2015-07-09T15:19:21-05:00 2014-08-31 300702322 HEMMING MORSE CPA'S AND CONSULTANTS 155 BOVET ROAD SUITE 600 SAN MATEO CA 94402 990 2013-09-01 996014749 HAWAII LABORERS HEALTH AND WELFARE PLAN HAWA 8084418600 1440 KAPIOLANI BLVD NO 800 HONOLULU HI 96814 TRUSTEE TRUSTEE 8084418600 2015-07-09 1 P00739466 4158364000 2013 2016-02-25 16:41:14Z TRUSTEE 1440 KAPIOLANI BLVD NO 800 HONOLULU HI 96814 158166093 0 X N/A X 1967 HI SEE PART III LINE 4A 10 10 0 0 0 0 0 0 22447573 23010631 2024228 2479581 499176 1262272 24970977 26752484 0 0 27316780 27676368 0 0 0 0 0 2384787 2651635 29701567 30328003 -4730590 -3575519 93671420 93273050 18541841 20108149 75129579 73164901 NONE 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR BENEFICIARIES ACCORDING TO THE TERMS OF THE COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE EMPLOYERS AND THE UNION. 0 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 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 575 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X PACIFIC ADMINISTRATORS INC 8084418600 1440 KAPIOLANI BLVD SUITE 800 HONOLULU HI 96814 X ALFONSO OLIVER TRUSTEE 5.00 X 0 0 0 PETER GANABAN TRUSTEE 5.00 X 0 0 0 JOBY NORTH II TRUSTEE 5.00 X 0 0 0 ANACLETO ALCANTRA TRUSTEE 5.00 X 0 0 0 RICHARD NISHIE TRUSTEE 5.00 X 0 0 0 MARK MATSUMOTO TRUSTEE 5.00 X 0 0 0 RUSSELL NONAKA TRUSTEE 5.00 X 0 0 0 LARRY LUM TRUSTEE 5.00 X 0 0 0 RON PRESCOTT TRUSTEE 5.00 X 0 0 0 MARK TAGAMI TRUSTEE 5.00 X 0 0 0 0 0 0 0 0 0 0 PACIFIC ADMINISTRATORS INC 1440 KAPIOLANI BLVD SUITE 800 HONOLULU HI 96814 PLAN ADMINISTRATION 1633449 EXPRESS SCRIPTS ONE EXPRESS WAY ST LOUIS MO 63121 CLAIMS PROCESSING 118161 2 EMPLOYER CONTRIBUTIONS 900099 21979295 21979295 PARTIC. CONTRIBUTIONS 900099 934504 934504 COBRA CONTRIBUTIONS 900099 96832 96832 23010631 2636381 2636381 131256809 131413609 -156800 -156800 -156800 STOP LOSS REIMBURSEMENT 900099 454552 454552 PREMIUM REFUNDS 900099 434969 434969 OTHER INCOME 900099 287884 287884 84867 84867 1262272 26752484 24116103 0 2636381 27676368 1836810 152017 36701 125547 162757 90738 13331 28243 ACA REINSURANCE FEE 152292 NATIONAL HEALTH FUND 32332 OTHER 17314 PCORI FEE 3553 30328003 23588312 13660808 2103133 2112864 22732 28283 66929006 76093930 1028237 1377165 93671420 93273050 113291 196951 18428550 19911198 18541841 20108149 X 0 0 0 0 75129579 73164901 75129579 73164901 93671420 93273050 -3575519 1610841 0 X X 0 1 X 1 0 0 CLAIMS INCURRED BUT NOT REPORTED 1949016 ACCUMULATED ELIGIBILITY CREDITS 16462182 DUE TO BROKER 1500000 19911198 28363325 1610841 1610841 26752484 0 26752484 30328003 0 30328003 0 30328003 FORM 990, PART VI, SECTION B, LINE 11 THE ADMINISTRATOR PERFORMS A REVIEW OF THE 990 FOR REASONABLENESS BASED ON THE PRIOR YEAR RETURN AND AUDITED FINANCIAL STATEMENTS; THE TRUSTEES ARE PROVIDED A COPY OF THE FORM 990 FOR THEIR REVIEW PRIOR TO SIGNING AND FILING. FORM 990, PART VI, SECTION B, LINE 12C DURING EACH REGULARLY SCHEDULED BOARD OF TRUSTEE MEETING, THE CONSULTANTS GIVE DETAILED REPORTS ON VARIOUS ASPECTS OF THE FUND'S ACTIVITIES. IN THE COURSE OF THESE REPORTS, POTENTIAL OR ACTUAL CONFLICTS OF INTEREST MAY BE REVEALED. EVERY SITUATION, SHOULD THEY ARISE, IS DEALT WITH IN THE APPROPRIATE MANNER BASED ON THE GUIDELINES SET FORTH IN THE POLICY. FORM 990, PART VI, SECTION C, LINE 18 THE ENTITY IS NOT A 501(C)(3) PLAN, AND IS THEREFORE NOT REQUIRED TO MAKE ITS FORM 990 AVAILABLE TO THE PUBLIC. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL INFORMATION ARE AVAILABLE UPON REQUEST AS STATED IN THE SUMMARY ANNUAL REPORTS THAT ARE DISTRIBUTED EACH PLAN YEAR TO ALL PLAN PARTICIPANTS. FORM 990, PART XI, LINE 2C: THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE PLAN'S FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT AUDITOR. HAWAII LABORERS PENSION 1440 KAPIOLANI BLVD STE 800 KAPOLEI HI 96814 996025107 TO PROVIDE PENSION BENEFITS TO PARTICIPANTS HI 401(A) 0 HAWAII LABORERS ANNUITY FUND 1440 KAPIOLANI BLVD STE 800 KAPOLEI HI 96814 990322478 TO PROVIDE AND MAINTAIN AN ANNUITY FUND FOR THE ELIGIBLE PARTICIPANTS HI 501(C)(9) 0 HAWAII LABORERS VACATION AND HOLIDAY FUND 1440 KAPIOLANI BLVD STE 800 KAPOLEI HI 96814 996025505 TO PROVIDE VACATION AND HOLIDAY BENEFITS TO ELIGIBLE PARTICIPATING EMPLOYEES HI 501(C)(9) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FORM 990, PART IV, LINE 34 SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS: THE FILING ENTITY IS A 501(C)(9) VEBA WHO MUST LIST CONTRIBUTING EMPLOYERS ON SCHEDULE R. THE ADMINISTRATIVE OFFICE MAINTAINS A LIST OF CONTRIBUTIONS EMPLOYERS, HOWEVER, THAT LIST DOES NOT INCLUDE FEDERAL TAX CLASSIFICATION. THEREFORE, THE LIST OF CONTRIBUTING EMPLOYERS IS REPORTED ON PART VII, SUPPLEMENTAL INFORMATION. COMMERCIAL ELECTRIC INC CONSTRUCTION SYSTEMS HAWAII LLC. 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