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Balance Sheet
Assets
Flat$23,091,030
Flat from 2012
Net Assets
Flat$12,859,780
Flat from 2012
Liabilities
Flat$10,231,250
Flat from 2012
Revenue And Expenses
Revenue
-
No earlier filing loaded for comparison.
Expenses
Flat$56,583,143
Flat from 2012
Net Income
-
No earlier filing loaded for comparison.
Historical Trend
Jump To
Filing Snapshot
- Filing Period
- May 1, 2011 to Apr 30, 2012
- Signed
- Feb 28, 2013
- Return Version
- 2011v1.2
- Gross Receipts
- $103,560,747
Mission and Program Overview
Mission
To provide health and welfare benefits to eligible participants.
Filing and Contact Details
Filer
- EIN
- 94-6284253
Raw XML AppendixShowing 400 of 454 raw XML fields
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/AccountsReceivable/EOY | 0 | 4120618 |
| IRS990/ActivitiesConductedPartnership | 0 | 0 |
| IRS990/ActivityOrMissionDescription | 0 | PROVIDE HEALTH AND WELFARE BENEFITS |
| IRS990/AddressPrincipalOfficerUS/AddressLine1 | 0 | 4160 DUBLIN BLVD NO 400 |
| IRS990/AddressPrincipalOfficerUS/City | 0 | DUBLIN |
| IRS990/AddressPrincipalOfficerUS/State | 0 | CA |
| IRS990/AddressPrincipalOfficerUS/ZIPCode | 0 | 94568 |
| IRS990/AnnualDisclosureCoveredPersons | 0 | 1 |
| IRS990/AuditCommittee | 0 | 1 |
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| IRS990/BenefitsPaidToMembersPriorYear | 0 | 50225523 |
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| IRS990/CashNonInterestBearing/BOY | 0 | 1556912 |
| IRS990/CashNonInterestBearing/EOY | 0 | 1018808 |
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| IRS990/CollectionsOfArt | 0 | 0 |
| IRS990/CompensationFromOtherSources | 0 | 0 |
| IRS990/CompensationProcessCEO | 0 | 0 |
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| IRS990/ConferencesMeetings/Total | 0 | 82312 |
| IRS990/ConflictOfInterestPolicy | 0 | 1 |
| IRS990/ConservationEasements | 0 | 0 |
| IRS990/ConsolidatedAuditFinancialStmt | 0 | 0 |
| IRS990/ContractorCompensation/AddressOfContractor/AddressUS/AddressLine1 | 0 | 4160 DUBLIN BLVD SUITE 400 |
| IRS990/ContractorCompensation/AddressOfContractor/AddressUS/AddressLine1 | 1 | DEPARTMENT 5812 |
| IRS990/ContractorCompensation/AddressOfContractor/AddressUS/AddressLine1 | 2 | PO BOX 166718 |
| IRS990/ContractorCompensation/AddressOfContractor/AddressUS/AddressLine1 | 3 | 483 NINTH STREET |
| IRS990/ContractorCompensation/AddressOfContractor/AddressUS/AddressLine1 | 4 | 100 MONTGOMERY STREET SUITE 500 |
| IRS990/ContractorCompensation/AddressOfContractor/AddressUS/City | 0 | DUBLIN |
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| IRS990/ContractorCompensation/AddressOfContractor/AddressUS/City | 2 | ATLANTA |
| IRS990/ContractorCompensation/AddressOfContractor/AddressUS/City | 3 | OAKLAND |
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| IRS990/ContractorCompensation/Compensation | 4 | 204426 |
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| IRS990/ContractorCompensation/NameOfContractor/NameBusiness/BusinessNameLine1 | 1 | BLUE CROSS OF CALIFORNIA |
| IRS990/ContractorCompensation/NameOfContractor/NameBusiness/BusinessNameLine1 | 2 | AMERICAN HEALTH WAYS |
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| IRS990/ContractorCompensation/NameOfContractor/NameBusiness/BusinessNameLine1 | 4 | THE SEGAL COMPANY |
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| IRS990/FeesForServicesManagement/Total | 0 | 3071995 |
| IRS990/FeesForServicesOther/Total | 0 | 1904277 |
| IRS990/FinancialStatementSeparate | 0 | X |
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| IRS990/ForeignOffice | 0 | 0 |
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| IRS990/Form990PartVIISectionA/AverageHoursPerWeek | 1 | 2.00 |
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| IRS990/Form990PartVIISectionA/AverageHoursPerWeek | 3 | 2.00 |
| IRS990/Form990PartVIISectionA/AverageHoursPerWeek | 4 | 2.00 |
| IRS990/Form990PartVIISectionA/AverageHoursPerWeek | 5 | 2.00 |
| IRS990/Form990PartVIISectionA/AverageHoursPerWeek | 6 | 2.00 |
| IRS990/Form990PartVIISectionA/AverageHoursPerWeek | 7 | 2.00 |
| IRS990/Form990PartVIISectionA/AverageHoursPerWeek | 8 | 2.00 |
| IRS990/Form990PartVIISectionA/AverageHoursPerWeek | 9 | 2.00 |
| IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector | 0 | X |
| IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector | 1 | X |
| IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector | 2 | X |
| IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector | 3 | X |
| IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector | 4 | X |
| IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector | 5 | X |
| IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector | 6 | X |
| IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector | 7 | X |
| IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector | 8 | X |
| IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector | 9 | X |
| IRS990/Form990PartVIISectionA/NamePerson | 0 | ASHLEY ALVARADO |
| IRS990/Form990PartVIISectionA/NamePerson | 1 | JOHN HURLEY |
| IRS990/Form990PartVIISectionA/NamePerson | 2 | CRESCENCIO DIAZ |
| IRS990/Form990PartVIISectionA/NamePerson | 3 | RICHARD EHRLER |
| IRS990/Form990PartVIISectionA/NamePerson | 4 | ADAM OCHOA |
| IRS990/Form990PartVIISectionA/NamePerson | 5 | RICHARD W MUTO |
| IRS990/Form990PartVIISectionA/NamePerson | 6 | PABLO BARRERA |
| IRS990/Form990PartVIISectionA/NamePerson | 7 | TOM NETT |
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| IRS990/FSAudited | 0 | 1 |
| IRS990/FundraisingActivities | 0 | 0 |
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| IRS990/Gaming | 0 | 0 |
| IRS990/GrantsAndSimilarAmntsCY | 0 | 0 |
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| IRS990/GrossReceipts | 0 | 103560747 |
| IRS990/GroupReturnForAffiliates | 0 | 0 |
| IRS990/Hospital | 0 | 0 |
| IRS990/IndependentAuditFinancialStmt | 0 | 1 |
| IRS990/IndoorTanningServices | 0 | 0 |
| IRS990/InfoInScheduleOPartVI | 0 | X |
| IRS990/InfoInScheduleOPartXI | 0 | X |
| IRS990/InfoInScheduleOPartXII | 0 | X |
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| IRS990/Insurance/Total | 0 | 36240 |
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| IRS990/LandBuildingsEquipmentBasis | 0 | 6966 |
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| IRS990/LoanToOfficerOrDQP | 0 | 0 |
| IRS990/LocalChapters | 0 | 0 |
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| IRS990/MinutesOfGoverningBody | 0 | 1 |
| IRS990/MissionDescription | 0 | TO PROVIDE HEALTH AND WELFARE BENEFITS. |
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| IRS990/NoListedPersonsCompensated | 0 | X |
| IRS990/NonDeductibleContributions | 0 | 0 |
| IRS990/NumberFormsTransmittedWith1096 | 0 | 1247 |
| IRS990/NumberIndependentVotingMembers | 0 | 0 |
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| IRS990/NumberOfContractorsGT100K | 0 | 5 |
| IRS990/NumberOfEmployees | 0 | 0 |
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| IRS990/PrepaidExpensesDeferredCharges/EOY | 0 | 24991 |
| IRS990/ProfessionalFundraising | 0 | 0 |
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| IRS990/ProgramServiceRevenueCY | 0 | 55137507 |
