2013-07-18T13:04:21-05:00 2012-12-31 910614823 SCHOEDEL & SCHOEDEL CPAS PLLC 422 W RIVERSIDE AVE STE 1420 SPOKANE WA 992010395 990 2012-01-01 916030747 Timber Products Manufacturers Trust TIMB 5095354646 951 East 3rd Avenue Spokane WA 99202 Andrew Tomlinson 5095354646 2013-07-18 1 SCOTT OPPERUD CPA P00542597 5097472158 2013-07-17 2012 2016-02-24 21:20:13Z Andrew Tomlinson 951 East 3rd Avenue Spokane WA 99202 34685266 0 X N/A X 1960 WA To provide health care benefits. 7 7 0 0 0 0 0 0 25880281 30855229 167202 158446 0 0 26047483 31013675 0 0 21145053 26321122 0 0 0 0 0 2586491 3117656 23731544 29438778 2315939 1574897 8822472 11458588 3792593 4821028 5029879 6637560 To provide and maintain, through self-insurance and/or by issued policies, health care benefits to the employees of the participating employers and the employees' qualified dependents. 0 0 The Trust was established to provide and maintain a program of health & welfare benefits constituting an "Employee Welfare Benefit Plan" for the exclusive benefit of employees of participating member employers of the Timber Products Manufacturers Association, and those employees' covered dependents. 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 1 0 0 0 0 0 1 0 0 1 5 0 1 0 0 0 0 0 0 0 X 7 7 0 1 0 0 0 1 1 1 1 0 0 1 1 1 1 0 0 0 0 0 MT X The Organization 5095354646 951 East 3rd Avenue Spokane WA 99202 X Andrew Tomlinson 5.00 X X 0 0 0 Richard Molenda 2.00 X 0 0 0 Loren R Rose 2.00 X 0 0 0 Jeff Gunnarson 2.00 X 0 0 0 John Swaggart 2.00 X 0 0 0 Larry Schmedding Jr 5.00 X X 0 0 0 James Michael Clements 2.00 X 0 0 0 0 0 0 0 0 0 0 Premera Blue Cross PO Box 327 Seattle WA 98111 Benefits Processor 1694044 Corkery & Jones Benefits Inc 818 W Riverside Ste 800 Spokane WA 99201 Benefits Consultant 211280 OptumInsight PO Box 86 SDS 12-2547 Minneapolis MN 554862547 Actuary, Consultant 142042 3 Employer contributions 525100 30501260 30501260 Participant contributions 525100 233520 233520 Late fees 525100 120449 120449 30855229 169971 169971 3660066 3671591 -11525 -11525 -11525 31013675 30855229 0 158446 26321122 2091227 17035 20000 44366 692248 12281 13388 9898 Premium taxes and asses 217213 29438778 2301344 842348 1150471 3708124 73989 472798 20000 5231187 6101572 45481 333746 8822472 11458588 226632 137088 303590 453587 3262371 4230353 3792593 4821028 X 0 0 0 0 5029879 6637560 5029879 6637560 8822472 11458588 1574897 32784 0 X 0 1 X 1 0 0 Claims payable 1269100 Claims incurred but not reported 2961253 4230353 31046459 32784 32784 31013675 0 31013675 28470796 0 28470796 967982 967982 29438778 Part XII, Line 4b - Other Adjustments: Increase in benefits obligation 967,982. Loren Ray Rose Trustee 989957 Loren Ray Rose is both a Trustee of the Trust and a key employee of a participating member employer contributing to the Trust. Contributions to the Trust by Pyramid Mountain Lumber, Inc. totaled $989,957. 0 Andy Tomlinson Trustee 63269 Andy Tomlinson is both a Trustee of the Trust and a key employee of a participating member employer contributing to the Trust. Contributions to the Trust by Atlas Logistics, LLC totaled $63,269. 0 Jeff Gunnarson Trustee 1458328 Jeff Gunnarson is both a Trustee of the Trust and a key employee of a participating member employer contributing to the Trust. Contributions to the Trust by SB, Inc., dba Sherman Brothers totaled $1,458,328. 0 Larry Schmedding Jr Trustee 854404 Larry Schmedding, Jr. is both a Trustee of the Trust and a key employee of a participating member employer contributing to the Trust. Contributions to the Trust by Empire Lumber Company totaled $854,404. 0 Richard Molenda Trustee 150808 Richard Molenda is both a Trustee of the Trust and a key employee of a participating member employer contributing to the Trust. Contributions to the Trust by Western Bee Supplies, Inc. totaled $150,808. 0 James Michael Clements Trustee 112935 James Michael Clements is both a Trustee of the Trust and a key employee of a participating member employer contributing to the Trust. Contributions to the Trust by Intermountain-Orient totaled $112,935. 