2015-01-28T12:57:07-06:00 2014-04-30 522385296 LINDQUIST LLP 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2013-05-01 946284253 JOINT BENEFIT TRUST JOIN 9254497070 4160 DUBLIN BLVD NO 400 DUBLIN CA 94568 RICHARD EHRLER TRUSTEE 9254497070 2015-01-28 1 JOSEPH M THIERMANN P01066616 9252779100 2013 2016-02-25 16:41:14Z RICHARD EHRLER 4160 DUBLIN BLVD NO 400 DUBLIN CA 94568 59552462 0 X N/A X 1972 CA PROVIDE HEALTH AND WELFARE BENEFITS 8 0 0 0 0 0 0 0 52129219 47831081 161666 204817 899 38 52291784 48035936 0 0 44062089 39357574 0 0 0 0 0 5764755 5399468 49826844 44757042 2464940 3278894 25867177 26854792 10538692 8325863 15328485 18528929 TO PROVIDE HEALTH AND WELFARE BENEFITS. 0 0 HEALTH AND WELFARE BENEFITS PROVIDED UNDER COLLECTIVE BARGAINING FOR PARTICIPANTS. 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 1 0 0 0 0 0 1 0 0 1 361 0 1 0 0 0 0 0 0 0 X 8 0 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X HEALTH SERVICES & BENEFIT ADMINISTRATORS 9258337300 4160 DUBLIN BLVD SUITE 400 DUBLIN CA 94588 ASHLEY ALVARADO TRUSTEE 2.00 X 0 0 0 JOHN HURLEY TRUSTEE 2.00 X 0 0 0 CRESCENCIO DIAZ TRUSTEE 2.00 X 0 0 0 RICHARD EHRLER TRUSTEE 2.00 X 0 0 0 ADAM OCHOA TRUSTEE 2.00 X 0 0 0 JUSTIN MULLINS TRUSTEE 2.00 X 0 0 0 PABLO BARRERA TRUSTEE 2.00 X 0 0 0 TOM NETT 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 HEALTH SERVICES & BENEFIT ADMIN 4160 DUBLIN BLVD SUITE 400 DUBLIN CA 94588 ADMINISTRATOR FEES 3342797 BLUE CROSS OF CALIFORNIA DEPARTMENT 5812 LOS ANGELES CA 900745812 PPO NETWORK FEE 714944 AMERICAN HEALTH WAYS PO BOX 166718 ATLANTA GA 303687180 ADMINISTRATION FEES 416861 THE SEGAL COMPANY 100 MONTGOMERY STREET SUITE 500 SAN FRANCISCO CA 94104 ACTUARIAL AND CONSULTING FEES 204792 BEESON TAYER & BODINE 483 NINTH STREET OAKLAND CA 94607 LEGAL FEES 196899 6 EMPLOYER CONTRIBUTIONS 900099 43680002 43680002 EMPLOYEE CONTRIBUTIONS 900099 2457540 2457540 STOP-LOSS RECOVERY 900099 1510798 1510798 PRESCRIPTION REBATE INCOME 900099 182741 182741 47831081 277230 277230 11444113 11516526 -72413 -72413 -72413 OTHER INCOME 900099 38 38 38 48035936 47831119 0 204817 39357574 3071147 172113 102070 39027 1665227 269014 34205 37730 MISC. EXPENSES 8935 44757042 1138421 1057406 3536787 4247497 24662 29700 0 0 20671937 21096852 495370 423337 25867177 26854792 236203 254821 10302489 8071042 10538692 8325863 X 0 0 0 0 15328485 18528929 15328485 18528929 25867177 26854792 3278894 -78450 0 X X 0 1 X 1 0 0 ACCUMULATED ELIGIBILITY CREDITS 3073042 GROUP INS PREMIUMS PAYABLE 452000 CLAIMS PAYABLE AND IBNR 4546000 8071042 X 47918459 -78450 -78450 47996909 39027 39027 48035936 46949462 0 46949462 39027 -2231447 -2192420 44757042 PART X, LINE 2: THE PLAN'S ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF APRIL 30, 2014, 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'S ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL YEARS PRIOR TO 2011. