Form 990, Part VI, Line 11B: Form 990 Review Process
“the form 990 tax return was provided to the chairman and secretary for their review before it was filed.”
990 • Fiscal year 2018 • EIN 91-0838639
Scores are not available for this record yet.
Assets
Flat$52,939,130
Flat from 2018
Net Assets
Flat$28,270,684
Flat from 2018
Liabilities
Flat$24,668,446
Flat from 2018
Revenue
Flat$69,814,932
Flat from 2018
Expenses
Flat$62,536,509
Flat from 2018
Net Income
Flat$7,278,423
Flat from 2018
To provide an entity to which contributions from participating employers and employees can be paid and through which the trustees can create and administer one or more employee welfare benefit plans for the participating employees on whose behalf the contributions have been paid, and their beneficiaries.
To provide health and welfare benefits to qualified participants
| Line | Beginning | End | Change |
|---|---|---|---|
| Assets | |||
| Rtn Earn Endowment Incm Other Fnds | $24,168,576 | $28,270,684 | ▲ $4,102,108 |
| Investments in Publicly Traded Securities | $28,261,626 | $24,812,569 | ▼ $3,449,057 |
| Cash and Non-Interest-Bearing Accounts | $10,330,785 | $13,475,886 | ▲ $3,145,101 |
| Accounts Receivable | $7,170,197 | $10,311,161 | ▲ $3,140,964 |
| Investments Other Securities | - | $4,320,774 | - |
| Prepaid Expenses and Deferred Charges | $2,529 | $18,740 | ▲ $16,211 |
| Savings and Temporary Cash Investments | - | $0 | - |
| Other Notes and Loans Receivable, Net | - | $0 | - |
| Pledges and Grants Receivable | - | $0 | - |
| Receivable From Disqualified Prsn | - | $0 | - |
| Receivables From Officers Etc | - | $0 | - |
| Investments Program Related | - | $0 | - |
| Land, Buildings, and Equipment, Net | - | $0 | - |
| Intangible Assets | - | $0 | - |
| Inventories for Sale or Use | - | $0 | - |
| Total Assets | $45,765,137 | $52,939,130 | ▲ $7,173,993 |
| Other Assets Total | - | $0 | - |
| Liabilities | |||
| Other Liabilities | $21,000,567 | $21,952,136 | ▲ $951,569 |
| Accounts Payable and Accrued Expenses | $594,358 | $2,715,850 | ▲ $2,121,492 |
| Deferred Revenue | $1,636 | $460 | ▼ $1,176 |
| Total Liabilities | $21,596,561 | $24,668,446 | ▲ $3,071,885 |
| Net Assets / Fund Balance | |||
| Total Net Assets Fund Balance | $24,168,576 | $28,270,684 | ▲ $4,102,108 |
| Total Liabilities and Net Assets / Fund Balance | $45,765,137 | $52,939,130 | ▲ $7,173,993 |
| Name | Title |
|---|---|
| Jeffery Owen | Chairman |
| Ed Holmes | Trustee |
| Jerry Bush | Trustee |
| Joel Crabtree | Trustee |
| Mark Webster | Trustee |
| Ed Kommers | Secretary |
| Contractor | Services | Location | Compensation |
|---|---|---|---|
| Zenith American Solutions Inc | Third Party Admin | 11724 NE 195th Street, Bothell, WA 98011 | $1,245,149 |
| Kaiser Foundation Health Plan of WA | Insurance benefits | 950 Pacific Avenue Suite 900, Tacoma, WA 98042 | $531,854 |
| Aetna | PPO network | 600 University Street Suite 920, Seattle, WA 98101 | $531,715 |
| Zelis Claims Integrity Inc | Cost containment | 2 Crossroads Drive, Bedminster, NJ 07921 | $232,704 |
| Delta Dental | Claims processing | PO Box 75983, Seattle, WA 98175 | $132,225 |
| Line Item | Amount |
|---|---|
| Other Expenses | $3,081,433 |
| Salaries, Compensation, and Employee Benefits | $42,232 |
| Grants and Similar Amounts Paid | $0 |
| Professional Fundraising Fees | $0 |
