2011-08-24T18:55:52-05:00 2010-12-31 LEMKE CHINEN & TANAKA CPA INC 210 WARD AVE SUITE 336 HONOLULU HI 968144012 990 2010-01-01 010757287 UFCW - HAWAII FOOD EMPLOYERS HEALTH & WELFARE TRUST FUND UFCW 8088417575 200 N VINEYARD BLVD STE 100 NO 200 HONOLULU HI 96817 PATRICK LOO CARL RAMNITZ 8088417575 2011-08-24 1 TERRY TAKAKI 8085336254 2010 2016-02-24 21:20:13Z 200 N VINEYARD BLVD STE 100 NO 200 HONOLULU HI 96817 18965091 0 X N/A X 2002 HI TO PROVIDE HEALTH & WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 4 4 0 0 0 0 0 0 9245694 9129110 114181 91798 0 53665 9359875 9274573 0 0 7813820 9403856 0 0 0 0 0 266095 330157 8079915 9734013 1279960 -459440 12849184 12394830 12154 17240 12837030 12377590 TO PROVIDE HEALTH & WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 7124956 PROVIDING MEDICAL SELF-INSURED BENEFITS FOR ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS (HMA $5,798,060, HMSA SUPPLEMENTAL DRUG $40,940, CATALYST $1,285,956). 1402343 PROVIDING MEDICAL INSURANCE PREMIUMS FOR ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS (KAISER PERMANENTE $1,130,922, HMSA $271,421). 876557 PROVIDING DENTAL, CHIRO, VISION, AND LIFE INSURANCE PREMIUMS FOR ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS (HAWAII DENTAL SERVICE $649,561, DCCH $58,833, PACIFIC GUARDIAN LIFE $32,860, CHIROPLAN $28,751, VISION SERVICE PLAN $106,552). 9403856 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 X 4 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X HAWAII BENEFIT ADMINISTRATORS INC 8088417575 200 N VINEYARD BLVD STE 100 HONOLULU HI 96817 X FRANK JORGENSEN 1.00 X 0 0 0 PATRICK K LOO 1.00 X 0 0 0 CARL RAMNITZ 1.00 X 0 0 0 LYLE SETTER 1.00 X 0 0 0 0 0 0 0 0 0 0 HMA INC 1440 KAPIOLANI BLVD HONOLULU HI 96814 CLAIMS ADMINISTRATOR 368105 HAWAII BENEFIT ADMINISTRATORS INC 200 N VINEYARD BLVD STE 100 HONOLULU HI 96817 THIRD PARTY ADMINISTRATOR 108379 2 EMPLOYER CONTRIBUTIONS 900099 8963180 8963180 SELF PAY & COBRA CONTR 900099 165930 165930 9129110 91490 91490 9690826 9690518 308 308 308 NET UNREALIZED GAINS 900099 53665 53665 53665 9274573 9129418 0 145155 9403856 101896 36004 23537 17773 20273 4220 11524 34272 7740 CONSULTANT FEES 67497 BANK FEES 5421 9734013 12025847 11602236 797340 790145 2501 2449 23496 12849184 12394830 12154 17240 12154 17240 X 12837030 12377590 12837030 12377590 12849184 12394830 -459440 0 X X 0 1 1 X 0 0 9274573 9734013 -459440 0 -459440 9256800 0 9256800 17773 17773 9274573 9716240 0 9716240 17773 17773 9734013 FORM 990, PART VI, SECTION B, LINE 11 ONE MANAGEMENT AND ONE LABOR TRUSTEE SIGN THE FORM 990. THE FORM 990 IS ALSO PROVIDED TO THE BOARD OF TRUSTEES AT THE QUARTERLY BOARD MEETINGS. FORM 990, PART VI, SECTION B, LINE 12C POLICY IS REVIEWED BY THE BOARD OF TRUSTEES ANNUALLY. FORM 990, PART VI, SECTION C, LINE 18 DOCUMENTS ARE AVAILABLE TO PUBLIC INSPECTION UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE TO PUBLIC INSPECTION UPON REQUEST. FORM 990, PART XI, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.