2016-08-12T14:16:59-07:00 2015-12-31 202116576 5500Tax Group Inc 110 S Mary Ste 2 268 Nipomo CA 93444 990 2015-01-01 870427760 Union Pacific Railroad Employes Health System UNIO 8015954388 1040 N 2200 W Suite 200 Salt Lake City UT 84116 Greg Barnett CFO 8015954368 2016-08-12 0 Amelia Boyd CPA P00183557 9517845316 2016-07-10 2015 2016-12-15 16:53:06Z Rich Egan 1040 N 2200W Suite 200 Salt Lake City UT 84116 172101535 0 X X 1948 UT To provide health care programs for active and retired members and their dependents of Union Pacific Railroad Company and their subsidiaries 11 11 90 0 0 0 52331114 52109530 117527215 118829244 3763142 79419 1190452 1067518 174811923 172085711 0 0 149454589 155779900 8501579 8251251 0 0 0 4464947 3098160 162421115 167129311 12390808 4956400 89835919 95266825 39957304 40431810 49878615 54835015 To provide health care programs for active and retired members and their dependents of Union Pacific Railroad Company and their subsidiaries 0 0 To provide health care programs for active and retired members and their dependents of Union Pacific Railroad Company and subsidiaries 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 93 0 1 90 1 1 1 0 0 0 0 0 X 11 11 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X Union Pacific Railroad Employes Health System 8015954388 1040 N 2200 W Suite 200 Salt Lake City UT 84116 Rene Orosco A VP Labor Relations UPRR 0 0 X 0 0 0 Jim Larreau NCF and O 0 0 X 0 0 0 Charles A Nowlin General Chairman UTU 0 0 X 0 0 0 Steven R Hirschbein Board Member 0 0 X 0 0 0 John McArthur General Chairman, BRS 0 0 X 0 0 0 Dennis R Albers General Chairman, Allied Federation, BMWED 0 0 X 0 0 0 Sam Mele UPRR 0 0 X 0 0 0 Tim Graumann General Tax Counsel, UPRR 0 0 X 0 0 0 Jim Dayton General Chairman BLET 0 0 X 0 0 0 Brent Leonard Chair, Board of Trustees, Gen Chair UTU 0 0 X 0 0 0 Chad Wilbourn UPRR 0 0 X 0 0 0 Kevin Potts Vice President 40 0 X X X 181622 0 0 Rich Egan President 40 0 X X X 226308 0 0 Ben Johnson Director of Pharmacy 40 0 X 147086 0 0 Curt Hughes Pharmacist 40 0 X 135664 0 0 Barbara Pappadakis Director of Government Relations 40 0 X 135908 0 0 Angela Neilson Director of IT 40 0 X 147281 0 0 Christopher Steele Pharmacist 40 0 X 145326 0 0 1119195 0 0 16 0 1 0 Anthem Blue Cross Blue Shield 332 Washington St SW Gainesville GA 30501 Network Systems 4770060 Optum RX 11000 Optum Circle Eden Prairie MN 55344 Prescription Drug 273923 VRX LLC 4190 S Highland Dr Suite 250 Salt Lake City UT 84124 Consulting 233167 Castlight Health Inc Deot Ch 19211 Palatine IL 60055 Network Consultant 217000 Watermark Medical Inc 200 Corporate place Suite 15B Peabody MA 01960 CPAP Setups 191600 7 0 52109530 0 0 0 0 0 52109530 Employer Contributions 900099 113194007 113194007 0 0 Pharmacy Copayments 900099 5635237 5635237 0 0 0 0 0 0 118829244 79419 79419 0 0 0 0 0 0 0 0 0 0 133824 0 15824 0 118000 0 118000 118000 0 0 0 0 0 Prescription Sales 446110 535698 535698 0 0 HUC Medohealth Pharmacy 446110 170242 170242 0 0 CPAP Equipment 446110 123580 123580 0 0 119998 119998 0 0 949518 172085711 119976181 0 0 155779900 407930 4421028 2160071 1262222 199919 623478 69303 76376 241257 448726 137243 Postage 378583 Software 252453 Telephone 172149 Repair & Maintenance 162671 336002 167129311 0 0 0 1950 1950 14929170 15398045 895019 6443812 1966524 1785852 417055 672106 8829251 4735899 4241355 4093352 61804879 61833900 5579967 5037808 89835919 95266825 28991853 30127760 343132 304650 10622319 9999400 39957304 40431810 X 0 0 0 0 49878615 54835015 49878615 54835015 89835919 95266825 4956400 0 0 0 0 0 X 0 1 X 1 0 435600 0 435600 5650215 0 2345554 3304661 0 0 0 0 2743436 0 2390345 353091 0 0 0 0 4093352 Physicians Deferred Compensation 5037808 5037808 0 Dues paid in advance 4961592 Physicians Deferred Compensation 5037808 9999400 171322275 0 0 0 15823 15823 171306452 0 779259 779259 172085711 173369008 0 0 0 7018956 7018956 166350052 0 779259 779259 167129311 Schedule D, Part XI, Line 2d Rental income reported as gross on the audited financial statements and reported as net on the Form 990. Schedule D, Part XI, Line 4b Certain income reported as net on the audited financial statements and reported as gross on the Form 990, including increase in net change in Physician Deferred Compensation and On Duty Injuries on audited financial statements. Schedule D, Part XII, Line 2d Certain expenses reported as gross on the audited financial statements and reported as net on the Form 990 including Rental Expenses increase in estimated reserve for claims incurred but not reported and Prior Period Adjustment related to receivable accruals which resulted in an overstatement of pharmacy expenses for years ended December 31 2006 thru 2014. Schedule D, Part XII, Line 4b Certain expenses reported as net on the audited financial statements and reported as gross on the Form 990, including increase