FURP.ORG / PUBLIC DATA EXPLORER

IBEW WESTERN UTILITIES HEALTH AND WELFARE TRUST FUND: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
IBEW WESTERN UTILITIES HEALTH AND WELFARE TRUST FUND (EIN 87-0496328)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-07-30
IRS object ID
201222129349300252
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-07-30T09:34:53-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN840676265EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SSA PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line13355 American DriveAddressLine1
CityColorado SpringsCity
StateCOState
ZIP Code809175707ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN870496328EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1IBEWWestern Utilities HealthBusinessNameLine1
Business Name Line2and Welfare Trust FundBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlUTAHNameControl
Phone8019731001Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12156 West 2200 SouthAddressLine1
CitySalt Lake CityCity
StateUTState
ZIP Code841191376ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJulie LewisName
TitleChairpersonTitle
Phone5038135048Phone
Date Signed2012-07-30DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameWilliam C Sanden CPAName
PTINP00013248PTIN
Phone7195740100Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJulie LewisNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1825 E MultnomahAddressLine1
CityPortlandCity
StateORState
ZIP Code97232ZIPCode
FieldValueIRS element (for citing)
Gross Receipts35547053GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Siten/aWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1991YearFormation
State Legal DomicileUTStateLegalDomicile
Activity Or Mission DescriptionProvide medical, dental and life insurance benefitsActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year31542398ProgramServiceRevenuePriorYear
Program Service Revenue CY34204921ProgramServiceRevenueCY
Investment Income Prior Year292317InvestmentIncomePriorYear
Investment Income Current Year327760InvestmentIncomeCurrentYear
Other Revenue Prior Year1200OtherRevenuePriorYear
Other Revenue Current Year3083OtherRevenueCurrentYear
Total Revenue Prior Year31835915TotalRevenuePriorYear
Total Revenue Current Year34535764TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year28944560BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY31093449BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1770230OtherExpensePriorYear
Other Expenses Current Year1734813OtherExpensesCurrentYear
Total Expenses Prior Year30714790TotalExpensesPriorYear
Total Expenses Current Year32828262TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1121125RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1707502RevenuesLessExpensesCY
Total Assets BOY11759394TotalAssetsBOY
Total Assets EOY12963403TotalAssetsEOY
Total Liabilities BOY6738702TotalLiabilitiesBOY
Total Liabilities EOY6319618TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY5020692NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY6643785NetAssetsOrFundBalancesEOY
Mission DescriptionTo provide medical, dental and life insurance benefits to participants of the Plan.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense31864642Expense
DescriptionThe Plan provides medical, dental and life insurance benefits under a collectively bargained agreement between IBEW Local Union 57 and PacifiCorp dba Rocky Mountain Power.Description
Total Program Service Expense31864642TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10961465NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons0AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement0RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Compusys of UtahBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8019731001TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12156 West 2200 SouthAddressLine1
CitySalt Lake CityCity
StateUTState
ZIP Code84119ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (8 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
Brent Donohue
Trustee5.00X000
Calvin Ockey
Trustee5.00X000
Gary Cox
Trustee5.00X000
Julie Lewis
Chairperson5.00X000
Erich Wilson
Trustee5.00X000
Travis Eri
Secretary5.00X000
Paul Radakovich
Trustee5.00X000
Jeremy Courval
Trustee5.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Contributions Medical5241143284054432840544
Contributions Life52411312932231293223
Self Pay Cobra Medical5241145755357553
Flex Forfeitures5241141360113601
FieldValueIRS element (for citing)
Total Program Service Revenue34204921TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column280808TotalRevenueColumn
Exclusion$280,808ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1058241Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1011289Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities46952Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column46952TotalRevenueColumn
Related Or Exempt Function Income46952RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOtherDescription
Business Code900099BusinessCode
Total Revenue Column3083TotalRevenueColumn
Related Or Exempt Function Income3083RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue3083TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column34535764TotalRevenueColumn
Related Or Exempt Function Income34254956RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$280,808ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total31093449Total
Program Services31093449ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total28906Total
Management And General28906ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total27085Total
Management And General27085ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total4852Total
Management And General4852ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total8270Total
Management And General8270ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
Administrative Fees - C552000552000
Managed Care Review - D298244298244
Consultant Fee - Segal198020198020
PPO Fees - Cigna177348177348

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total440088Total
Program Services295601ProgramServices
Management And General144487ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total32828262Total
Program Services31864642ProgramServices
Management And General963620ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY401338BOY
EOY1090637EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1604460BOY
EOY908721EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY433467BOY
EOY604631EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY16446BOY
EOY17783EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY9303683BOY
EOY10341631EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY11759394BOY
EOY12963403EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY663962BOY
EOY185143EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY6074740BOY
EOY6134475EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY6738702BOY
EOY6319618EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY5020692BOY
EOY6643785EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5020692BOY
EOY6643785EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY11759394BOY
EOY12963403EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1707502ReconcilationRevenueExpenses
Reconcilation Other Changes-84409ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Claims Incurred Not Reported$4,716,000
Claims Payable$1,418,475
FieldValueIRS element (for citing)
Total Of Amounts6134475TotalOfAmounts
Total Revenue34535764TotalRevenue
Total Expenses32828262TotalExpenses
Excess Or Deficit For Year1707502ExcessOrDeficitForYear
Net Unrealized GL On Investments-84409NetUnrealizedGLOnInvestments
Total Adjustments-84409TotalAdjustments
Excess Or Deficit Per FS1623093ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt34359886TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-84409NetUnrealizedGainsInvestments
Revenue Not Rptd F990-84409RevenueNotRptdF990
Revenue Subtotal34444295RevenueSubtotal
Investment Expenses Not Included91469InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt91469RevenueNotRptdOnFinStmt
Total Revenue Per Form99034535764TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt32677058TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal32677058ExpensesSubtotal
Investment Expenses Not Included291469InvestmentExpensesNotIncluded2
Other Expenses Not Included59735OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt151204ExpensesNotRptdOnFinStmt
Total Expenses Per Form99032828262TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Uncertain Tax Positions Under FIN 48:Part X:The Plan has adopted Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) 740, Accounting for Uncertainty in Income Taxes, which prescribes a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return and also provides guidance on various related matters such as derecognition, interest, penalties and disclosures required. The Plans determination as a tax-exempt entity is considered a tax position subject to the requirements of ASC 740. There were no unrecognized tax benefits at December 31, 2011, and the Plan does not believe it is reasonably possible that unrecognized tax benefits related to this tax position will significantly change within twelve months of the reporting date. The Plan would recognize interest and penalties, if any, related to unrecognized tax benefits as income tax expense. The Plan did not have any accrued liabilities or expense for interest or penalties related to unrecognized tax benefits for the years ended December 31, 2010 and 2009.
Part XIII, Line 4b: Change in claims incurred not yet reported and change in claims payable.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section B, line 11The Form 990 is reviewed at the Board of Trustees meeting prior to filing the return. All board members have the opportunity to ask questions. The board chairman signs the return at the conclusion of the discussion and is responsible for mailing the return.
Form 990, Part VI, Section C, line 19The documents and financial statements are available upon request by any interested party.
Form 990, Part XI, line 5:Net unrealized losses on investments: -84409.Changes in Net Assets or Fund Balances: