2024-07-15T22:08:20-05:00 2023-08-31 990155373 SINGERLEWAK LLP 500 ALA MOANA BLVD 2 302 HONOLULU HI 96813 990 2022-09-01 996009135 TEAMSTERS HEALTH & WELFARE TRUST FUND TEAM 8085230199 560 N NIMITZ HWY 209 HONOLULU HI 96817 KEVIN HOLU JENNY LEMAOTA UNION TRUSTEE/ EMPLOYER TRUSTEE 8085230199 2024-07-15 KEVIN HOLU JENNY LEMAOTA 999009999 0 TERRY TAKAKI P00036112 8085336254 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z KEVIN HOLU JENNY LEMAOT 560 N NIMITZ HWY 209 HONOLULU HI 96817 61449031 0 X N/A X 1957 HI TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS, THEIR DEPENDENTS, AND RETIREES. 4 0 2 0 0 0 0 0 46751799 48411347 284911 321380 2328658 2550322 49365368 51283049 0 0 45549983 46817219 0 0 0 0 0 680569 790079 46230552 47607298 3134816 3675751 29614494 35794377 0 0 29614494 35794377 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS, THEIR DEPENDENTS, AND RETIREES. 0 0 37647563 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS, THEIR DEPENDENTS, AND RETIREES BY PAYING MONTHLY INSURANCE PREMIUMS TO INSURANCE CARRIERS (MEDICAL/DENTAL $37,340,621, CHIROPRACTIC CARE $46,555, MEDICARE PREMIUM REIMBURSEMENTS $1,923, LIFE INSURANCE $24,301, AND VISION $234,163). 6621691 TO PROVIDE SELF-INSURED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS, THEIR DEPENDENTS, AND RETIREES (DRUG $4,738,727 AND DENTAL $1,882,964). 185874 TO PAY FOR SELF-FUNDED BENEFIT ADMINISTRATIVE FEES. 44455128 0 0 0 0 0 0 0 0 0 0 0 0 1 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 1 2 1 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 HI X BENEFIT RISK & MANAGEMENT SERVICES 8085230199 560 N NIMITZ HIGHWAY STE 209 HONOLULU HI 96817 X KEVIN HOLU UNION TRUSTEE 1.00 X 0 0 0 JOELLE HUSSEY UNION TRUSTEE 1.00 X 0 0 0 JONATHAN REED UNION TRUSTEE 1.00 X 0 0 0 CHRIS UEOKA UNION TRUSTEE 1.00 X 0 0 0 ROBERT YU EMPLOYER TRUSTEE 1.00 X 0 0 0 JENNY LEMAOTA EMPLOYER TRUSTEE 1.00 X 0 0 0 EILEEN MORI-MISHINA EMPLOYER TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 BENEFIT & RISK MANAGEMENT SERVICES 560 N NIMITZ HWY STE 209 HONOLULU HI 96817 THIRD PARTY ADMINISTRATOR/CLAIMS REPRICI 322092 HAWAII DENTAL SERVICE 700 BISHOP STREET 700 HONOLULU HI 96813 DENTAL CLAIMS ADMINISTRATOR 122350 BENEFIT PLAN SOLUTIONS 680 IWILEI ROAD STE 528 HONOLULU HI 96817 PLAN CONSULTANT 104511 3 EMPLOYERS' CONTRIB 900099 47000760 47000760 EMPLOYEES' CONTRIB 900099 1401560 1401560 LIQUIDATED DAMAGES 900099 9027 9027 48411347 867880 867880 9619482 10165982 -546500 -546500 -546500 DRUG REBATES 900099 2547965 2547965 OTHER 900099 2357 2357 2550322 51283049 50415169 0 867880 46817219 35405 48361 50624 322092 1849 19625 21738 ADMINISTRATIVE FEES - D 185874 CONSULTANT FEES 104511 47607298 54421 9044936 12227430 4818958 5227761 15604350 15882821 146250 2401944 29614494 35794377 0 0 X 29614494 35794377 0 0 0 0 29614494 35794377 29614494 35794377 3675751 347083 2157049 0 X X 0 1 X 1 0 0 INSURANCE RESERVE - UNIVERSITY HEALTH ALLIANCE 2239426 INSURANCE RESERVE - PACIFIC GUARDIAN LIFE 162518 2401944 X 49031543 347083 347083 48684460 50624 2547965 2598589 51283049 45008709 0 45008709 50624 2547965 