2016-03-07T18:40:57-06:00 2015-05-31 MILLER KAPLAN ARASE LLP 600 STEWART ST STE 618 SEATTLE WA 981011261 990 2014-06-01 930478837 THE BLEDSOE HEALTH TRUST % GARTH FISHER BLED 2063294900 2323 EASTLAKE AVE E SEATTLE WA 98102 RODGER M GLOS chairman 2063294900 2016-03-03 true miller kaplan arase llp P01499738 2065963930 2014 2016-08-17 19:52:53Z GARTH FISHER 2323 Eastlake Ave E Seattle WA 98102 159632286 false X N/A X 1959 OR SEE SCHEDULE O 9 0 293 0 0 0 46627009 46526518 5787246 8012909 1154 199 52415409 54539626 0 0 56491949 56361051 0 0 0 0 0 1057160 2349777 57549109 58710828 -5133700 -4171202 132153281 121369799 15505548 14666410 116647733 106703389 ORGANIZATION'S MISSION IS TO PROVIDE HEALTH BENEFITS TO ELIGIBLE ACTIVE PARTICIPANTS AND THEIR COVERED DEPENDENTS. THE PLAN ALSO PROVIDES HEALTH BENEFITS TO SELF-PAY PARTICIPANTS AND RETIREES FOR WHICH A CONTRIBUTION IS RECEIVED. false false ORGANIZATION'S MISSION IS TO PROVIDE HEALTH BENEFITS TO ELIGIBLE ACTIVE PARTICIPANTS AND THEIR COVERED DEPENDENTS. THE PLAN ALSO PROVIDES HEALTH BENEFITS TO SELF-PAY PARTICIPANTS AND RETIREES FOR WHICH A CONTRIBUTION IS RECEIVED. false false false false false false false false false true false false true true true false false false false false false false false false false false false false false false false false false false false false false false false true false false true 4 0 true 293 true false false false false false false X 9 0 true false false false false false false true true false false false true true true true true false X GARTH FISHER 2063294900 2323 EASTLAKE AVE E SEATTLE WA 98102 X RODGER M GLOS TRUSTEE 1.0 0.0 X 0 0 0 KEVIN PETERSON TRUSTEE 1.0 0.0 X 0 0 0 JOHN SAHLBERG TRUSTEE 1.0 0.0 X 0 0 0 KELLYE T WISE TRUSTEE 1.0 0.0 X 0 0 0 TONY HADLEY TRUSTEE 1.0 0.0 X 0 0 0 PAUL MARKS TRUSTEE 1.0 0.0 X 0 0 0 MICHAEL PIETI TRUSTEE 1.0 0.0 X 0 0 0 CAL WELBORN SR TRUSTEE 1.0 0.0 X 0 0 0 TODD GORHAM ALTERNATE TRUSTEE 1.0 0.0 X 0 0 0 RANDY FOUTS TRUSTEE - FORMER 1.0 0.0 X 0 0 0 DEREK GLOS TRUSTEE - FORMER 1.0 0.0 X 0 0 0 0 0 0 0 false false false REGENCE BLUECROSS BLUESHIELD OF ORE PO Box 1271 PORTLAND OR 97207 ADMIN SERVICE ORG 7740313 NORTHWEST ADMINISTRATORS INC 2323 EASTLAKE AVE E SEATTLE WA 98102 Administrative Fees 533535 EXPRESS SCRIPTS INC 225 SUMMIT AVE MONTVALE NJ 07645 ADMIN SERVICE ORG 969308 4 0 EMPLOYER CONTRIBUTIONS 900099 38954709 38954709 SELF-PAY CONTRIBUTIONS 900099 7571809 7571809 46526518 3505733 3505733 0 0 0 0 0 109599836 105092660 4507176 4507176 4507176 0 0 0 OTHER 900099 199 199 199 54539626 46526717 8012909 0 0 0 56361051 0 0 0 0 0 0 524851 40700 59424 0 0 124974 139362 0 20112 0 0 0 0 0 7311 0 0 0 17700 NEWSLETTER EXPENSES 39168 BANK FEES 26985 ADMIN. - EXPRESS SCRIPTS INC. 969308 ACA REINSURANCE FEE 367868 12014 58710828 315 45064 8983272 6697093 0 0 4159975 4470933 0 0 0 0 0 0 0 0 1000000 1024781 0 118009719 93253240 0 15878688 0 0 0 0 0 0 132153281 121369799 100703 147817 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15404845 14518593 15505548 14666410 X 0 0 0 0 116647733 106703389 116647733 106703389 132153281 121369799 -4171202 -5773142 X false true X true GROSVENOR INSTITUTIONAL PARNTE 11350885 F MFS INTERNATIONAL GROWTH LLC 4527803 F 15878688 0 BENEFIT OBLIGATIONS 14518593 14518593 X 48766484 -5773142 -5773142 54539626 54539626 58710828 58710828 58710828 PART X, LINE 2: The Plan has adopted guidance on accounting for uncertainty in income taxes issued by the Financial Accounting Standards Board. The Plan administrator believes that the Plan has taken no uncertain tax positions that require adjustment to the financial statements to comply with the provisions of this guidance. AS OF MAY 31, 2015, INFORMATION RETURNS FOR YEARS SUBSEQUENT TO 2011 ARE SUBJECT TO EXAMINATION BY AUTHORITIES. PART I, LINE 1: ORGANIZATION'S MISSION IS TO PROVIDE HEALTH BENEFITS TO ELIGIBLE ACTIVE PARTICIPANTS AND THEIR COVERED DEPENDENTS. THE PLAN ALSO PROVIDES HEALTH BENEFITS TO SELF-PAY PARTICIPANTS AND RETIREES FOR WHICH A CONTRIBUTION IS RECEIVED. PART VI, LINE 2: TRUSTEE RODGER M. GLOS AND FORMER TRUSTEE DEREK GLOS ARE FATHER AND SON. PART VI, LINE 11B: FORM 990 WAS REVIEWED BY THE ADMINISTRATIVE OFFICE PRIOR TO BEING FILED. THE ADMINISTRATIVE OFFICE WILL NOTIFY THE BOARD OF TRUSTEES OF UNUSUAL OR SIGNIFICANT ITEMS, IF NOTED. PART VI, LINE 12C: TRUSTEES ARE REQUIRED TO NOTIFY THE TRUST OF ANY CHANGES IN THEIR INTEREST THAT COULD GIVE RISE TO CONFLICTS. PART VI, LINE 19: THE PLAN'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MAINTAINED AT THE ADMINISTRATIVE OFFICE AND ARE AVAILABLE UPON REQUEST. PART VII, SECTION A: THE BOARD OF TRUSTEES SERVES FOR NO COMPENSATION. SALARIES PAID TO TRUSTEES BY THE TRUSTEES' EMPLOYERS IS REPORTED ON THE EMPLOYERS' ANNUAL PAYROLL TAX FILINGS AND IS NOT REPORTED OR KNOWN TO THE ADMINISTRATIVE OFFICE. CIC-TOC PENSION PLAN 2323 EASTLAKE AVE E SEATTLE WA 98102 456909074 PENSION BEN. WA 1.401-1(B)3 NA false LUMBER INDUSTRY PENSION PLAN 2323 EASTLAKE AVE E SEATTLE WA 98102 456909074 PENSION BEN. WA 1.401-1(B)3 NA false CIC DEFINED CONTRIBUTION RETIREMENT PLAN 2323 EASTLAKE AVE E SEATTLE WA 98102 456909074 PENSION BEN. WA 1.401-1(B)3 NA false Carpenters Industrial Council 12788 SE Stark St Portland OR 97233 421693707 Labor Org. OR 501(C)5 NA false see supplemental information na see supplemental information na false false false false false false false false false false false false false false false false false false true PART II - IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS: THE ADMINISTRATIVE OFFICE DOES NOT CURRENTLY MAINTAIN THIS INFORMATION FOR THE 30 CONTRIBUTING EMPLOYERS. PLEASE CONTACT THE ADMINISTRATIVE OFFICE IF YOU HAVE ANY QUESTIONS. part iii - identification of related organizations taxable as A partnership: the administrative office does not currently maintain this information for the 30 contributing employers. please contact the administrative office if you have any questions. part Iv - identification of related organizations taxable as A corporation or trust: the administrative office does not currently maintain this information for the 30 contributing employers. please contact the administrative office if you have any questions.