in net change in Physician Deferred Compensation and On Duty Injuries on audited financial statements. X X X X 1 0 0 Rich Egan President 191558 0 34750 0 0 0 0 0 0 0 226308 0 0 Kevin Potts Vice President 156622 0 25000 0 0 0 0 0 0 0 181622 0 0 Schedule J, Part I, Line 3 a) From time to time the Board of Trustees Compensation Committee requests a third party salary survey and b) annually the Board of Trustees reviews goal achievements and operating results of the operating trustees and the Board of Trustees votes on compensation for executives Schedule J, Part I, Line 4 Angela Neilson, separation agreement effective August 19, 2015, includes accrued and eligible vacation, 75% of accrued unused sick leave, three months salary severance, and portion of group medical insurance. Total value of $60,387 to be paid in twelve equal payments of $5,032. Dell T Butterfield Former CEO Non-Qualified X 343132 304650 0 1 1 304650 Form 990, Part VI, Section A, Line 6 The President of the Union Pacific Railroad Company appoints four trustees of the organization. Members of the Bargaining Units that have the largest number of former members of the Missouri Pacific Employees' Health Association who are participating employees under the plan offered by the Corporation elects an additional two trustees of the organization. Accredited representatives of various Bargaining Units representing classes of employees of the Employer Companies elect an additional five trustees of the organization. Form 990, Part VI, Section A, Line 7a Four trustees are appointed by the President of the Union Pacific Railroad Company. An additional two trustees are elected by the membership of the Bargaining Units that have the largest number of former members of the Missouri Pacific Employees' Health Association who are participating employees under the plan offered by the Corporation. The two trustees are collectively referred to as the "MPEHA Union Trustees." An additional five Trustees are elected by accredited representatives (under the Railway labor Act) of various Bargaining Units representing classes of employees of the Employer Companies. Employee representatives are divided into five groups (seven groups including MPEHA Union Trustees) to nominate one or more General Chairpersons or International Representatives from such group and that a majority of the accredited representatives elect one trustee from each group. Each of the five trusteed so elected holds office for a term of four years. The accredited representatives, by two-thirds vote, can recall any trustee elected by them, provided that no recall action has been taken during the time the Board is meeting and for ten days following adjournment. If any said employee group fail to elect a trustee or if the President of the Union Pacific Railroad Company fails to appoint trustees, then the trustees actually elected or appointed will constitute the Board. Form 990, Part VI, Section B, Line 11b Senior management reviews the Form 990 Return of Organization Exempt from Income Tax each year prior to filing The review consists of reconciling the audited financial statements to the 990 return The return is also forwarded to the independent auditors for review As an ERISA plan the Board of Trustees reviews the audited financial statements Under the direction of the Board of Trustees management reviews the reconciliation of financial statement to the Form 5500 Annual Return Report of Employee Benefit Plan and all accompanying statement relating to the annual report Form 990, Part VI, Section B, Line 12c It is the policy of the Union Pacific Railroad Employes Health Systems UPREHS for any officers and directors and trustees and key employees and highest compensation professional and or other independent contractors to not receive compensation from any other organization or organizations whether tax exempt or taxable that are related to UPREHS through common supervision or common control In additional it is the policy of UPREHS to not allow any officers or directors or trustees or key employees or highest compensated professional and or other independent contractors to be related to each other either through family or business relationships Form 990, Part VI, Section B, Line 15 a) From time to time the Board of Trustees Compensation Committee requests a third party salary survey and b) annually the Board of Trustees reviews goal achievements and operating results of the operating trustees and the Board of Trustees votes on compensation for executives Form 990, Part VI, Section C, Line 19 The organization makes its governing documents and conflict of interest policy available to the public, upon request Annual reports and financial statements are available to the public as required by ERISA and are available on the Department of Labor EFAST2 website An extension was timely filed