EXECUTIVE DIRECTOR

2011-03-29T11:04:59-05:00 2010-09-30 Lindquist LLP 5000 Executive Parkway Suite 400 San Ramon CA 94583 990 2009-10-01 776009955 CALIFORNIA'S VALUED TRUST CALI 5594372960 520 EAST Herndon AVENUE Fresno CA 93720 VALERIE CORNUELLE EXECUTIVE DIRECTOR 5594372960 2011-03-29 1 9252779100 2009 2016-02-24 21:20:13Z VALERIE CORNUELLE 520 EAST Herndon AVENUE Fresno CA 93720 824478410 0 X WWW.CVTRUST.ORG X 1984 CA PROVIDE HEALTH AND WELFARE BENEFITS. 12 12 30 0 0 0 0 486717941 521700015 -11366210 4953696 22762 22471 475374493 526676182 0 494654653 505308934 2687022 3224151 0 0 19572028 19651479 516913703 528184564 -41539210 -1508382 105492838 105960246 52116609 50715638 53376229 55244608 TO PROVIDE HEALTH AND WELFARE BENEFITS. 0 0 PROVIDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 6 0 1 30 1 0 0 0 0 0 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Robert Powers 5594372960 520 E Herndon Fresno CA 93720 Michael Parks Trustee 4.00 X 0 0 270 RAMIRO CARREON Trustee 4.00 X 0 0 270 Carole Luckenbach Trustee 4.00 X 0 0 270 Elizabeth Zulueta Trustee 4.00 X 0 0 270 Sue Eustice Trustee 4.00 X 0 0 68 Elaine Cash Trustee 4.00 X 0 0 270 Nancy Smith Trustee 4.00 X 0 0 270 John Pestorich Trustee 4.00 X 0 0 270 Larry Yeghoian Trustee 4.00 X 0 0 270 CARYN COSS Trustee 4.00 X 0 0 0 Lee Coelho trustee 4.00 X 0 0 270 Anthony Parreira trustee 4.00 X 0 0 270 David B Vaughn Executive Director 40.00 X 185878 0 27472 ROBERT POWERS DIRECTOR OF FINANCIAL SERV 40.00 X 106726 0 21536 VALERIE CORNUELLE DIRECTOR OF MEMBER SERVICE 40.00 X 132294 0 23454 424898 0 75230 3 0 1 0 ANTHEM BLUE CROSS 11050 OLSON DRIVE SUITE 110 RANCHO CORDOVA CA 95670 CLAIMS ADMINISTRATIVE SERVICES 11514380 DELTA DENTAL 100 FIRST STREET 6TH FLOOR SAN FRANCISCO CA 94105 CLAIMS ADMINISTRATIVE SERVICES 3753039 VISION SERVICE PLAN 3333 QUALITY DRIVE RANCHO CORDOVA CA 95670 CLAIMS ADMINISTRATIVE SERVICES 883909 CVS CAREMARK 9501 E SHEA BLVD MC 045 SCOTTSDALE AZ 85260 CLAIMS ADMINISTRATIVE SERVICES 625392 MERCER 777 SOUTH FIGUEROA STREET SUITE 19 LOS ANGELES CA 90017 ACTUARIAL SERVICES 450462 9 Employer Contributions 900099 487599936 487599936 Participant Contributi 900099 25042847 25042847 Stop Loss Income 900099 3996810 3996810 EARLY RETIREE SUBSIDY 900099 3481114 3481114 COBRA SUBSIDY 900099 1579308 1579308 521700015 3264733 3264733 299491191 297802228 1688963 1688963 1688963 Administrative Service 900099 22471 22471 22471 526676182 521722486 0 4953696 505308934 228120 1774397 124853 945806 150975 90712 103555 149559 17850533 104521 415073 25177 90935 124729 137754 1368 445853 111710 528184564 -6293695 -1163692 4942839 7411381 14900228 157939 128628 3855131 1270288 2985212 2584843 54734095 55616368 41555067 33893871 105492838 105960246 1720623 1656118 8293770 8784930 42102216 40274590 52116609 50715638 X 0 0 0 0 53376229 55244608 53376229 55244608 105492838 105960246 X 0 1 1 X 0 1012000 1012000 1538704 352944 1185760 1304427 917344 387083 2584843 COMMON/COLLECTIVE TRUST 33893871 F 33893871 CLAIMS/IBNR AND PREMIUMS PAYABLE 37918330 Obligations for Benefits of Others 616599 POST RETIREMENT BENEFIT COST 1578500 DUE TO BROKER FOR SECURITIES PURCHASED 161161 40274590 526676182 528184564 -1508382 3376761 -2702950 673811 -834571 529903384 3376761 3376761 526526623 149559 149559 526676182 530737955 0 530737955 149559 -2702950 -2553391 528184564 Part XI, Line 8 - Other Adjustments: CHANGE IN BENEFIT OBLIGATIONS Part XIII, Line 4b - Other Adjustments: CHANGE IN BENEFIT OBLIGATIONS X 0 0 0 David B Vaughn 185878 0 0 0 0 0 13940 0 13532 0 213350 0 0 0 VALERIE CORNUELLE 132294 0 0 0 0 0 9922 0 13532 0 155748 0 0 0 Form 990, Part VI, Section B, line 11 A copy of the form 990 WAS provided to the organization's governing body FOR THEIR REVIEW PRIOR TO FORM 990 beING FILED. Form 990, Part VI, Section B, line 12c AT LEAST ANNUALLY, DIRECTORS AND OTHER FIDUCIARIES ARE ASKED TO DISCLOSE IN WRITING ANY RELATIONSHIPS OR INTERESTS THAT COULD GIVE RISE TO A CONFLICT. If there is a conflict of interest, the conflicting interest is fully disclosed and documented in writing; the Director or fiduciary with the conflict of interest is excluded from the discussion and approval of such transactions; and the Board determines that the transaction is in the best interest of the Trust and the terms of the transaction are fair with respect to terms available through armS-length transactions in the marketplace. Form 990, Part VI, Section B, line 15 Compensation for the Executive Director WAS APPROVED BY THE BOARD OF TRUSTEES IN 2009. 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. Form 990, Part X, Line 2C: The AUDIT COMMITTEE assumes responsibility of the audited financial statements and the selection of their independent accountant that audits the organization's financial statements.