2014-04-10T20:39:48-05:00 2013-06-30 910189318 MOSS ADAMS LLP 805 SW BROADWAY 1200 PORTLAND OR 97205 990 2012-07-01 942329720 RETA TRUST CO GALLAGHER BENEFIT SERVICES OF CA RETA 4155368428 1255 BATTERY STREET SUITE 450 SAN FRANCISCO CA 94111 JOHN STEIN 4155368428 2014-04-07 1 WENDY CAMPOS P00448102 5032421447 2012 2015-11-30 17:44:51Z X JOHN STEIN 1255 BATTERY STREET SUITE 450 SAN FRANCISCO CA 94111 236523972 0 X N/A X 1976 CA THE RETA TRUST WAS FORMED UNDER A RELIGIOUS TRUST AGREEMENT ENTERED INTO BY TWO ROMAN CATHOLIC ARCHDIOCESES, SEVERAL DIOCESES AND SEVERAL RELIGIOUS ORDERS OF THE ROMAN CATHOLIC CHURCH AS A MEANS WHEREIN TO PROVIDE COST EFFECTIVE MEDICAL BENEFITS TO CLERGY, WOMEN RELIGIOUS, AND THEIR LAY EMPLOYEES AND THEIR DEPENDENTS. 10 10 0 12 0 0 0 0 203468669 179761489 1604185 2983205 2859469 1825002 207932323 184569696 0 0 116589568 133054226 0 0 0 0 0 78739447 60752653 195329015 193806879 12603308 -9237183 82793495 92552575 14176549 30073230 68616946 62479345 X THE RETA TRUST WAS FORMED UNDER A RELIGIOUS TRUST AGREEMENT ENTERED INTO BY TWO ROMAN CATHOLIC ARCHDIOCESES, SEVERAL DIOCESES AND SEVERAL RELIGIOUS ORDERS OF THE ROMAN CATHOLIC CHURCH AS A MEANS WHEREIN TO PROVIDE COST EFFECTIVE MEDICAL BENEFITS TO CLERGY, WOMEN RELIGIOUS, AND THEIR LAY EMPLOYEES AND THEIR DEPENDENTS. 0 0 THE RETA TRUST PROVIDES MEDICAL BENEFITS TO CLERGY, WOMEN RELIGIOUS, AND LAY EMPLOYEES AND THEIR DEPENDENTS OF ROMAN CATHOLIC ORGANIZATIONS. 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 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 0 0 1 1 0 0 CA X GALLAGHER BENEFIT SERVICES OF CA 4155368428 1255 BATTERY STREET SUITE 450 SAN FRANCISCO CA 94111 X X PHILIP J RIES 2.50 X X 0 0 0 CLAIRE BLOHM 1.00 X X 0 0 0 SR MARY JO ANDERSON 1.00 X 0 0 0 TOM ARNOLD 1.00 X 0 0 0 MIKE BROWN 1.00 X 0 0 0 MICHAEL CANIZZARO 1.00 X 0 0 0 REV GERALD COLEMAN 1.00 X 0 0 0 SR MARY ELIZABETH GALT 1.00 X 0 0 0 ROBERT SERVENTI 1.00 X 0 0 0 RANDY STEINER 1.00 X 0 0 0 STEVE SALLOT 1.00 X 0 0 0 TOM SCHADLE 1.00 X 0 0 0 JOHN STEIN 40.00 X 0 0 0 0 0 0 0 0 0 0 BENEFIT ALLOCATION SYSTEMS PO BOX 62407 KING OF PRUSSIA PA 19406 CONSULTING SERVICES 2331603 GALLAGHER BENEFIT SERVICES 1255 BATTERY STREET SUITE 450 SAN FRANCISCO CA 94111 CONSULTING SERVICES 2088867 WEBMD 12186 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 CONSULTING SERVICES 822827 MOSS ADAMS LLP 805 SW BROADWAY SUITE 1200 PORTLAND OR 97205 AUDIT, TAX, AND CONSULTING 290836 ARMANINO LLP 9755 SW BARNES ROAD SUITE 660 PORTLAND OR 97225 ACCOUNTING SERVICES 281103 9 TRUSTOR CONTRIBUTIONS 525100 179761489 179761489 179761489 1264497 1264497 53672984 51954276 1718708 1718708 1718708 PRESCRIPT DRUG REBATE 525100 1825002 1825002 1825002 184569696 181586491 0 2983205 133054226 136412 530868 244703 785907 98628 148934 5978 18299 HMO PREMIUMS 43581244 CLAIMS ADMINISTRATION 11387979 REINSURANCE, NET OF REC 2271240 TRUST ADMINISTRATION 199991 1342470 193806879 11378559 10223431 725729 1099641 3814202 2636963 66875005 78592540 82793495 92552575 400627 623788 0 4875000 13775922 24574442 14176549 30073230 X 68616946 62479345 0 0 0 0 68616946 62479345 