| Total Fundraising Expense | $0 |
| Line Item | Program | Management | Fundraising | Total |
|---|---|---|---|---|
| Benefits to Members | - | - | - | $59,412,844 |
| Fees for Services Management | - | - | - | $1,721,915 |
| Fees for Services Other | - | - | - | $1,014,242 |
| Fees for Service Investment Mgmnt Fees | - | - | - | $61,513 |
| Fees for Services Accounting | - | - | - | $45,653 |
| Payroll Taxes | - | - | - | $42,232 |
| Fees for Services Legal | - | - | - | $29,565 |
| Office Expenses | - | - | - | $22,604 |
| Other Expenses | - | - | - | $21,075 |
| Insurance | - | - | - | $15,667 |
| Conferences and Meetings | - | - | - | $12,894 |
| Total Functional Expenses | $0 | $0 | $0 | $62,536,509 |
| Line Item | Amount |
|---|---|
| Total Expenses per Form 990 | $62,536,509 |
| Expenses per Audited Statements | $61,962,004 |
| Total Expenses per Audited Statements | $61,962,004 |
| Expenses Not Reported on Financial Statements | $574,505 |
| Other Expense Adjustments | $512,992 |
| Line Item | Amount |
|---|---|
| Professional Fundraising Fees | $0 |
| Line Item | Beginning | End | Change |
|---|---|---|---|
| Receivables from Disqualified Persons | - | $0 | - |
| Receivables from Officers, Directors, Trustees, and Key Employees | - | $0 | - |
| Liability | Amount |
|---|---|
| Accumulated Eligibiility Credits | $14,754,000 |
| Claims Incurred but Not Reported | $4,428,000 |
| Vacation benefits payable | $2,007,265 |
| Aetna claims payable | $539,450 |
| Premiums Payable | $223,421 |
“the form 990 tax return was provided to the chairman and secretary for their review before it was filed.”
“the plan regularly and consistently monitors and enforces compliance with the applicable policies.”
“the plan documents, conflict of interest policy, and financial statements are available to the participants and public”
“Accumulated eligibility credits 2017 = $14057000”
“Accumulated eligibility credits 2018 = -$14754000”
“Aetna Claims Payable 2017 = $797873”
“Aetna claims payable 2018 = -$539450”
“The trust established under the Plan to hold the Plans assets is intended to qualify pursuant to Section 501(c)(9) of the Internal Revenue Code (IRC) and, accordingly, the trusts net investment income is exempt from income taxes. The trust has obtained a favorable tax determination letter from the Internal Revenue Service (IRS). Management believes that the trust, as amended, continues to qualify and to operate in accordance with applicable provisions of the IRC.Accounting principles generally accepted in the United States of America require plan management to evaluate tax positions taken by the Plan and recognize a tax liability (or asset) if the Plan has taken an uncertain position that more likely than not would not be sustained upon examination by the IRS. The plan administrator has analyzed the tax positions taken by the Plan, and has concluded that as of June 30, 2018 and 2017, there are no uncertain positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the financial statements. The Plan is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress.”
“Cost of benefits payable 6/30/17 $-4252627 Cost of benefits payable 6/30/18 $4651421 Vacation benefits payable 6/30/17 $-1893067 Vacation benefits payable 6/30/18 $2007265”
This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.
