2016-07-11T16:26:40-05:00 2015-09-30 522385296 LINDQUIST LLP 600 CITY PARKWAY WEST SUITE 300 ORANGE CA 92868 990 2014-10-01 956049026 OPERATING ENGINEERS LOCAL 501 SECURITY FUND OPER 6266461079 PO BOX 990 WEST COVINA CA 91793 EDWARD CURLY CHAIRMAN 6266461079 2016-07-11 1 RICHARD G THIERMANN P00974294 7142570100 2014 2016-09-27 15:27:22Z X EDWARD CURLY PO BOX 990 WEST COVINA CA 91793 48024909 0 X N/A X 1952 CA TO PROVIDE HEALTH AND WELFARE BENEFITS. 10 0 0 0 0 0 0 0 45924094 47607631 685307 331699 60245 85579 46669646 48024909 0 0 36110070 34764382 0 0 0 0 0 2111392 2175870 38221462 36940252 8448184 11084657 23538276 34580326 8377285 8317075 15160991 26263251 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 4 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 MICHAEL LATHAM TRUSTEE 5.00 X 0 0 0 MIKE NAREZ TRUSTEE 5.00 X 0 0 0 DENISE VUKOJEVICH TRUSTEE 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 5.00 X 0 0 0 KEVIN DEVINE TRUSTEE 5.00 X 0 0 0 ERIC FLETT ALTERNATE TRUSTEE 2.00 X 0 0 0 JIM JOHNSON ALTERNATE TRUSTEE 2.00 X 0 0 0 SEE SCHEDULE O FOR COMPENSATION PAID BY RELATED ORGANIZATIONS 0.00 X 0 1 0 0 1 0 0 0 0 0 BENEFIT PROGRAMS ADMIN 13191 CROSSROADS PKWY N STE 205 CITY OF INDUSTRY CA 91746 CONTRACT ADMINISTRATOR 1102517 LINDQUIST LLP 600 CITY PARKWAY WEST SUITE 300 ORANGE CA 92868 AUDIT 267107 ANTHEM BLUE CROSS OF CALIFORNIA 21555 OXNARD ST WOODLAND HILLS CA 91367 NETWORK ACCESS FEES 151337 DONALDSON & CORNWELL 1017 EAST GRAND AVENUE ESCONDIDO CA 92025 LEGAL SERVICE 138282 MILLIMAN 650 CALIFORNIA STREET 17TH FL SAN FRANCISCO CA 941082702 ACTUARY 123087 7 EMPLOYER CONTRIBUTIONS 900099 43539702 43539702 PARTICIPANT CONTRIBUTIONS 900099 3337617 3337617 PRESCRIPTION REBATE 900099 404907 404907 STOP LOSS REIMBURSEMENT 900099 325405 325405 47607631 331699 331699 OTHER REVENUE 900099 85579 85579 85579 48024909 47693210 0 331699 34764382 889596 143620 192085 57364 463572 163861 13200 3441 31412 ER REINSURANCE FEE 203931 MEMBERSHIP DUES 13788 36940252 5150943 8380325 4763904 5454836 6848 79282 13616581 20665883 23538276 34580326 191316 121598 295969 226779 7890000 7968698 8377285 8317075 X 0 0 0 0 15160991 26263251 15160991 26263251 23538276 34580326 11084657 17603 0 X X 0 1 X 1 0 0 CLAIMS PAYABLE AND IBNR 1456000 ACCUMULATED ELIGIBILITY CREDITS 5760000 DUE TO RELATED PLANS 752698 7968698 X 47985148 17603 17603 47967545 57364 57364 48024909 37556888 0 37556888 57364 -674000 -616636 36940252 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, 2015, 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 2012. 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, 2015, THERE ARE 163 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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