| IRS990/ProgramServiceRevenue/Description | 0 | EMPLOYER CONTRIBUTIONS |
| IRS990/ProgramServiceRevenue/Description | 1 | EMPLOYEE CONTRIBUTIONS |
| IRS990/ProgramServiceRevenue/Description | 2 | PRESCRIPTION REBATE IN |
| IRS990/ProgramServiceRevenue/Description | 3 | STOP-LOSS RECOVERY |
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| IRS990/RelatedEntity | 0 | 1 |
| IRS990/RelatedOrgControlledEntity | 0 | 0 |
| IRS990/ReportFin48Footnote | 0 | 1 |
| IRS990/ReportInvestOthSecurities | 0 | 0 |
| IRS990/ReportLandBldgEquip | 0 | 1 |
| IRS990/ReportOtherAssets | 0 | 0 |
| IRS990/ReportOtherLiabilities | 0 | 1 |
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| IRS990/SalariesEtcPriorYear | 0 | 0 |
| IRS990/ScheduleBRequired | 0 | 0 |
| IRS990ScheduleD/ExcessOrDeficitForYear | 0 | -1184872 |
| IRS990ScheduleD/ExcessOrDeficitPerFS | 0 | -1936760 |
| IRS990ScheduleD/ExpensesNotRptdF990 | 0 | 0 |
| IRS990ScheduleD/ExpensesNotRptdOnFinStmt | 0 | -648146 |
| IRS990ScheduleD/ExpensesSubtotal | 0 | 57231289 |
| IRS990ScheduleD/Form990ScheduleDPartXIV/Explanation | 0 | CHANGES IN BENEFIT OBLIGATIONS -695,309. |
| IRS990ScheduleD/Form990ScheduleDPartXIV/Explanation | 1 | CHANGES IN BENEFIT OBLIGATIONS |
| IRS990ScheduleD/Form990ScheduleDPartXIV/Explanation | 2 | PART X, LINE 2: THE PLAN'S ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT AS OF APRIL 30, 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN, OR EXPECTED TO BE TAKEN, THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN'S ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE YEARS PRIOR TO THE FISCAL YEAR ENDING APRIL 30, 2009. |
| IRS990ScheduleD/Form990ScheduleDPartXIV/Identifier | 0 | PART XI, LINE 8 - OTHER ADJUSTMENTS: |
| IRS990ScheduleD/Form990ScheduleDPartXIV/Identifier | 1 | PART XIII, LINE 4B - OTHER ADJUSTMENTS: |
| IRS990ScheduleD/InvestmentExpensesNotIncluded | 0 | 47163 |
| IRS990ScheduleD/InvestmentExpensesNotIncluded2 | 0 | 47163 |
| IRS990ScheduleD/NetUnrealizedGainsInvestments | 0 | -56579 |
| IRS990ScheduleD/NetUnrealizedGLOnInvestments | 0 | -56579 |
| IRS990ScheduleD/OtherAmount | 0 | -695309 |
| IRS990ScheduleD/OtherExpensesNotIncluded | 0 | -695309 |
| IRS990ScheduleD/OtherLandBuildings/BookValue | 0 | 0 |
| IRS990ScheduleD/OtherLandBuildings/Depreciation | 0 | 6966 |
| IRS990ScheduleD/OtherLandBuildings/OtherCostOrOtherBasis | 0 | 6966 |
| IRS990ScheduleD/OtherLiabilities/Amount | 0 | 3825496 |
| IRS990ScheduleD/OtherLiabilities/Amount | 1 | 1408000 |
| IRS990ScheduleD/OtherLiabilities/Amount | 2 | 4587000 |
| IRS990ScheduleD/OtherLiabilities/Description | 0 | ACCUMULATED ELIGIBILITY CREDITS |
| IRS990ScheduleD/OtherLiabilities/Description | 1 | GROUP INS PREMIUMS PAYABLE |
| IRS990ScheduleD/OtherLiabilities/Description | 2 | CLAIMS PAYABLE AND IBNR |
| IRS990ScheduleD/RevenueNotRptdF990 | 0 | -56579 |
| IRS990ScheduleD/RevenueNotRptdOnFinStmt | 0 | 47163 |
| IRS990ScheduleD/RevenueSubtotal | 0 | 55351108 |
| IRS990ScheduleD/TotalAdjustments | 0 | -751888 |
| IRS990ScheduleD/TotalExpenses | 0 | 56583143 |
| IRS990ScheduleD/TotalExpensesPerForm990 | 0 | 56583143 |
| IRS990ScheduleD/TotalOfAmounts | 0 | 9820496 |
| IRS990ScheduleD/TotalOfBookValueLandBuildings | 0 | 0 |
| IRS990ScheduleD/TotalRevenue | 0 | 55398271 |
| IRS990ScheduleD/TotalRevenuePerForm990 | 0 | 55398271 |
| IRS990ScheduleD/TotExpensesEtcAuditedFinclStmt | 0 | 57231289 |
| IRS990ScheduleD/TotRevenueEtcAuditedFinclStmt | 0 | 55294529 |
| IRS990/ScheduleJRequired | 0 | 0 |