0 John Swaggart Trustee 351598 John Swaggart is both a Trustee of the Trust and a key employee of a participating member employer contributing to the Trust. Contributions to the Trust by Swaggert Brothers, Inc. totaled $351,598. 0 Form 990, Part VI, Section A, line 3 The day to day operations of the Trust are supervised by a Trust Health Plan Director who reports directly to the Trust's Board of Trustees. The Trust also utilizes Premera Blue Cross and REHN & Associates to perform claims processing, case management, and other administrative services. Form 990, Part VI, Section A, line 7a The Trust is administered by a Board of Trustees. Individual trustee positions are selected as described below. The Trust shall be administered by a Board of Trustees which shall consist of nine (9) trustees appointed by the Board of Directors of the sponsor (sponsor board). Only directors of the sponsor board whose companies are participating employers may vote on the appointment of Trustees. At least seven (7) of the Trustees must be individuals who represent participating employees who are covered under the plan. Such individuals may include a covered employee as well as an officer or management representative of a participating employer, even if that officer or management representative is not an actual plan participant. The Trustees so appointed shall sign the Trust Agreement, or a duplicate thereof, or an Oath of Trustee in a form approved by the Board of Trustees, and such signatures shall constitute acceptance of office and agreement to act under and be subject to all the terms and conditions of the Trust Agreement and amendments thereto. Form 990, Part VI, Section A, line 7b Any changes in the Plan document authorized by the Board of Trustees of this trust must be approved by the sponsor, Timber Products Manufacturers Inc. Form 990, Part VI, Section B, line 11 The Form 990 was prepared under the guidance of the Trust's Health Plan Director by the independent accounting firm SCHOEDEL & SCHOEDEL, Certified Public Accountants, PLLC. Draft copies of the Trust's financial statements and Form 990 were first provided to the Health Plan Director, who reviewed the Form 990 for accuracy and completeness. Any questions, concerns or issues raised by the Health Plan Director were addressed and any necessary revisions were made to the Form 990. The revised Form 990 was then provided to the Board of Trustees for its review. Any additional questions, concerns or issues raised by the Board of Trustees were addressed and any necessary revisions were made to the Form 990. Form 990, Part VI, Section B, line 12c Trustees, service providers, third-party administrators, or any other person having responsibility for the management or administration of the Trust's finances, investments, or other proprietary information concerning the Trust are considered interested persons. An interested person is under a continuing obligation to disclose any potential conflict of interest to the Board of Trustees as soon as it is known or reasonably should be known. The interested person is given the opportunity to disclose all material facts to the Trustees when considering the proposed transaction or arrangement. After disclosure of the financial, professional, or personal interest and all material facts, and after any discussion with the interested person, he/she leaves the Trustees meeting while the determination of a conflict of interest is considered. If the disinterested Trustees determine a conflict of interest exists, the Chairman of the Board, if appropriate, appoints a disinterested person or committee to investigate alternatives to the proposed transaction or arrangement. After exercising due diligence, the Trustees determine whether the Trust can obtain with reasonable efforts a more advantageous transaction or arrangement with a person