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGES IN BENEFIT OBLIGATIONS TEAMSTERS ALCOHOL REHABILITATION PROGRAM COMMON TRUSTEES 56003 PAYMENTS FOR PARTICIPATION IN THE PROGRAM. 0 HEALTH SERVICES FOUNDATION COMMON TRUSTEES 1562630 PAYMENTS FOR HEALTH CHECK-UP EXAMINATIONS. 0 FORM 990, PART VI, SECTION A, LINE 3 THE TRUST HAS CONTRACTED WITH HEALTH SERVICES & BENEFIT ADMINISTRATORS, INC. TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 8B THERE IS NO COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY FOR REVIEW BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C AT LEAST ANNUALLY, TRUSTEES AND OTHER INDIVIDUALS SUBJECT TO THE CONFLICT-OF-INTEREST POLICY WILL BE ASKED TO DISCLOSE IN WRITING ANY RELATIONSHIPS OR INTERESTS THAT COULD GIVE RISE TO A CONFLICT. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, THE CONFLICT-OF-INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE BOARD ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDITED FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED. FORM 990, 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 WTIH THE INTERNAL REVENUE SERVICE BY THE RELATED TAX-EXEMPT ORGANIZATION. IF YOU WOULD LIKE ADDITIONAL INFORMATION, PLEASE CONTACT THE THIRD-PARTY ADMINSTRATOR, HEALTH SERVICES & BENEFIT ADMINISTRATORS, INC. HEALTH SERVICES FOUNDATION 4160 DUBLIN BLVD DUBLIN CA 94568 942260587 TO PROVIDE MEDICAL EXAMINATIONS CA 501(C)(4) N/A N/A 0 TEAMSTERS CA STATE COUNCIL OF CANNERY & FOOD PROCESSING UNIONS 1933 W CALDWELL AVENUE VISALIA CA 93277 942801732 LABOR ORGANIZATION CA 501(C)(5) N/A N/A 0 CALIFORNIA PROCESSORS INC 425 MILITARY EAST BENECIA CA 94510 940360771 TO PROVIDE LABOR RELATIONS SERVICES TO MEMBERS OF CPI CA 501(C)(6) N/A N/A 0 TEAMSTERS ALCOHOL REHABILITATION PROGRAM 1620 N CARPENTER ROAD MODESTO CA 95351 942875955 TO PROVIDE GUIDANCE AND REHABILITATION ACTIVITIES CA 501(C)(4) N/A N/A 0 TEAMSTERS LOCAL UNION 948 TEAMSTERS CANNERY WORKERS FOOD PROCESSORS & HELP CONTRIBUTING EMPLOYER 0 CANNERY WAREHOUSEMEN FOOD PROCESSORS DRIVERS AND HELPERS UNION NO 601 CONTRIBUTING EMPLOYER 0 MOTT'S LLP CONTRIBUTING EMPLOYER 0 0 DEL MONTE CORPORATION CONTRIBUTING EMPLOYER 0 CAMPBELL SOUP SUPPLY CO CONTRIBUTING EMPLOYER 0 H J HEINZ COMPANY CONTRIBUTING EMPLOYER 0 HORMEL FOODS CORP CONTRIBUTING EMPLOYER 0 CON AGRA CONTRIBUTING EMPLOYER 0 OASIS FOODS INC CONTRIBUTING EMPLOYER 0 PACIFIC COAST PRODUCERS CONTRIBUTING EMPLOYER 0 UNILEVER SUPPLY CHAIN INC CONTRIBUTING EMPLOYER 0 STANISLAUS FOOD PRODUCTS CONTRIBUTING EMPLOYER 0 SENECA FOODS LLC CONTRIBUTING EMPLOYER 0 CASCADE LOGISTICS CONTRIBUTING EMPLOYER 0 DOLE PROCESSED FOODS CONTRIBUTING EMPLOYER 0 GENERAL MILLS CONTRIBUTING EMPLOYER 0 MOMENTIVE SPECIALTY CHEMICALS INC CONTRIBUTING EMPLOYER 0 NESTLE CORPORATION CONTRIBUTING EMPLOYER 0 REXAM CONTRIBUTING EMPLOYER 0 SILGAN CONTAINER COMPANY CONTRIBUTING EMPLOYER 0 SUN GARDEN CONTRIBUTING EMPLOYER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0