2011-06-06T13:48:23-05:00 2010-07-31 SCHOEDEL & SCHOEDEL CPAS PLLC 422 W RIVERSIDE AVE STE 1420 SPOKANE WA 992010395 990 2009-08-01 910597991 Employee Painters' Trust PAIN 2062824100 201 Queen Anne Avenue North No 100 Seattle WA 98109 Nancy Gudmundson Mike Ball 2062824100 2011-05-26 1 SCOTT OPPERUD CPA 5097472158 2011-05-26 2009 2016-02-24 21:20:13Z Nancy Gudmundson Mike B 201 Queen Anne Avenue North No 100 Seattle WA 98109 87688489 0 X N/A X 1952 WA To provide health and welfare benefits pursuant to a collective bargaining agreement between delegates of union locals of the Brotherhood of Painters, Decorators and Paperhangers of America and participating employers. 10 10 0 0 0 0 0 58524284 43087375 2923913 3915806 314345 460574 61762542 47463755 0 56246663 51008839 0 0 0 3523930 3304005 59770593 54312844 1991949 -6849089 93458256 86038387 9455350 7770497 84002906 78267890 The Trust provides health and welfare benefits to qualified employees of participating employers in the painting, drywall, floor covering, glassworkers, glaziers and sign painters/paint maker industries that are required to contribute as a result of a collective bargaining agreements or a special agreement with the Board of Trustees. 0 0 The Trust provides health and welfare benefits pursuant to collective bargaining and special agreements between various employers and the Trust. 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 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 10 10 1 1 0 0 0 1 0 1 1 0 0 1 1 1 1 0 1 0 0 0 X Zenith Administrators Inc 2062824100 201 Queen Avenue North Suite 100 Seattle WA 98109 X Nancy Gudmundson 1.00 X X 0 0 0 Mel Tousseau 1.00 X 0 0 0 Mike Guza 1.00 X 0 0 0 Bob Puzas 1.00 X 0 0 0 Tim Bendokas 1.00 X 0 0 0 Mike Ball 1.00 X X 0 0 0 Denis Sullivan 1.00 X 0 0 0 Tim Carrier 1.00 X 0 0 0 Todd Koch 1.00 X 0 0 0 John Smirk 1.00 X 0 0 0 0 0 0 0 0 0 0 Zenith Administrators Inc 18861 90th Avenue Suite A Mokena IL 60448 Contracted administrator 1425552 Ekman Bohrer & Thulin PS 220 W Mercer Suite 400 Seattle WA 98119 Attorney on retainer, collections 254737 Lindquist CPAs LLP 5000 Executive Parkway Suite 400 San Ramon CA 94583 Payroll auditor 214455 Sierra Healthcare Options Inc PO Box 15392 Las Vegas NV 89114 Claims processing 178684 Cigna Behavioral Health 5144 Collection Center Drive Chicago IL 60693 Utilization review 161690 5 Employer contributions 525100 41143408 41143408 Participant contributi 525100 1943967 1943967 43087375 3667089 3667089 40473451 40224734 248717 248717 248717 COBRA Subsidies 525100 374759 374759 Payroll audit related 525100 81598 81598 Miscellaneous income 525100 4217 4217 460574 47463755 43547949 0 3915806 51008839 2083429 641675 31000 257914 197185 51444 37161 Bank fees 2287 Dues 1910 54312844 2813557 301976 6546561 4891741 20752 14138 79689459 79211525 4387927 1619007 93458256 86038387 155634 125178 9299716 7645319 9455350 7770497 X 0 0 0 0 84002906 78267890 84002906 78267890 93458256 86038387 X 0 1 0 X 0 0 Checks written in excess of deposits 288741 Premiums due insurers 35578 Benefits claims payable 1100000 Claims incurred but not reported 6221000 7645319 47463755 54312844 -6849089 1114073 1114073 -5735016 48319914 1114073 1114073 47205841 257914 257914 47463755 54054930 0 54054930 257914 257914 54312844 Nancy Gudmundson Trustee 186970 Nancy Gudmundson is both a trustee of this trust and employee of Gudmundson company, a participating employer contributing to this trust. During the year ended July 31, 2010, contributions to this trust from Gudmundson Company totaled $186,970. 0 Mel Tousseau Trustee 430273 Mel Tousseau is both a trustee of this trust and an employee of Raymond George Company, a participating employer contributing to this trust. During the year ended July 31, 2010, contributions of this trust from Raymond George Company totaled $430,273. 0 Mike Guza Trustee 9499 Mike Guza is both a trustee of this trust and employee of Rainbow Painting Company (in Montana), a participating employer contributing to this trust. During the year ended July 31, 2010, contributions from Rainbow Painting Company totaled $9,499. 0 Bob Puzas Trustee 87488 Bob Puzas is both a trustee of this trust and employee of Rainbow Painting Company (in Oregon), a participating employer contributing to this trust. During the year ended July 31, 2010, contributions from Rainbow Painting Company totaled $87,488. 0 Mike Ball Trustee 317469 Mike Ball is both a trustee of this trust and an employee of IUPAT District Council #5 - Seattle, a participating employer contributing to this trust. During the year ended July 31, 2010, contributions to this trust from IUPAT District Council #5 totaled $317,469. 0 Mike Ball Trustee 129292 Mike Ball is both a trustee of this trust and a trustee of District Council 5 Apprenticeship and Training Trust Fund (Training Fund). The Training Fund is a participating employer contributing to this trust. During the year ended July 31, 2010, contributions to this trust from the Training Fund totaled $129,292. 0 Denis Sullivan Trustee 317469 Denis Sullivan is both a trustee of this trust and an employee of Paintmakers Local #1094, represented by IUPAT District Council #5, a participating employer contibuting to this trust. During the year ended July 31, 2010, contributions to this trust from IUPAT district council #5 totaled $317,469. 