82793495 92552575 X -9237183 3099581 1 X 0 1 X 1 0 0 CLAIMS INCURRED BUT NOT REPORTED 21367794 PRESCRIPTION CLAIMS PAYABLE 3206648 24574442 187424578 3099581 4 3099585 184324993 244703 244703 184569696 193562178 2 2 193562176 244703 244703 193806879 PART XI, LINE 2D - OTHER ADJUSTMENTS: ROUNDING ADJUSTMENT 4. PART XII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING ADJUSTMENT 2. PART IV, LINE 11F: THE RETA TRUST, AS ESTABLISHED TO HOLD THE PLAN'S NET ASSETS, IS QUALIFIED UNDER SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE AND BY THE CALIFORNIA FRANCHISE TAX BOARD UNDER SECTION 23701(I). ACCORDINGLY, THE RETA TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE RETA TRUST OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE EFFECTIVE AS OF AUGUST 5, 1977. THE TRUST HAS BEEN AMENDED SINCE RECEIPT OF THAT DETERMINATION LETTER. HOWEVER, THE TRUST ADMINISTRATOR AND THE TRUST'S TAX COUNSEL BELIEVE THAT THE TRUST IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET), IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF JUNE 30, 2012 AND 2011, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET), OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2009. JOHN STEIN SEE PART V BELOW 274910 JOHN STEIN IS THE EXECUTIVE DIRECTOR OF THE TRUST BY CONTRACT WITH A THIRD-PARTY MANAGEMENT COMPANY AND IS AN EMPLOYEE OF THAT MANAGEMENT COMPANY; THE MANAGEMENT COMPANY PROVIDES VARIOUS SERVICES TO THE TRUST, WHICH INCLUDE THE EXECUTIVE DIRECTOR POSITION. THE TRANSACTION AMOUNT IS THE AMOUNT THE TRUST PAID THE MANAGEMENT COMPANY FOR HIS SERVICES. 0 (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: TRUST EXECUTIVE DIRECTOR/EMPLOYEE OF MANAGEMENT COMPANY PROVIDING SERVICES TO THE TRUST. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE TRUST ARE THE TRUSTOR ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 7A THE TRUSTOR MEMBERS VOTE TO ELECT THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY SUBJECT TO APPROVAL BY MEMBERS ARE ELECTION OF TRUSTEES, INDEMNIFICATION OF ANY PERSON WHO CLAIMS HIS OR HER ACTIONS WERE TAKEN ON BEHALF OF THE TRUST, AND INDEMNIFICATION AND REMOVAL OF A MEMBER. FORM 990, PART VI, SECTION B, LINE 11 THE EXECUTIVE DIRECTOR AND GENERAL COUNSEL REVIEW THE FORM 990 WITH THE AUDITORS AND KEY MEMBERS OF THE GOVERNING BODY CONCURRENT WITH THE FILING OF THE FORM. FORM 990, PART VI, SECTION B, LINE 15A EXECUTIVE DIRECTOR COMPENSATION IS DETERMINED THROUGH USE OF A COMPENSATION STUDY, WITH APPROVAL BY THE COMPENSATION COMMITTEE AND THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A: THE ORGANIZATION MADE A REASONABLE EFFORT TO COLLECT THE DATA TO COMPLETE PART VII BY REQUESTING FROM EACH TRUSTEE COMPENSATION AND BENEFITS PAID BY THE RELATED ORGANIZATION TO EACH TRUSTEE OF THE FILING ORGANIZATION, HOWEVER, NO ONE PROVIDED THE REQUESTED DATA. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: ROUNDING ADJUSTMENT 1. ARCHDIOCESE OF LOS ANGELES 3224 WILSHIRE BLVD LOS ANGELES CA 90010 951642382 ARCHDIOCESE CA 501(C)(3) 170(B)(1) (A)(I) 0 ARCHDIOCESE OF SAN FRANCISCO ONE PETER YORK WAY SAN FRANCISCO CA 94109 941156707 ARCHDIOCESE CA 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF ORANGE 2811 EAST VILLA REAL DR ORANGE CA 92863 953018918 DIOCESE CA 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF OAKLAND 2121 HARRISON STREET OAKLAND CA 94612 941527086 DIOCESE CA 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF SAN JOSE 1150 N FIRST STREET 100 SAN JOSE CA 95112 942734503 DIOCESE CA 501(C)(3) 170(B)(1) (A)(I) 0 ARCHDIOCESE OF SAN ANTONIO 2718 W WOODLAWN AVE SAN ANTONIO TX 78228 741109740 ARCHDIOCESE TX 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF SAN BERNARDINO 1201 EAST HIGHLAND AVE SAN BERNARDINO CA 92404 530196617 DIOCESE CA 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF TUSCON 111 S CHURCH AVE TUSCON AZ 85701 860133391 DIOCESE AZ 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF BELLEVILLE 222 S THIRD STREET BELLEVILLE IL 62220 370673467 DIOCESE IL 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF NORWICH 201 BROADWAY NORWICH CT 06360 060687373 DIOCESE CT 501(C)(3) 170(B)(1) (A)(I) 0 ARCHDIOCESE OF OKLAHOMA CITY 7501 NW EXPRESSWAY OKLAHOMA CITY OK 73132 730632924 ARCHDIOCESE OK 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF MONTEREY 631 ABREGO STREET MONTEREY CA 93940 941658203 DIOCESE CA 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF LAS VEGAS 336 CATHEDRAL WAY LAS VEGAS NV 89109 880059349 DIOCESE NV 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF VICTORIA 1505 E MESQUITE LANE VICTORIA TX 77901 752231873 DIOCESE TX 501(C)(3) 170(B)(1) (A)(I) 0 FATHER JOE'S VILLAGES 3350 E STREET SAN DIEGO CA 92102 330492304 SOCIAL SERVICES CA 501(C)(3) 509(A)(1) 0 DIOCESE OF TULSA PO BOX 690240 TULSA OK 74169 730942657 DIOCESE OK 501(C)(3) 170(B)(1) (A)(I) 0 ARCHDIOCESE OF ANCHORAGE 1110 WEST SIXTH AVE 606 ANCHORAGE AK 99501 920019215 ARCHDIOCESE AK 501(C)(3) 170(B)(1) (A)(I) 0 SALESIANS OF ST JOHN BOSCO 1100 FRANKLIN ST SAN FRANCISCO CA 94109 941642297 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 CATHOLIC CHARITIES OF GALVESTON-HOUSTON 2900 LOUISANA STREET HOUSTON TX 77006 741109733 SOCIAL SERVICES TX 501(C)(3) 170(B)(1) (A)(I) 0 DOMINICAN SISTERS OF MISSION SAN JOSE 43326 MISSION BLVD FREMONT CA 94539 941449873 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 MARIANIST PROVINCE OF THE UNITED STATES 4425 W PINE BLVD ST LOUIS MO 63108 030415363 RELIGIOUS ORDER MO 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF JUNEAU 419 SIXTH ST STE 300 JUNEAU AK 99801 920019215 DIOCESE AK 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF LAS CRUCES 1280 MED PARK DRIVE LAS CRUCES NM 88005 850303816 DIOCESE NM 501(C)(3) 170(B)(1) (A)(I) 0 HOSPITALLER BROTHERS HEALTHCARE INC 2468 S ST ANDREWS PLACE LOS ANGELES CA 90018 954334552 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 DIOCESE OF FAIRBANKS 1316 PEGER ROAD FAIRBANKS AK 99709 920019215 DIOCESE AK 501(C)(3) 170(B)(1) (A)(I) 0 CARMELITE SISTERS 920 E ALHAMBRA ROAD ALHAMBRA CA 91801 952564138 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 THOMAS AQUINAS COLLEGE 10000 N OJAI ROAD SANTA PAULA CA 93060 941698615 CATHOLIC SCHOOL CA 501(C)(3) 170(B)(1) (A)(II) 0 SANTA