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|---|---|---|
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| IRS990/OtherRevenueTotalAmt | 0 | 38592 |
| IRS990/OtherSalariesAndWagesGrp/TotalAmt | 0 | 0 |
| IRS990/OthNotesLoansReceivableNetGrp/EOYAmt | 0 | 0 |
| IRS990/PartialLiquidationInd | 0 | false |
| IRS990/PaymentsToAffiliatesGrp/TotalAmt | 0 | 0 |
| IRS990/PayrollTaxesGrp/TotalAmt | 0 | 42232 |
| IRS990/PensionPlanContributionsGrp/TotalAmt | 0 | 0 |
| IRS990/PledgesAndGrantsReceivableGrp/EOYAmt | 0 | 0 |
| IRS990/PoliticalCampaignActyInd | 0 | false |
| IRS990/PrepaidExpensesDefrdChargesGrp/BOYAmt | 0 | 2529 |
| IRS990/PrepaidExpensesDefrdChargesGrp/EOYAmt | 0 | 18740 |
| IRS990/ProfessionalFundraisingInd | 0 | false |
| IRS990/ProgramServiceRevenueGrp/BusinessCd | 0 | 230000 |
| IRS990/ProgramServiceRevenueGrp/BusinessCd | 1 | 230000 |
| IRS990/ProgramServiceRevenueGrp/Desc | 0 | Employee Contributions |
| IRS990/ProgramServiceRevenueGrp/Desc | 1 | Employer Contributions |
| IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt | 0 | 24580258 |
| IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt | 1 | 41279156 |
| IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt | 0 | 24580258 |
| IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt | 1 | 41279156 |
| IRS990/ProhibitedTaxShelterTransInd | 0 | false |
| IRS990/PYBenefitsPaidToMembersAmt | 0 | 53645717 |
| IRS990/PYInvestmentIncomeAmt | 0 | 706013 |
| IRS990/PymtTravelEntrtnmntPubOfclGrp/TotalAmt | 0 | 0 |
| IRS990/PYOtherExpensesAmt | 0 | 2844159 |
| IRS990/PYOtherRevenueAmt | 0 | 4086 |
| IRS990/PYProgramServiceRevenueAmt | 0 | 60318430 |
| IRS990/PYRevenuesLessExpensesAmt | 0 | 4538653 |
| IRS990/PYTotalExpensesAmt | 0 | 56489876 |
| IRS990/PYTotalRevenueAmt | 0 | 61028529 |
| IRS990/RcvblFromDisqualifiedPrsnGrp/EOYAmt | 0 | 0 |
| IRS990/ReceivablesFromOfficersEtcGrp/EOYAmt | 0 | 0 |
| IRS990/ReconcilationRevenueExpnssAmt | 0 | 7278423 |
| IRS990/RegularMonitoringEnfrcInd | 0 | true |
| IRS990/RelatedEntityInd | 0 | true |
| IRS990/RelatedOrganizationCtrlEntInd | 0 | false |
| IRS990/ReportInvestmentsOtherSecInd | 0 | true |
| IRS990/ReportLandBuildingEquipmentInd | 0 | false |
| IRS990/ReportOtherAssetsInd | 0 | false |
| IRS990/ReportOtherLiabilitiesInd | 0 | true |
| IRS990/ReportProgramRelatedInvstInd | 0 | false |
| IRS990/RoyaltiesGrp/TotalAmt | 0 | 0 |
| IRS990/RoyaltiesRevenueGrp/TotalRevenueColumnAmt | 0 | 0 |
| IRS990/RtnEarnEndowmentIncmOthFndsGrp/BOYAmt | 0 | 24168576 |
| IRS990/RtnEarnEndowmentIncmOthFndsGrp/EOYAmt | 0 | 28270684 |
| IRS990/SavingsAndTempCashInvstGrp/EOYAmt | 0 | 0 |
| IRS990/ScheduleBRequiredInd | 0 | false |
| IRS990ScheduleD/ExpensesNotRptFinclStmtAmt | 0 | 574505 |
| IRS990ScheduleD/ExpensesSubtotalAmt | 0 | 61962004 |
| IRS990ScheduleD/FootnoteTextInd | 0 | X |
| IRS990ScheduleD/InvestmentExpensesNotIncld2Amt | 0 | 61513 |
| IRS990ScheduleD/InvestmentExpensesNotIncldAmt | 0 | 61513 |
| IRS990ScheduleD/NetUnrealizedGainsInvstAmt | 0 | -2737738 |
| IRS990ScheduleD/OtherExpensesNotIncludedAmt | 0 | 512992 |
| IRS990ScheduleD/OtherLiabilitiesOrgGrp/Amt | 0 | 14754000 |
| IRS990ScheduleD/OtherLiabilitiesOrgGrp/Amt | 1 | 539450 |
| IRS990ScheduleD/OtherLiabilitiesOrgGrp/Amt | 2 | 4428000 |
| IRS990ScheduleD/OtherLiabilitiesOrgGrp/Amt | 3 | 223421 |
| IRS990ScheduleD/OtherLiabilitiesOrgGrp/Amt | 4 | 2007265 |
| IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc | 0 | Accumulated Eligibiility Credits |
| IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc | 1 | Aetna claims payable |
| IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc | 2 | Claims Incurred but Not Reported |
| IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc | 3 | Premiums Payable |
| IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc | 4 | Vacation benefits payable |
| IRS990ScheduleD/RevenueNotReportedAmt | 0 | -2737738 |
| IRS990ScheduleD/RevenueNotReportedFinclStmtAmt | 0 | 61513 |