| IRS990ScheduleO/GeneralExplanation/Explanation | 0 | THE TRUST HAS CONTRACTED WITH HEALTH SERVICE BENEFIT ADMINISTRATORS, INC. TO PROVIDE ADMINISTRATIVE SERVICES FOR THE ORGANIZATION. |
| IRS990ScheduleO/GeneralExplanation/Explanation | 1 | THERE IS NO COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| IRS990ScheduleO/GeneralExplanation/Explanation | 2 | A COPY OF THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY FOR REVIEW BEFORE IT WAS FILED. |
| IRS990ScheduleO/GeneralExplanation/Explanation | 3 | AT LEAST ANNUALLY, TRUSTEES AND OTHER INDIVIDUALS SUBJECT TO THE CONFLICT OF INTEREST POLICY WILL BE ASKED TO DISCLOSE IN WRITING ANY RELATIONSHIPS OR INTERESTS THAT COULD GIVE RISE TO A CONFLICT. |
| IRS990ScheduleO/GeneralExplanation/Explanation | 4 | ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| IRS990ScheduleO/GeneralExplanation/Explanation | 5 | NET UNREALIZED LOSSES ON INVESTMENTS: -56,579. |
| IRS990ScheduleO/GeneralExplanation/Explanation | 6 | THE BOARD ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDITED FINANCIAL STATEMENTS AND FOR THE SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED. |
| IRS990ScheduleO/GeneralExplanation/Identifier | 0 | CHANGES IN NET ASSETS OR FUND BALANCES: |
| IRS990ScheduleO/GeneralExplanation/ReturnReference | 0 | FORM 990, PART VI, SECTION A, LINE 3 |
| IRS990ScheduleO/GeneralExplanation/ReturnReference | 1 | FORM 990, PART VI, SECTION A, LINE 8B |
| IRS990ScheduleO/GeneralExplanation/ReturnReference | 2 | FORM 990, PART VI, SECTION B, LINE 11 |
| IRS990ScheduleO/GeneralExplanation/ReturnReference | 3 | FORM 990, PART VI, SECTION B, LINE 12C |
| IRS990ScheduleO/GeneralExplanation/ReturnReference | 4 | FORM 990, PART VI, SECTION C, LINE 19 |
| IRS990ScheduleO/GeneralExplanation/ReturnReference | 5 | FORM 990, PART XI, LINE 5: |
| IRS990ScheduleO/GeneralExplanation/ReturnReference | 6 | FORM 990, PART XII, LINE 2C: |
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| IRS990ScheduleR/Form990ScheduleRPartII/AddressUS/ZIPCode | 0 | 94551 |
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| IRS990ScheduleR/Form990ScheduleRPartII/NameOfDisregardedEntity/BusinessNameLine1 | 0 | HEALTH SERVICES FOUNDATION |
| IRS990ScheduleR/Form990ScheduleRPartII/PrimaryActivities | 0 | TO PROVIDE MEDICAL EXAMINATIONS |
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| IRS990ScheduleR/Form990ScheduleRPartVII/Explanation | 0 | THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF APRIL 30, 2012 THERE ARE APPROXIMATELY 17 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. HOWEVER, CERTAIN INFORMATION THAT IS REQUIRED TO BE REPORTED ON SCHEDULE R SUCH AS EMPLOYER IDENTIFICATION NUMBERS AND LEGAL STRUCTURE (CORPORATION, PARTNERSHIP, ETC.) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT, THE CONTRIBUTING EMPLOYERS HAVE NOT BEEN INCLUDED ON SCHEDULE R. |
| IRS990ScheduleR/Form990ScheduleRPartVII/ReturnReference | 0 | SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS: |
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| IRS990ScheduleR/SaleOfAssetsToOtherOrg | 0 | 0 |
| IRS990ScheduleR/SharingOfFacilities | 0 | 0 |
| IRS990ScheduleR/SharingOfPaidEmployees | 0 | 0 |
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| IRS990/StateLegalDomicile | 0 | CA |
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Document Assets
No mirrored PDF or thumbnail assets are attached yet.
Filings
Displayed year
2012 • Form 990Facts available. Structured filing facts are available, but richer extracted sections are limited.
- Assets
- $23,091,030
- Liabilities
- $10,231,250
- Net assets
- $12,859,780
- Revenue
- -
- Expenses
- $56,583,143
- Net income
- -