2024-02-14T17:12:25-06:00 2023-03-31 208149084 ANASTASI MOORE & MARTIN PLLC 9 S WASHINGTON ST STE 600 SPOKANE WA 99201 990 2022-04-01 811094866 LABORERS AGC TRUST OF MONTANA HEALTH & WELFARE LABO 5095345625 201 WEST NORTH RIVER DRIVE 450 SPOKANE WA 99201 RICHARD J MORRISON CHAIRMAN 5095345625 2024-02-14 1 RICHARD MORRISON 999009999 1 PAUL ANASTASI CPA P00395796 5093230272 2024-02-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X RICHARD J MORRISON 201 WEST NORTH RIVER DRIVE 450 SPOKANE WA 99201 24159192 0 X N/A X 1961 MT PREMIUM AND BENEFIT PAYMENTS AND OTHER RELATED EXPENSES FOR MEDICAL, DENTAL, VISION, ACCIDENTAL DEATH AND DISMEMBERMENT, LIFE INSURANCE, AND TIME LOSS BENEFITS. 6 0 10 0 0 0 0 0 10419214 9371096 693775 -768111 31356 11882 11144345 8614867 0 0 10116195 8425194 0 0 0 0 0 753149 728869 10869344 9154063 275001 -539196 18871331 18260526 1390266 1460198 17481065 16800328 PREMIUM AND BENEFIT PAYMENTS AND OTHER RELATED EXPENSES FOR MEDICAL, DENTAL, VISION, ACCIDENTAL DEATH AND DISMEMBERMENT, LIFE INSURANCE, AND TIME LOSS BENEFITS. 0 0 TO PROVIDE QUALIFIED HEALTH AND WELFARE BENEFITS TO QUALIFIED PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 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 3 0 1 10 1 0 0 0 0 0 0 0 0 X 6 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 X ZENITH AMERICAN SOLUTIONS INC 5095345625 201 WEST NORTH RIVER DRIVE SUITE SPOKANE WA 99201 KIM RICKARD UNION TRUSTEE 1.00 40.00 X 0 62500 41000 MICKEY MULHOLLAND UNION TRUSTEE 1.00 40.00 X 0 46442 41000 WARREN SMELTZER SECRETARY 1.00 40.00 X X 0 17352 8000 RICHARD J MORRISON CHAIRMAN 1.00 40.00 X X 0 0 0 NICK PATCH EMPLOYER TRUSTEE 1.00 40.00 X 0 0 0 CODY MORRITT EMPLOYER TRUSTEE 1.00 40.00 X 0 0 0 JO PERKINS EMPLOYER TRUSTEE (OUTGOING) 1.00 40.00 X 0 0 0 NICK NEUMAN EMPLOYER TRUSTEE (OUTGOING) 1.00 40.00 X 0 0 0 0 126294 90000 0 0 0 0 ZENITH AMERICAN SOLUTIONS INC 201 WEST NORTH RIVER DRIVE SUITE 4 SPOKANE WA 99201 THIRD PARTY ADMINISTRATOR 240439 PREMERA BLUE CROSS 7001 220TH STREET SOUTHWEST MOUNTLAKE TERRACE WA 98043 NETWORK ACCESS 198011 2 EMPLOYER CONTRIBUTIONS 900099 9134984 9134984 RETIREES CONTRIBUTIONS 900099 134182 134182 PARTICIPANTS CONTRIBUTION 900099 101930 101930 9371096 550164 550164 14226050 15544325 -1318275 -1318275 -1318275 PENALTIES AND INTEREST 900099 11882 11882 11882 8614867 9382978 0 -768111 8425194 511698 28789 24840 64897 36135 42980 6927 12603 9154063 1085935 747173 255341 571226 1119683 1564335 4463 4047 16357751 15325439 48158 48306 18871331 18260526 20864 2187 1369402 1458011 1390266 1460198 X 0 0 0 0 17481065 16800328 17481065 16800328 18871331 18260526 X -539196 -65852 -75689 X 0 1 X 0 0 0 CLAIMS PAYABLE 528484 CLAIMS INCURRED BUT NOT REPORTED 929527 1458011 X 8408429 -65852 -75689 -141541 8549970 64897 64897 8614867 9000557 0 9000557 64897 88609 153506 9154063 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS QUALIFIED PURSUANT TO THE APPROPRIATE SECTION OF THE INTERNAL REVENUE CODE (IRC) AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE PLAN HAS OBTAINED A FAVORABLE DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS), BUT HAS SINCE BEEN AMENDED. HOWEVER, THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC. THEREFORE, THEY BELIEVE THAT THE PLAN IS QUALIFIED, AND THE RELATED TRUST IS TAX-EXEMPT AS OF THE FINANCIAL STATEMENT DATES. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE PLAN'S FINANCIAL STATEMENTS. 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 MARCH 31, 2023, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF THE LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS AND THE PLAN COULD BE SUBJECT TO INCOME TAX IF CERTAIN ISSUES WERE FOUND BY THE IRS THAT COULD RESULT IN THE DISQUALIFICATION OF THE PLAN'S TAX-EXEMPT STATUS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: MEDICARE GAP REIMBURSEMENT -75,689. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN CLAIMS PAYABLE 141,821. CHANGE IN CLAIMS IBNR -53,212. FORM 990, PART VI, SECTION A, LINE 3 DAY TO DAY TASKS WERE DELEGATED TO A THIRD PARTY ADMINISTRATOR, ZENITH AMERICAN SOLUTIONS, INC. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE CHAIRMAN OF THE BOARD OF TRUSTEES AND THE THIRD-PARTY ADMINISTRATOR PRIOR TO FILING. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS THAT ARE AVAILABLE TO PUBLIC WILL BE SENT UPON REQUEST. FORM 990, PART XI, LINE 9: MEDICARE GAP REIMBURSEMENT -75,689. 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