| IRS990ScheduleD/RevenueSubtotalAmt | 0 | 69753419 |
| IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt | 0 | The trust established under the Plan to hold the Plans assets is intended to qualify pursuant to Section 501(c)(9) of the Internal Revenue Code (IRC) and, accordingly, the trusts net investment income is exempt from income taxes. The trust has obtained a favorable tax determination letter from the Internal Revenue Service (IRS). Management believes that the trust, as amended, continues to qualify and to operate in accordance with applicable provisions of the IRC.Accounting principles generally accepted in the United States of America require plan management to evaluate tax positions taken by the Plan and recognize a tax liability (or asset) if the Plan has taken an uncertain position that more likely than not would not be sustained upon examination by the IRS. The plan administrator has analyzed the tax positions taken by the Plan, and has concluded that as of June 30, 2018 and 2017, there are no uncertain positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the financial statements. The Plan is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. |
| IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt | 1 | Cost of benefits payable 6/30/17 $-4252627 Cost of benefits payable 6/30/18 $4651421 Vacation benefits payable 6/30/17 $-1893067 Vacation benefits payable 6/30/18 $2007265 |
| IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | Part X : FIN48 Footnote |
| IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc | 1 | Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S |
| IRS990ScheduleD/TotalBookValueSecuritiesAmt | 0 | 4320774 |
| IRS990ScheduleD/TotalExpensesPerForm990Amt | 0 | 62536509 |
| IRS990ScheduleD/TotalLiabilityAmt | 0 | 21952136 |
| IRS990ScheduleD/TotalRevenuePerForm990Amt | 0 | 69814932 |
| IRS990ScheduleD/TotalRevEtcAuditedFinclStmtAmt | 0 | 67015681 |
| IRS990ScheduleD/TotExpnsEtcAuditedFinclStmtAmt | 0 | 61962004 |
| IRS990/ScheduleJRequiredInd | 0 | false |
| IRS990/ScheduleORequiredInd | 0 | true |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 0 | the form 990 tax return was provided to the chairman and secretary for their review before it was filed. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 1 | the plan regularly and consistently monitors and enforces compliance with the applicable policies. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 2 | the plan documents, conflict of interest policy, and financial statements are available to the participants and public |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 3 | Accumulated eligibility credits 2017 = $14057000 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 4 | Accumulated eligibility credits 2018 = -$14754000 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 5 | Aetna Claims Payable 2017 = $797873 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 6 | Aetna claims payable 2018 = -$539450 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | Form 990, Part VI, Line 11b: Form 990 Review Process |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 1 | Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 2 | Form 990, Part VI, Line 19: Other Organization Documents Publicly Available |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 3 | Other Changes In Net Assets Or Fund Balances - Other Increases |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 4 | Other Changes In Net Assets Or Fund Balances - Other Decreases |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 5 | Other Changes In Net Assets Or Fund Balances - Other Increases |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 6 | Other Changes In Net Assets Or Fund Balances - Other Decreases |
| IRS990ScheduleR/AssetExchangeInd | 0 | false |
| IRS990ScheduleR/AssetPurchaseFromOtherOrgInd | 0 | false |
| IRS990ScheduleR/AssetSaleToOtherOrgInd | 0 | false |
| IRS990ScheduleR/DivRelatedOrganizationInd | 0 | false |
