2011-05-16T20:17:58-05:00 2010-07-31 LEMKE CHINEN & TANAKA CPA INC 210 WARD AVENUE SUITE 336 HONOLULU HI 968144012 990 2009-08-01 996009435 PAMCAH-UA LOCAL 675 HEALTH & WELFARE FUND PAMC 8085364408 1109 Bethel St No 403 HONOLULU HI 96813 REGINALD CASTANARES KENT MATSUZAKI 8085364408 2011-05-18 1 DIANE HOSOKAWA 8085336254 2009 2016-02-24 21:20:13Z REGINALD CASTANARES KENT 1109 Bethel St No 403 HONOLULU HI 96813 35419139 0 X N/A X 1961 HI TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS, THEIR DEPENDENTS, AND RETIREES. 6 6 0 0 0 0 0 12400901 926539 -3487354 802693 -868307 2458884 8045240 4188116 0 11539873 11932318 0 0 0 1442618 1501107 12982491 13433425 -4937251 -9245309 42812448 34405613 763867 1602341 42048581 32803272 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS, THEIR DEPENDENTS, AND RETIREES. 0 0 10653056 PROVIDING SELF-INSURED BENEFITS TO ELIGIBLE PARTICIPANTS BY PAYING FOR INCURRED CLAIMS AND CLAIMS ADMINISTRATIVE FEES (MEDICAL CLAIMS $7,618,069, DRUG CLAIMS $2,259,883, VISION CLAIMS $197,909, MEDICAL CLAIMS ADMINISTRATION FEES $547,141, AND VISION CLAIMS ADMINISTRATION FEES $30,054). 2043476 PROVIDING HEALTH AND WELFARE BENEFITS BY PAYING FOR MONTHLY INSURANCE PREMIUMS TO INSURANCE CARRIERS, DISABILITY TAXES, AND ANNUAL GYM MEMBERSHIP FEES (HAWAII DENTAL SERVICE $1,582,589, PACIFIC GUARDIAN LIFE $119,522, HAWAII MEDICAL SERVICE ASSOCIATION $319,027, TAXES $19,197, AND FITNESS CENTER MEMBERSHIP $3,141). 12696532 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 0 0 0 0 0 0 0 0 6 6 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 0 0 1 1 X PAMCAH-UA LOCAL 675 ADMINISTRATIVE 8085364408 1109 BETHEL ST 403 HONOLULU HI 96813 X KENT A MATSUZAKI 1.00 X 0 0 0 REGINALD V CASTANARES JR 1.00 X 0 0 0 MARK K SUZUKI 1.00 X 0 0 0 VALENTINO B CERIA 1.00 X 0 0 0 DONOVAN E LEWIS 1.00 X 0 0 0 GREGG SERIKAKU 1.00 X 0 0 0 SAMUEL FUJIKAWA 1.00 X 0 0 0 0 0 0 0 0 0 0 HAWAII MEDICAL SERVICE ASSOCIATION 818 KEEAUMOKU STREET HONOLULU HI 96814 MEDICAL CLAIMS ADMINISTRATOR 547141 1 PREMIUM SUBSIDY 900099 749335 749335 EMPLOYER CONTRIBUTION 900099 172597 172597 COBRA CONTRIBUTIONS 900099 4607 4607 926539 804720 804720 130847 20036 110811 110811 110811 31208960 31210987 -2027 -2027 -2027 UNREALIZED GAINS/ LOSS 900099 2308015 2308015 OTHER INCOME 900099 40058 40058 2348073 4188116 926539 0 3261577 11932318 284626 44882 43455 207408 4565 54959 14395 ADMINISTRATIVE FEES - C 577195 INSURANCE STOP LOSS FEE 167822 CONSULTING FEES 78659 TAXES - THIRD PARTY SIC 19197 MISCELLANEOUS 3944 13433425 4370928 5960757 1637669 501278 20709 