0 Denis Sullivan Trustee 129292 Denis Sullivan is both a trustee of this trust and a trustee of District Council 5 Apprenticeship and Training Trust Fund (Training Fund). The Training Fund is a participating employer contributing to this trust. During the year ended July 31, 2010, contributions to this trust from the Training Fund totaled $129,292. 0 Tim Carrier Trustee 317469 Tim Carrier is both a trustee of this trust and an employee of IUPAT District Council #5 - Portland, a participating employer contributing to this trust. During the year ended July 31, 2010, contributions to this trust from IUPAT District Council #5 totaled $317,469. 0 Todd Koch Trustee 19395 Todd Koch is both a trustee of this trust and an employee of IUPAT Local #567, a participating employer contributing to this trust. During the year ended July 31, 2010, contibutions to this trust from IUPAT Local #567 totaled $19,395. 0 John Smirk Trustee 139394 John Smirk is both a trustee of this trust and and employee of IUPAT Local #159, a participating employer contributing to this trust. During the year ended July 31, 2010, contributions to this trust from IUPAT Local #159 totaled $139,394. 0 Tim Bendokas Trustee 2230 Tim Bendokas is both a trustee of this trust and an employee of Bendokas Painting company, Inc., a participating employer contributing to this trust. During the year ended July 31, 2010, contributions to this trust from Bendokas Painting company, Inc., totaled $2,230. 0 Form 990, Part VI, Section A, line 2 Mike Ball, Denis Sullivan and Tim Carrier are all trustees of this trust and employees of International Union of Painters and Allied Trades District Council #5, a participating employer of this trust. Mike Ball and Denis Sullivan are also trustees of this trust and trustees of District council #5 Apprenticeship and Training Trust fund, a participating employer of this trust. Form 990, Part VI, Section A, line 3 The Trust has contracted with a third-party administrator (Zenith Administrators, Inc.) to provide bookkeeping and administrative services. Form 990, Part VI, Section A, line 7a The trust is administered by a ten-member Board of Trustees. Individual trustee positions are filled and removed by the appointing authorites described below. Union trustees: District Council #5 of the the Internation Union of Painters and Allied Trades (IUPAT) has the appointing and removal authority, according to it internal rules, procedures or practices, over three union trustee positions. Painters Union Local No. 159 of the IUPAT has similar authority over one union trustee position. Together, these four union trustee postitions have the appointing and removal authority over the one at-large union trustee position. Employer Trustees: Western Washington Signatory Painting employers have the appointing and removal authority over two employer trustee postions. The signatory Painting Contractors of Oregon have similar authority over one employer trustee position. Together, these three employer trustee positions have the appointing and removal authority over the two at-large employer trustee positions. Each trustee consents to and accepts his/her appointment as a trustee in writing. Form 990, Part VI, Section B, line 11 The Form 990 was prepared by the independent accounting firm SCHOEDEL & SCHOEDEL, Certified Public Accountants, PLLC from information provided by the third-party administrator and other consultants and advisors. Draft copies of the Trust's financial statements and Form 990 were first provided to the Trust's consultants and advisors, who reviewed the Form 990 for accuracy and completeness. Any questions, concerns or issues raised by the consultants and advisors were addressed and any necessary revisions were made to the Form 990. The revised Form 990 was then provided to the Board of Trustees for its review and approval. Any additional questions, concerns or issues raised by the Board of Trustees were addressed and any necessary revisions were made to the Form 990. The final version of the Form 990 was reviewed, approved and filed by the Board of Trustees. Form 990, Part VI, Section B, line 12c A copy of the Trust's Conflict of Interest Policy has been distributed to each Trustee. At a designated board meeting, at least annually, the Board of Trustees reviews the policy. Further, any interested party who has knowledge of any transaction that may arguably be restricted pursuant to the policy, is under a continuing obligation to disclose such information to the Board of Trustees at the earliest opportunity. the Board of Trustees will document such information and investigate. Documentation will include a description of the issue, pertinent facts, circumstances and inquiries, as well as conclusions reached by the Board of Trustees and related actions taken by the Board of Trustees. If the Board of Trustees determines that a conflict exists between the Trust and a Trustee, the Trustee will be pronibited from discussions, votes or attempts to influence the issue or decision that is impacted. There are no compensated management officials, officers or key employees of the organization. If the organization had such compensated individuals, policies and procedures would be developed to determine compensation. Form 990, Part VI, Section C, line 19 The Trust's governing documents, conflict of interest policy, financial statements and Form 990 is available to the general public upon written request sent to Zenith administrators, Inc at: 201 Queen Avenue North, Suite 100, Seattle, WA 98109