASON'S PLUMBING SERVICES, INC. 63. MECHANICAL INCORPORATED 64. NAKAMURA - R.M. NAKAMURA 65. NO SWEAT AIR CONDITIONING, INC. 66. NOZOMI PLUMBING LLC 67. OAHU AIR CONDITIONING SERVICE INC. 68. OAHU PLUMBING & SHEET METAL 69. OAHU SALES, INC. 70. PAMCAH-UA LOCAL 675 AD OFFICE 71. PAN PACIFIC PLUMBING CO., INC. 72. PARSONS RCI INC. 73. PIPE TRADES TRUST-NORTHERN ROCKY AREA 74. PLBG & MECHANICAL CONTRACTORS ASSOCIATION OF HI 75. PLUMBERS & FITTERS, UA LOCAL 675, AFL-CIO 76. PLUMBERS & PIPEFITTERS LOCAL #250 77. PLUMBING WORKS LLC 78. PREFERRED AC SERVICE, LLC 79. QUALIFIED PLUMBING, INC. 80. RAY'S PLUMBING, INC. 81. REFRIGERATION UNLIMITED INC. 82. REGENT PLUMBING 83. RPS MECHANICAL 84. SERVICE AIR CONDITIONING & PLUMBING INC. 85. SHOBU'S REFRIGERATION & AIR CONDITIONING 86. SIMPLEXGRINNELL LP 87. SKIPPY'S PLUMBING & REPAIR, INC. 88. SMAC HAWAII, INC. 89. SONODA - ED SONODA PLUMBING, INC. 90. SOUTHERN CALIFORNIA PIPE TRADES 91. STANDARD SHEETMETAL & MECHANICAL, INC. 92. STRIKER CONSTRUCTION, LLC 93. STS PLUMBING, INC. 94. TANAKA - H. TANAKA PLUMBING, INC. 95. THE PLUMBERS, INC. 96. TNH PLUMBING, INC. 97. TOTAL FIRE SYSTEMS, INC. 98. TRANE PACIFIC SERVICE 99. TROPIC PLUMBING 100. UA LOCAL 447 PIPE TRADES 101. WAIALUA PLUMBING & MECHANICAL, INC. 102. WAIANAE PLUMBING COMPANY, INC. 103. WELDING & INDUSTRIAL TRADES CONSTRUCTION, LLC