2011-06-15T16:07:06-05:00 2010-08-31 Lindquist LLP 5000 executive parkway suite 400 san ramon CA 94583 990 2009-09-01 946667029 CALIFORNIA TEACHERS ASSOC EMPLOYEES' HEALTH AND WELFARE BENEFITS TRUST CALI 5032825581 PO BOX 4148 Portland OR 97208 dean vogel 5032825581 2011-06-15 1 9252779100 2009 2016-02-24 21:20:13Z Dean Vogel PO BOX 4148 Portland OR 97208 42523995 0 X n/a X 1993 CA provide health and welfare benefits to eligible participants 9 9 0 0 0 0 0 18962630 19429155 705447 1242477 430 4391 19668507 20676023 0 16993601 19464087 0 0 0 1595748 1794223 18589349 21258310 1079158 -582287 20221296 19727540 1931938 1642621 18289358 18084919 To provide health and welfare benefits to eligible participants. 0 0 Provided health and welfare benefits to eligible active and retired 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 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 4 0 1 0 0 0 0 0 0 9 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X wc earhart company inc 5032825581 3140 ne broadway street Portland OR 97232 X dean vogel 3.00 X 0 0 0 roseanne N BECHER 3.00 X 0 0 0 david sanchez 2.00 X 0 0 0 merri BOSTON 2.00 X 0 0 0 carolyn doggett 2.00 X 0 0 0 shannon o'hara 2.00 X 0 0 0 john stephens jr 2.00 X 0 0 0 lisa eck 2.00 X 0 0 0 liz tokar 2.00 X 0 0 0 Gerry Fong 2.00 X 0 0 0 Lisa Adams 2.00 X 0 0 0 0 0 0 0 0 0 0 BLUE CROSS OF CALIFORNIA 801 S FIGUEROA STREET 5TH FLOOR LOS ANGELES CA 90017 CLAIMS ADMINISTRATION 670307 Horizon Consulting 6120 Rolling Road Dr Miami FL 33156 Consulting 192061 THE WILLIAM C EARHART COMPANY PO BOX 4148 PORTLAND OR 97208 CONTRACT ADMINISTRATION 176765 3 Employer Contributions 900099 18976173 18976173 Retiree Medicare Subsi 900099 360771 360771 Participant Contributi 900099 92211 92211 19429155 786527 786527 22303922 21847972 455950 455950 455950 Other Income 900099 4391 4391 4391 20676023 19433546 0 1242477 19464087 177000 99723 52100 25000 1206749 71109 13677 73422 47140 Other Expenses 28303 21258310 -364808 -201959 2056187 1063058 1346959 1360873 85804 62314 17097154 17443254 20221296 19727540 221938 156421 1710000 1486200 1931938 1642621 X 0 0 0 0 18289358 18084919 18289358 18084919 20221296 19727540 X 0 1 1 X 0 0 Mutual funds 17443254 C 17443254 claims payable and incurred but not reported 1486200 1486200 20676023 21258310 -582287 377848 -223800 154048 -428239 21028871 377848 377848 20651023 25000 25000 20676023 21457110 0 21457110 25000 -223800 -198800 21258310 Part XI, Line 8 - Other Adjustments: change in benefit obligations Part XIII, Line 4b - Other Adjustments: CHANGE IN BENEFIT OBLIGATIONS Form 990, Part VI, Section A, line 3 the organization has contracted with W.C. Earhart Company, Inc. to provide administrative services for the organization. Form 990, Part VI, Section B, line 11 the form 990 was provided to all members of the board prior to filing. the board reviewed the form 990 with the administrative manager. Form 990, Part VI, Section B, line 12c if and when a potential conflict of interest is disclosed, the conflict of interest officer (organization's legal counsel) will evaluate if the matter would likely prevent an unbiased or objective decision by a trustee, and as appropriate, disclipinary or corrective action will be taken. Form 990, Part VI, Section C, line 19 The organization makes its financial statements, governing documents and conflict of interest policy available to the public upon request. Form 990, Part XI, Line 2c: The Board of Trustees has responsibility for oversight of the audit and selection of an independent accountant. The process has not changed from the prior year. CALIFORNIA TEACHERS ASSOCIATION EMPLOYEES RETIREMENT BENEFITS 4160 DUBLIN BLVD SUITE 400 DUBLIN CA 94568 TO PROVIDE RETIREMENT BENEFITS CA 501(A) N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0