2598589 47607298 PART X, LINE 2: THE AUDITED FINANCIAL STATEMENTS CONTAIN THE FOLLOWING DISCLOSURE PERTAINING TO FIN 48 (ASC 740) "THE TRUST FUNDING CERTAIN BENEFITS OF THE PLAN RECEIVED AN EXEMPTION LETTER FROM THE IRS DATED MARCH 1, 1996, STATING THAT THE TRUST IS TAX-EXEMPT UNDER THE PROVISIONS OF SECTION 501(C)(9) OF THE IRC. HOWEVER, AS A RESULT OF THE PLAN'S FUNDING POLICY, FROM TIME TO TIME THE TRUST MAY BE SUBJECT TO INCOME TAXES. NO FEDERAL OR STATE INCOME TAXES HAVE BEEN RECORDED IN 2022 AND 2021 FOR UNRELATED BUSINESS TAXABLE INCOME. IN ADDITION, THE PLAN AND THE TRUST ARE REQUIRED TO OPERATE IN CONFORMITY WITH THE IRC TO MAINTAIN THE TAX-EXEMPT STATUS OF THE TRUST. THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC AND, THEREFORE, BELIEVES THAT THE RELATED TRUST IS TAX-EXEMPT. 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 IF IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS." PART XI, LINE 4B - OTHER ADJUSTMENTS: DRUG REBATES PART XII, LINE 4B - OTHER ADJUSTMENTS: DRUG REBATES FORM 990, PART VI, SECTION B, LINE 11B THE ADMINISTRATOR DISSEMINATES THE FORM 990 TO UNION AND EMPLOYER TRUSTEE REPRESENTATIVES FOR THEIR REVIEW AND EXECUTION. FORM 990, PART VI, SECTION B, LINE 12C THE TRUSTEES EXECUTE A STATEMENT OF COMPLIANCE WHICH IS KEPT ON FILE. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: NO CHANGE IN REVIEW PROCESS FROM PRIOR YEAR. BOARD OF TRUSTEES SELECTS AN INDEPENDENT AUDITOR. ADMINISTRATOR FORMALLY REVIEWS AND APPROVES THE FINANCIAL STATEMENTS. BOARD OF TRUSTEES REVIEW AND APPROVE THE FINANCIAL STATEMENTS. SEE SCHEDULE R SUPPLEMENTAL INFORMATION SEE SCHEDULE R SUPPLEMENTAL INFORMATION SEE SCHEDULE R SUPPLEMENTAL INFORMATION 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FORM 990, SCHEDULE R, PARTS II, III, IV: THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER PLAN THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. THE ADMINISTRATOR'S OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS INCLUDING THE NAMES, ADDRESSES, AND OTHER CONTACT INFORMATION. HOWEVER, THE LEGAL STRUCTURE (CORPORATION, PARTNERSHIP, ETC) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND COULD NOT BE REASONABLY OBTAINED. AS A RESULT, THE CONTRIBUTING EMPLOYERS COULD NOT BE SEPARATED BY TYPE OF ORGANIZATION, HOWEVER, THEY ARE LISTED BELOW: 1. ALOHA PETROLEUM TERMINAL OPERATORS 2. ALOHA PETROLEUM LTD. 3. HC&D, LLC 4. B&C TRUCKING CO. LTD. 5. BAKER COMMODITIES, INC. 6. ISLAND PUMPING SERVICES, INC. 7. YOUNG'S MARKET COMPANY - HILO/KONA 8. YOUNG'S MARKET COMPANY - MAUI 9. YOUNG'S MARKET COMPANY - OAHU 10. CITY MILL COMPANY LTD. 11. AIRGAS USA, LLC 12. GOLDEN STATE FOODS CORP. 13. HAWAII TRANSFER COMPANY 14. HAWAIIAN CEMENT 15. HONOLULU WOOD TREATING LLC 16. HONSADOR LUMBER CORP. 17. TEAMSTERS UNION LOCAL 996 18. MARTIN TRANSPORTATION SERVICES 19. MCKESSON DRUG CO. 20. OTS CLERICAL 21. OTS NON-CLERICAL 22. OTS PARATRANSIT HANDIVAN 23. OTS SALARY NON-CLERICAL 24. PARADISE BEVERAGES KAUAI 25. UNICOLD CORP. 26. YELLOW TRANSPORTATION 27. ST. FRANCIS HEALTHCARE SYSTEM HAWAII 28. ST. FRANCIS MEDICAL CENTER 29. DON QUIJOTE