| IRS990ScheduleR/GiftGrntCapContriFromOthOrgInd | 0 | false |
| IRS990ScheduleR/GiftGrntOrCapContriToOthOrgInd | 0 | false |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/ControlledOrganizationInd | 0 | false |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/DirectControllingNACd | 0 | N/A |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/LegalDomicileStateCd | 0 | WA |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/RelatedOrganizationName/BusinessNameLine1Txt | 0 | See Attached Statement |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/AddressLine1Txt | 0 | 11724 NE 195th Street |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/CityNm | 0 | Bothell |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/StateAbbreviationCd | 0 | WA |
| IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/ZIPCd | 0 | 98011 |
| IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/DirectControllingNACd | 0 | N/A |
| IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/DisproportionateAllocationsInd | 0 | false |
| IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/GeneralOrManagingPartnerInd | 0 | false |
| IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/LegalDomicileStateCd | 0 | WA |
| IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/RelatedOrganizationName/BusinessNameLine1Txt | 0 | See Attached Statement |
| IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/USAddress/AddressLine1Txt | 0 | 11724 NE 195th Street |
| IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/USAddress/CityNm | 0 | Bothell |
| IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/USAddress/StateAbbreviationCd | 0 | WA |
| IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/USAddress/ZIPCd | 0 | 98011 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd | 0 | false |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingNACd | 0 | N/A |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt | 0 | See Attached Statement |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd | 0 | WA |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt | 0 | 11724 NE 195th Street |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm | 0 | Bothell |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd | 0 | WA |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd | 0 | 98011 |
| IRS990ScheduleR/LoansOrGuaranteesFromOthOrgInd | 0 | false |
| IRS990ScheduleR/LoansOrGuaranteesToOtherOrgInd | 0 | false |
| IRS990ScheduleR/PaidEmployeesSharingInd | 0 | false |
| IRS990ScheduleR/PerformOfServicesByOtherOrgInd | 0 | false |
| IRS990ScheduleR/PerformOfServicesForOthOrgInd | 0 | false |
| IRS990ScheduleR/ReceiptOfIntAnntsRntsRyltsInd | 0 | false |
| IRS990ScheduleR/ReimbursementPaidByOtherOrgInd | 0 | false |
| IRS990ScheduleR/ReimbursementPaidToOtherOrgInd | 0 | false |
| IRS990ScheduleR/RentalOfFacilitiesToOthOrgInd | 0 | false |
| IRS990ScheduleR/RentalOfFcltsFromOthOrgInd | 0 | false |
| IRS990ScheduleR/SharingOfFacilitiesInd | 0 | false |
| IRS990ScheduleR/TransactionsRelatedOrgGrp/InvolvedAmt | 0 | 1362516 |
| IRS990ScheduleR/TransactionsRelatedOrgGrp/InvolvedAmt | 1 | 8819102 |
| IRS990ScheduleR/TransactionsRelatedOrgGrp/InvolvedAmt | 2 | 32718119 |
| IRS990ScheduleR/TransactionsRelatedOrgGrp/MethodOfAmountDeterminationTxt | 0 | cash |
| IRS990ScheduleR/TransactionsRelatedOrgGrp/MethodOfAmountDeterminationTxt | 1 | cash |
| IRS990ScheduleR/TransactionsRelatedOrgGrp/MethodOfAmountDeterminationTxt | 2 | cash |
| IRS990ScheduleR/TransactionsRelatedOrgGrp/OtherOrganizationName/BusinessNameLine1Txt | 0 | See Attached Statement |
| IRS990ScheduleR/TransactionsRelatedOrgGrp/OtherOrganizationName/BusinessNameLine1Txt | 1 | See Attached Statement |
| IRS990ScheduleR/TransactionsRelatedOrgGrp/OtherOrganizationName/BusinessNameLine1Txt | 2 | See Attached Statement |
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Displayed year
2018 • Form 990Detailed filing. Detailed filing data is available for this year.