or entity that would not give rise to a conflict of interest. If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a conflict of interest, the Board or committee determines by majority vote of the disinterested Trustees whether the transaction agreement or arrangement is in the Trusts best interest, for its own benefit, and whether it is fair and reasonable. In conformity with the above determination the Trustees make a decision as to whether to enter into the transaction agreement or arrangement. The minutes of the meeting reflect that the conflict disclosure was made to the Board, the vote taken and, where applicable, the abstention from voting and participation by the interested party. Whenever possible, the minutes frame the decision of the Board in such a way to provide guidance for consideration of future conflict of interest situations. To ensure the Trust operates in a manner consistent with its tax-exempt purposes and does not engage in activities that could jeopardize its tax-exempt status, the Board of Trustees conducts periodic reviews. The periodic reviews include, at a minimum, the following subjects: Whether the contractual arrangements with service providers and the services provided are reasonable, based on competent market and survey information, and the result of arm's length negotiation. Whether contractual arrangements with service providers and arrangements with other organizations conform to written policies, are properly recorded, reflect reasonable investment or payments for goods and services, further tax-exempt purposes, and do not result in inurement, impermissible private benefit or in an excess benefit transaction. Whether any transaction conducted by the Trust during the review period involves or could possibly give rise to a conflict of interest. Form 990, Part VI, Section B, line 15: The Trust has no compensated management officials, officers or key employees. If the organization had such compensated individuals, policies and procedures would be developed to determine compensation. Form 990, Part VI, Section C, line 19 The Trust's governing documents, conflict of interest policy, financial statements and Form 990 are available to the general public upon written request sent to the sponsor of the Trust, Timber Products Manufacturers Inc., at 951 East Third Avenue, Spokane, WA 99202. Timber Products Manufacturers Assoc 951 E Third Ave Spokane WA 99202 910820598 A human resources and employee benefits association. WA 501(C)(6) N/A 0 AOL Services Inc OR 0 Atlas Logistics ID 0 Axmen - BTO Inc MT 0 Baker Truck Service Inc ID 0 Basco Logging OR 0 Bear Creek Lumber Inc WA 0 Bitterroot Valley Forest Products MT 0 Blackwell Consolidation OR 0 BMI Contractors OR 0 Bob Roper Logging MT 0 Borgford Group Design & Mfg LLC WA 0 Bovenkamp Development Inc DBA Westside Building Supply WA 0 Bronson Lumber Co OR 0 Buckeye Hardwoods and Lumber LLC MT 0 Burnich Frame & Moulding MT 0 Carlock Logging ID 0 Chinook Wood LLC OR 0 Columbia Cedar- Lazy S Lumber WA 0 Columbia Cedar Inc WA 0 Colville Tribal Enterprise Corp (CTEC) WA 0 Colville Tribal Gaming Division (CTGD) WA 0 Conrad Forest Products OR 0 Cowboy Truss Inc dba Laramie Trusses WY 0 CTSC WA 0 Cudahy Lumber Company OR 0 Dabco Inc ID 0 Darby Distribution MT 0 Dart Enterprises Inc dba HPS OR 0 Dawson Trucking Inc WA 0 Dayspring Hardwood & Moulding Inc OR 0 Dealers Supply Company OR 0 Diamond Line ID 0 Diamond Line Delivery Systems ID 0 Diebold Lumber OR 0 Don G Averill Trucking Inc OR 0 Douglas County DBA Douglas County Forest Products OR 0 Drakes 7 Dees Inc OR 0 Dunkel Logging ID 0 EBC Truss Inc MT 0 Eby Brothers Inc ID 0 Edward E Anderson Logging LLC OR 0 Empire Lumber Co WA 0 Energy Products of Idaho ID 0 Enyeart Cedar Products LLC ID 0 Essex General Construction OR 0 Fast Way Freight System Inc WA 0 First Call Computer Solutions MT 0 Fodge Pulp Inc ID 0 Frontier Transportation Inc MT 0 Gates Furniture of Grants Pass Inc ID 0 GDA