18862 33559 5356 10935 28203 34543271 25501191 2228936 2212936 0 182386 42812448 34405613 253036 742103 510831 860238 763867 1602341 X 0 0 0 0 0 0 42048581 32803272 42812448 34405613 X 0 1 1 X 0 33559 5356 28203 28203 REAL ESTATE - IWILEI PROPERTY 1610736 F REAL ESTATE - KAPOLEI PROPERTY 602200 F 2212936 BANK OVERDRAFT 851151 SECURITY DEPOSIT 9087 860238 4188116 13433425 -9245309 0 -9245309 4188116 0 4188116 0 4188116 13433425 0 13433425 0 13433425 Form 990, Part VI, Section B, line 11 ALL DOCUMENTS ARE REVIEWED BY THE ADMINISTRATOR, ASSISTANT ADMINISTRATOR, AND DESIGNATED BOARD MEMBERS. Form 990, Part VI, Section B, line 12c POLICY IS GIVEN TO THE TRUSTEES FOR THEIR REVIEW AND SIGNATURE. Form 990, Part VI, Section C, line 19 DOCUMENTS ARE AVAILABLE UPON REQUEST. Form 990, Part VII Contact Addresses for Officers, Directors, Etc KENT A. MATSUZAKI - 1029 ULUPONO STREET, HONOLULU, HI 96819. REGINALD V. CASTANARES JR. - 1109 BETHEL ST., BASEMENT, HONOLULU, HI 96813. MARK K. SUZUKI - 1820 COLBURN ST., HONOLULU, HI 96819. VALENTINO B. CERIA - 1109 BETHEL ST., BASEMENT, HONOLULU, HI 96813. DONOVAN E. LEWIS - 1109 BETHEL ST., BASEMENT, HONOLULU, HI 96813. GREGG SERIKAKU - 1314 S. KING ST., SUITE 961, HONOLULU, HI 96814. SAMUEL FUJIKAWA - 2149 PUUHALE PLACE, HONOLULU, HI 96819. FORM 990, PART XI, LINE 2C BOARD OF TRUSTEES SELECT THE INDEPENDENT AUDITOR AND APPOINTS THE ADMINISTRATIVE OFFICE TO REVIEW THE FINANCIAL STATEMENTS. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. PAMCAH-UA LOCAL 675 ANNUITY PLAN 1109 BETHEL STREET 403 HONOLULU HI 96813 990221545 TO PROVIDE ANNUITY BENEFITS TO ELIGIBLE MEMBERS HI 401(A) N/A PAMCAH-UA LOCAL 675 COOPERATION FUND 1109 BETHEL STREET 403 HONOLULU HI 96813 990266164 TO PROMOTE THE INDUSTRY AND IMPROVE RELATIONSHIPS BETWEEN LABOR AND MGMT. HI 501(C)(5) N/A PAMCAH-UA LOCAL 675 TRAINING PLAN 1109 BETHEL STREET 403 HONOLULU HI 96813 996009433 TO PROVIDE EDUCATIONAL BENEFITS TO ELIGIBLE MEMBERS AND EMPLOYERS HI 501(C)(5) N/A PAMCAH-UA LOCAL 675 VACATION & HOLIDAY PLAN 1109 BETHEL STREET 403 HONOLULU HI 96813 996009438 TO PROVIDE VACATION AND HOLIDAY BENEFITS TO ELIGIBLE MEMBERS HI 501(C)(9) N/A PAMCAH-UA LOCAL 675 PENSION PLAN 1109 BETHEL STREET 403 HONOLULU HI 96813 996024083 TO PROVIDE PENSION BENEFITS TO ELIGIBLE MEMBERS HI 401(A) N/A PAMCAH-UA LOCAL 675 ADMINISTRATIVE OFFICE 1109 BETHEL STREET 403 HONOLULU HI 96813 990110375 TO ALLOCATE COMMON EXPENSES AMOUNG THE PAMCAH TRUST FUNDS HI N/A C 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 PAMCAH-UA LOCAL 675 ADMINISTRATIVE OFFICE O 388628