2013-08-12T18:34:16-05:00 2012-09-30 522385296 LINDQUIST LLP 600 CITY PARKWAY WEST SUITE 300 ORANGE CA 92868 990 2011-10-01 956049026 OPERATING ENGINEERS LOCAL 501 SECURITY FUND OPER 5624635000 13191 CROSSROADS PKWY NORTH NO 205 CITY OF INDUSTRY CA 91746 EDWARD CURLY 5624635000 2013-08-12 1 RICHARD G THIERMANN P00974294 7142570100 2011 2016-02-25 16:41:14Z PAUL BENSI 13191 CROSSROADS PKWY NORTH NO 205 CITY OF INDUSTRY CA 91746 42658663 0 X N/A X 1952 CA TO PROVIDE HEALTH AND WELFARE BENEFITS. 7 0 0 0 0 0 0 0 34309225 34990155 304863 421916 0 4340 34614088 35416411 0 0 33032959 34091738 0 0 0 0 0 1873512 1922940 34906471 36014678 -292383 -598267 14901906 14282441 9868389 8176307 5033517 6106134 TO PROVIDE HEALTH AND WELFARE BENEFITS. 0 0 PROVIDED HEALTH AND WELFARE BENEFITS FOR PARTICIPANTS AND THEIR DEPENDENTS. 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 0 0 0 0 0 0 1 0 0 0 1 X 0 0 1 0 0 0 0 0 0 0 X 7 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 X PETER BATES - BENEFIT PROGRAMS ADMINISTRATION 5624635000 13191 CROSSROADS PARKWAY NORTH CITY OF INDUSTRY CA 917463434 X PAUL BENSI 5.00 X 0 0 0 MICHAEL LATHAM 5.00 X 0 0 0 MILLIE BISONO 5.00 X 0 0 0 WENDY NUTT 5.00 X 0 0 0 JESS ATKINSON 5.00 X 0 0 0 DENISE VUKOJEVICH 5.00 X 0 0 0 EDWARD CURLY 5.00 X 0 0 0 CHRIS BROWN 5.00 X 0 0 0 0 0 0 0 0 0 0 BENEFIT PROGRAMS ADMIN 13191 CROSSROADS PKWY N STE 205 CITY OF INDUSTRY CA 91746 CONTRACT ADMINISTRATOR 1072023 SIERRA HEALTHCARE 2650 N TENAYA WY LAS VEGAS NV 89128 COST CONTAINMENT 142527 ANTHEM BLUE CROSS OF CALIFORNIA 21555 OXNARD ST WOODLAND HILLS CA 91367 NETWORK ACCESS FEES 137977 CREWS MACQUARRIE ASSOC INC 2855 MICHELLE DRIVE STE 100 IRVINE CA 92606 CONSULTANT 114087 4 EMPLOYER CONTRIBUTIONS 900099 30456465 30456465 PARTICIPANT CONTRIBUTI 900099 3961877 3961877 STOP LOSS REIMBURSEMEN 900099 349719 349719 PRESCRIPTION REBATE 900099 211000 211000 MEDICARE PART D SUBSID 900099 11094 11094 34990155 337505 337505 7326663 7242252 84411 84411 84411 OTHER REVENUE 900099 4340 4340 4340 35416411 34994495 0 421916 34091738 1006817 46622 48017 39446 638604 111748 1648 2347 850 12472 MEMBERSHIP FEES 14369 36014678 1092887 1863802 672672 606730 3184211 3326286 67463 3710 9884673 8481913 14901906 14282441 168756 84766 0 192493 9699633 7899048 9868389 8176307 X 0 0 0 0 5033517 6106134 5033517 6106134 14901906 14282441 X -598267 1670884 X X 0 1 1 X 0 0 CLAIMS PAYABLE AND IBNR 2484000 ACCUMULATED ELIGIBILITY CREDITS 5342000 CONTRIB REC'D ON BEHALF OF PENSION PLAN 73048 7899048 35416411 36014678 -598267 320205 -690000 -369795 -968062 35697170 320205 320205 35376965 39446 39446 35416411 36665232 0 36665232 39446 -690000 -650554 36014678 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: MANAGEMENT OF THE ORGANIZATION HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGANIZATION AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2012, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN, OR EXPECTED TO BE TAKEN, THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE YEARS PRIOR TO THE FISCAL YEAR ENDED SEPTEMBER 30, 2009. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS PART XIII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS FORM 990, PART V, LINE 1A: THE THIRD PARTY ADMINISTRATOR FILES ONE 1099 ON BEHALF OF ALL THE PLANS THEY ADMINISTER FOR THE VARIOUS INDEPENDENT CONTRACTORS. THEREFORE, THIS QUESTION HAS BEEN ANSWERED ZERO FOR THIS ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 3 THE PLAN HAS A CONTRACT WITH BENEFIT PROGRAMS ADMINISTRATION (BPA) TO PROVIDE DAY TO DAY ADMINISTRATIVE SERVICES FOR THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO OTHER COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PROVIDED TO THE CHAIRMAN AND SECRETARY FOR THEIR REVIEW PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 320,205. PRIOR PERIOD ADJUSTMENTS: 1,350,679. TOTAL TO FORM 990, PART XI, LINE 5: 1,670,884. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES ASSUMES RESPONSIBILTY FOR OVERSIGHT OF THE ANNUAL AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THERE HAS BEEN NO CHANGE IN THIS PROCESS FROM PRIOR YEAR. INTERNATIONAL UNION OF OPERATING ENGINEERS LOCAL NO 501 2405 WEST 3RD STREET LOS ANGELES CA 90057 951751526 LABOR UNION CA 501(C)(5) N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE R, IDENTICATION OF RELATED ORGANIZATION: THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF SEPTEMBER 30, 2012, THERE ARE APPROXIMATELY 140 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. HOWEVER, CERTAIN INFORMATION THAT IS REQUIRED TO BE REPORTED ON SCHEDULE R SUCH AS EMPLOYER IDENTIFICATION NUMBERS AND LEGAL STRUCTURE (CORPORATION, PARTNERSHIP, ETC.) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT, THE CONTRIBUTING EMPLOYERS HAVE NOT BEEN INCLUDED ON SCHEDULE R.