2024-06-10T13:25:15-05:00 2023-07-31 WITHUMSMITHBROWNPC 5000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON CA 94583 990 2022-08-01 946073033 NORTHERN CALIFORNIA GENERAL TEAMSTERS SECURITY FUND % DELTA FUND ADMINISTRATORS NORT 2099405100 PO BOX 2300 STOCKTON CA 95201 Peter Nunez Co-Chair 2099405100 2024-05-14 true Peter Nunez 999009999 DONNIE J SPRINGER P01451649 9252779100 3 2022 2023-04-26 12:10:37Z Peter Nunez PO BOX 2300 STOCKTON CA 95201 756132591 false X N/A X 1952 CA TO PROVIDE HEALTH & WELFARE BENEFITS. 6 0 20 0 0 0 0 0 382987723 413384562 31136866 10423839 0 0 414124589 423808401 0 0 294784455 347700488 0 0 0 0 0 42547003 48540889 337331458 396241377 76793131 27567024 564873395 605660529 93466917 95114105 471406478 510546424 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. false false PROVIDED HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. false false false false false false false false false false true false false true true true false false false false false false false false false false false false false false false false false false false false false false false false true false false true 9 0 true 20 true false false false false false false false false X 6 0 false true false false false false false true false false false true true true true true true false false false CA X DELTA FUND ADMINISTRATORS 2099405100 3244 BROOKSIDE ROAD SUITE 230 STOCKTON CA 95219 X Dave Hawley CO-CHAIR 1.0 0.0 X X 0 0 0 Jim Wells CO-CHAIR 1.0 0.0 X X 0 0 0 Allen Cheek TRUSTEE 1.0 0.0 X 0 0 0 Jeff Berdion TRUSTEE 1.0 0.0 X 0 0 0 PETER NUNEZ TRUSTEE 1.0 0.0 X 0 0 0 Walter Mendez TRUSTEE 1.0 0.0 X 0 0 0 SEE SCH O FOR COMPENSATION PAID BY RELATED ORGANIZATIONS 0.0 0.0 X 0 0 0 0 0 0 0 false false false Delta Fund Administrators LLC 3244 Brookside Rd Suite 230 STOCKTON CA 95219 CONNTRACT ADMIN 9394641 Anthem Blue Cross 2121 N California Blvd WALNUT CREEK CA 94596 NETWORK FEES 4401784 McMorgan Company One Front Street Ste 500 SAN FRANCISCO CA 94111 Invest MGMT 1016909 WELLDYNERX INC 500 EAGLES LANDING DR LAKELAND FL 33810 CONTRACT ADMIN 534478 CYPRESS DENTAL ADMINISTRATORS 3244 BROOKSIDE ROAD STOCKTON CA 95219 CONTRACT ADMIN 457459 13 0 EMPLOYER CONTRIBUTIONS 525100 391599242 391599242 SUBROGATION RECOVERY 525100 11330018 11330018 PRESCRIPTION REBATES 525100 9360497 9360497 PARTICIPANT CONTRIBUTIONS 525100 516766 516766 REFUNDS 525100 366376 366376 211663 211663 413384562 22855692 22855692 0 0 0 0 0 319892337 332324190 -12431853 -12431853 -12431853 0 0 0 0 0 0 0 0 0 0 0 423808401 413384562 0 10423839 0 0 0 347700488 0 0 0 0 0 0 9916001 140143 335138 0 0 1940680 6677909 0 527352 0 0 0 0 0 24314 0 0 0 126956 RESERVE SUBSIDIES PAID 17382946 RETIREE SUBSIDIES PAID 11469450 396241377 0 0 45433523 39649558 0 0 51682191 39590657 0 0 0 0 0 0 0 0 28859 53887 0 0 445006807 473293432 22722015 53072995 0 0 0 0 0 0 564873395 605660529 23140593 10057821 0 0 700000 0 0 0 0 0 0 0 0 0 0 0 69626324 85056284 93466917 95114105 X 0 0 0 0 471406478 510546424 471406478 510546424 564873395 605660529 27567024 11572922 X X false true X true false 0 0 CLAIMS PAYABLE AND IBNR 56044284 ELIGIBILITY CREDITS 29012000 85056284 X 433440643 11572922 11572922 421867721 1940680 1940680 423808401 378342275 378342275 1940680 15958422 17899102 396241377 Part X, Line 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE THE TAX POSITIONS TAKEN BY THE PLAN AND TO RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT, MORE LIKELY THAN NOT, WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN AND HAS CONCLUDED THAT, AS OF JULY 31, 2023 AND 2022, 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 BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL YEARS PRIOR TO 2020. Part XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS FORM 990, PART VI, SECTION A, LINE 3: THE GOVERNING BODY HAS APPOINTED MANAGEMENT DUTIES TO A THIRD-PARTY ADMINISTRATOR. FORM 990, PART VI, SECTION A, LINE 8B: THE ORGANIZATION DOES NOT HAVE A COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B: THE FORM 990 WAS MADE AVAILABLE TO EACH OF THE TRUSTEES FOR REVIEW BEFORE THE RETURN WAS FILED. THE THIRD-PARTY ADMINISTRATOR REVIEWED THE FORM FOR COMPLETENESS AND ACCURACY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C: THE CONFLICT-OF-INTEREST POLICY COVERS ALL TRUSTEES AND ANY OTHER INDIVIDUALS WHO EXERCISE DISCRETIONARY AND/OR FIDUCIARY AUTHORITY OVER THE AFFAIRS OF THE TRUST. AT LEAST ONCE ANNUALLY, TRUSTEES AND OTHER FIDUCIARIES ARE REQUIRED TO DISCLOSE IN WRITING ANY RELATIONSHIPS OR INTERESTS THAT COULD GIVE RISE TO A CONFLICT. THE BOARD HAS DISCRETIONARY AUTHORITY TO DETERMINE WHETHER A CONFLICT DOES IN FACT, EXIST AND IF SO, WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR AND REASONABLE TO THE TRUST. SUCH DETERMINATIONS ARE MADE WITHOUT THE INPUT OR PARTICIPATION OF THE CONFLICTED INDIVIDUAL. FORM 990, PART VI, SECTION B, LINE 15: THE ORGANIZATION DOES NOT COMPENSATE TRUSTEES. FORM 990, PART VI, SECTION C, LINE 19: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT-OF-INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 9A: TRUSTEES ARE NOT COMPENSATED BY THE TRUST. COMPENSATION PAID TO TRUSTEES EMPLOYED BY OTHER RELATED ORGANIZATIONS IS REPORTED ON THE FORM 990 FILED WITH THE INTERNAL REVENUE SERVICE BY THE RELATED TAX-EXEMPT ORGANIZATION. IF YOU WOULD LIKE ADDITIONAL INFORMATION, PLEASE CONTACT THE THIRD-PARTY ADMINISTRATOR, DELTA FUND ADMINISTRATORS LLC. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND FOR THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED. N/A false false false false false false false false false false false false false false false false false false false SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF JULY 31, 2023, THERE ARE APPROXIMATELY 214 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. THE FEDERAL TAX CLASSIFICATION (DISREGARDED ENTITY, TAX-EXEMPT ORGANIZATION, PARTNERSHIP, TAXABLE CORPORATION OR TRUST) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT, THE NAMES OF THE CONTRIBUTING EMPLOYERS ARE LISTED ON PART VII BELOW AND NOT ON PARTS II THROUGH IV BY FEDERAL TAX CLASSIFICATION. 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