CATALINA SCHOOL 1500 MARK THOMAS DR MONTEREY CA 93940 911156652 CATHOLIC SCHOOL CA 501(C)(3) 170(B)(1) (A)(II) 0 RANCHO SAN ANTONIO BOY'S HOME INC 21000 PLUMMER STREET CHATSWORTH CA 91311 951642382 FAMILY SERVICES CA 501(C)(3) 509(A)(3), TYPE III 0 IMMACULATE HEART HIGH SCHOOL 5515 FRANKLIN AVE LOS ANGELES CA 900285999 951643329 CATHOLIC SCHOOL CA 501(C)(3) 170(B)(1) (A)(II) 0 CATHOLIC CHARITIES DIOCESE OF SAN DIEGO 349 CEDAR STREET SAN DIEGO CA 92101 237334012 SOCIAL SERVICES CA 501(C)(3) 170(B)(1) (A)(I) 0 SISTERS OF THE COMPANY OF MARY 16791 E MAIN STREET TUSTIN CA 92780 952462907 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 MERCY HIGH SCHOOL BURLINGAME 2750 ADELINE DRIVE BURLINGAME CA 94010 941230999 CATHOLIC SCHOOL CA 501(C)(3) 170(B)(1) (A)(II) 0 SMALL RELIGIOUS COMMUNITIES 3424 WILSHIRE BLVD LOS ANGELES CA 90005 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 LITTLE SISTERS OF THE POOR 2100 SOUTH WESTERN AVE SAN PEDRO CA 907324389 951972847 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 BISHOP GARCIA DIEGO HIGH SCHOOL 4000 LA COLINA RD SANTA MARIA CA 931101412 952056632 CATHOLIC SCHOOL CA 501(C)(3) 170(B)(1) (A)(II) 0 SISTERS OF THE HOLY NAMES OF JESUS AND MARY US ONTARIO PR 17410 HOLY NAMES DRIVE LAKE OSWEGO OR 97034 204366910 RELIGIOUS ORDER OR 501(C)(3) 170(B)(1) (A)(I) 0 DISCALCED CARMELITE FRIARS PO BOX 2178 REDLANDS CA 923730701 911635570 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 SISTERS OF NOTRE DAME DE NAMUR 1500 RALSTON AVE BELMONT CA 94002 941347084 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 PAULINE BOOKS AND MEDIA 50 ST PAULS AVENUE BOSTON MA 02130 042966563 CATHOLIC BOOKSTORE MA 501(C)(3) 170(B)(1) (A)(I) 0 SOCIETY OF THE SACRED HEART UNITED STATES PROVINCE PO BOX 56607 ST LOUIS MO 63156 431272049 RELIGIOUS ORDER MO 501(C)(3) 170(B)(1) (A)(I) 0 SISTERS OF THE SOCIETY DEVOTED TO THE SACRED HEART 10480 1/2 WINNETKA AVE CHATSWORTH CA 91311 954201880 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 CAPUCHIN FRANCISCAN ORDER OF CALIFORNIA 1345 CORTEZ AVENUE BURLINGAME CA 94010 942609627 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 CATHOLIC CHARITIES OF ORANGE COUNTY 1820 E 16TH STREET SANTA ANA CA 92701 953031389 SOCIAL SERVICES CA 501(C)(3) 170(B)(1) (A)(I) 0 SISTERS OF MERCY WEST MIDWEST COMMUNITY INC 7262 MERCY ROAD OMAHA NE 68124 946071848 RELIGIOUS ORDER NE 501(C)(3) 170(B)(1) (A)(I) 0 SISTERS OF ST FRANCIS - MT ALVERNO 1520 RALSTON AVENUE BELMONT CA 94002 237290790 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 NOTRE DAME ELEMENTARY SCHOOL 1200 NOTRE DAME AVENUE BELMONT CA 940021846 912072682 CATHOLIC SCHOOL CA 501(C)(3) 170(B)(1) (A)(II) 0 RELIGIOUS SISTERS OF CHARITY 10668 ST JAMES DRIVE CULVER CITY CA 90230 953085555 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 FRANCISCAN MISSIONARY SISTERS OF OUR LADY OF SORROWS 2381 LAUREL GLEN ROAD SOQUEL CA 95073 941365586 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 STMICHAELS ABBEY 9292 EL TORO ROAD SILVERADO CA 92676 952380993 RELIGIOUS ORDER CA 501(C)(3) 170(B)(1) (A)(I) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1