Engineers OR 0 Giustina Resoures WY 0 Goshen Forest Products OR 0 Granger Company OR 0 Gunnels Brothers Inc WA 0 HE Simpson Lumber Co MT 0 Hagerman Inc OR 0 Harbor Paper LLC WA 0 Hatley Construction Inc OR 0 Henness Logging OR 0 Hermann Intermountain Corporation WA 0 Huff Construction MT 0 Huffman Wright Logging OR 0 Huffman Wright Logging Co MT 0 Hunt's Timbers Inc MT 0 Idaho Veneer Company ID 0 Inland Telephone Company WA 0 Intermountain Forest Association (WY) WY 0 Intermountain-Orient Inc ID 0 Ironwood Manufacturing Inc MT 0 J & R Planing Inc MT 0 J I Morgan Logging ID 0 Jerry Short Cabinets ID 0 John Jump Trucking Inc MT 0 Ken Miller Logging ID 0 Kenyon Noble Lumber Co MT 0 Kenyon Noble Lumber Co-Cobra OR 0 Kimwood Corporation OR 0 Kingston Cedar MT 0 Klingler Lumber Co MT 0 Knutson Towboat OR 0 Kuykendall Logging ID 0 LC Staffing MT 0 LC Staffing - Bozeman MT 0 Leavitt's Freight Service OR 0 Leavitt's Freight Service-Cobra OR 0 Lester Sales OR 0 Lewis & Clark Machinery OR 0 LHC Inc MT 0 Lincoln's Silver Dollar Bar & Gifts Inc MT 0 Line Haul Logistics Inc MT 0 Linton's Big R Stores WY 0 Little Green dba Paneltech WA 0 Log Max Inc WA 0 Lulay Timber Co Inc OR 0 Lydig Construction WA 0 Mann Industrial Contractors ID 0 Marks Lumber MT 0 Marshall Company ID 0 McCollum Logging Inc OR 0 McFarland Co OR 0 McLaughlin Logging Inc ID 0 Medley Co Cedar Inc ID 0 Metriguard WA 0 Mineral Community Hospital MT 0 Mineral Community Hospital-Clinic MT 0 Missoula Saws Inc MT 0 Montana Container Corp MT 0 My Family Contractor Inc dba Timberline WA 0 Neal Canaday Trucking Inc ID 0 Nelson Personnel MT 0 North Idaho Energy Logs Inc ID 0 North Idaho Maritime ID 0 Northwest Management Inc ID 0 Northwest Youth Corps OR 0 NWD dba Northwestern Design OR 0 Orchard Wood Products OR 0 Oroville Reman & Reload Inc WA 0 PRO Inc (Professional Reforestation of OR) OR 0 Pacific Architectural Wood Products Inc OR 0 Pacific Cabinets Inc ID 0 Pacific Rim Manufacturing LLC OR 0 Paulson Logging Inc OR 0 PFB America ID 0 PFB America-Mountian Architects ID 0 PFB America-PFB Manufacturing ID 0 PFB America-Precision Craft ID 0 PFP Particle Board ID 0 Plummer Forest Products ID 0 Precision Machine and Manufacturing Inc OR 0 Pyramid Mountain Lumber Inc MT 0 Rain Forest Lumber Company Inc OR 0 Rainier Custom Remanufacturing OR 0 Real Wood Products OR 0 Reeds Fuel OR 0 Renfro & Sons Inc WA 0 Rich's Modern Flooring MT 0 Roadtech Inc MT 0 Ron Bowers Inc OR 0 Rowand Machinery Company MT 0 S & L Industrial WA 0 SE Incorporated WY 0 Salmon River Wood Inc MT 0 Samuel's (Marks Inc) MT 0 SB Inc dba Sherman Brothers OR 0 Schlegel Enterprises Inc MT 0 Select Euro Systems ID 0 SEW of Oregon Inc OR 0 Shake & Shingle Sales Inc WA 0 Sidney Millwork Co MT 0 Snow Peak Forest Products ID 0 Snow Peak Forest Products - Coeur d'Alene ID 0 SonByrd Industries Inc ID 0 Spacesaver Specialists Inc OR 0 Springdale Lumber and BioEnergy LLC WA 0 St Maries Logging ID 0 Stapleton Timber & Excavation OR 0 Stensrud Cabinet Company MT 0 Strata Forestry Inc OR 0 Structural Components WA 0 Sun Mountain Lumber MT 0 Sunshine Disposal Inc WA 0 Swaggart Brothers Inc OR 0 Synergy Construction WY 0 Taylormade Products OR 0 Teevin Bros Land & Timber OR 0 Teton West Lumber Inc WY 0 The Lift Company OR 0 Thomas H Ireland Trucking OR 0 Thompson River Lumber Co of MT MT 0 Timber Products Manufacturers Assoc WA 0 TMI Forest Products OR 0 Tower Timber Service Inc WA 0 Tricon Timber LLC MT 0 Tricon Timber LLC- Clark Fork Transport MT 0 Tricon Timber LLC- Inland Northwest Landscape MT 0 Trus-Way Inc WA 0 Uncommon Cabinetry OR 0 Ureco Inc MT 0 Vaught Trucking MT 0 Vinson Brothers Construction Inc OR 0 WB & L Machine DBA AIMMCO WA 0 Western Bee Supplies Inc MT 0 Western Reclamation LLC MT 0 Whitco Inc ID 0 Whiteman Lumber Company ID 0 Withers Lumber Company OR 0 Woodpecker Truck & Equipment Inc OR 0 Zacharias Logging OR 0 Zosel Lumber Company WA 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1