2024-08-12T14:17:10-05:00 2023-09-30 320043599 LEGACY PROFESSIONALS LLP 6800 FRANCE AVENUE SO SUITE 550 EDINA MN 55435 990 2022-10-01 810305103 MONTANA RETAIL EMPLOYEES HEALTH AND WELFARE TRUST MONT 5095340600 1322 N POST PLACE SPOKANE WA 99201 NICOLAI COCERGINE TRUSTEE 5095340600 2024-08-12 0 LARRY WOOD P00634996 9528413950 2022 2024-08-08 14:25:15Z NICOLAI COCERGINE 1322 N POST PLACE SPOKANE WA 99201 13499364 0 X N/A X 1968 MT PROVIDE HEALTH AND WELFARE BENEFITS 5 3 0 0 0 0 0 0 12054088 13154361 58913 345003 335392 0 12448393 13499364 0 0 11669420 11800983 0 0 0 0 0 1067656 665829 12737076 12466812 -288683 1032552 13802115 14350506 4388147 30869 9413968 14319637 PROVIDE HEALTH AND WELFARE BENEFITS. 0 0 THE PLAN PROVIDES COMPREHENSIVE MEDICAL BENEFITS INCLUDING DENTAL, VISION, PRESCRIPTION DRUG, LIFE INSURANCE, ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D) AND TIME LOSS BENEFITS FOR ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1 442 0 1 0 0 0 0 0 0 0 0 0 0 0 X 5 3 0 1 0 0 0 1 0 1 0 0 0 1 1 1 1 0 1 0 0 0 X REHN & ASSOCIATES 5095340600 1322 N POST PLACE SPOKANE WA 99201 NICOLAI COCERGINE TRUSTEE 1.00 40.00 X 0 98777 15493 TERRIE TRETTENBACH TRUSTEE 1.00 40.00 X 0 68230 15493 PAULETTE DURYEE ALTERNATE TRUSTEE 1.00 40.00 X 0 44508 14973 BRENT BOHN TRUSTEE 1.00 X 0 0 0 KATINA WOOD TRUSTEE 1.00 X 0 0 0 STEVE BREZENSKI TRUSTEE 1.00 X 0 0 0 ROBERT MCLAUCHLIN TRUSTEE - PAST 1.00 X 0 0 0 0 211515 45959 0 0 0 0 A W REHN & ASSOCIATES 1322 N POST PLACE SPOKANE WA 99201 CLAIMS PROCESSING AND ADMINISTRATION 358735 MEDICAL REHABILITATION CONSULTANTS INC 621 SANTA FE AVENUE FRESNO CA 93721 MEDICAL AND UTILIZATION MANAGEMENT 280510 2 EMPLOYER CONTRIBUTIONS 900099 11680207 11680207 PARTICIPANT CONTRIBUTIONS 900099 749761 749761 PRESCRIPTION DRUG REBATES 900099 483194 483194 STOP LOSS REIMBURSEMENTS 900099 237493 237493 SUBROGATION SETTLEMENTS 900099 3706 3706 13154361 345003 345003 13499364 13154361 0 345003 11800983 317454 93820 51036 8386 96636 58219 18115 18835 FEES MANDATED BY ACA 3328 12466812 -643666 7214485 7700080 1224747 1711116 9624 89882 5353259 5493094 13802115 14350506 18667 30869 4369480 4388147 30869 X 0 0 0 0 9413968 14319637 9413968 14319637 13802115 14350506 1032552 -66098 3939215 0 X 0 1 X 1 0 0 X 13424880 -66098 -66098 13490978 8386 8386 13499364 12458426 0 12458426 8386 8386 12466812 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN TO EVALUATE TAX POSITIONS TAKEN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN UNCERTAIN TAX POSITIONS THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY TAX AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. FORM 990, PART VI, SECTION A, LINE 3 ALTHOUGH THE BOARD OF TRUSTEES RETAINS ULTIMATE CONTROL AND RESPONSIBILITY FOR THE PLAN, THE TRUSTEES HAVE DELEGATED THE DAY-TO-DAY ADMINISTRATIVE DUTIES TO REHN & ASSOCIATES AS THE THIRD PARTY ADMINISTRATOR OF THE PLAN. FORM 990, PART VI, SECTION A, LINE 7A THE PLAN IS GOVERNED BY UP TO EIGHT TRUSTEES; FOUR TRUSTEES ARE APPOINTED BY THE UNION AND FOUR TRUSTEES ARE APPOINTED BY THE EMPLOYERS. THE UNION AND THE EMPLOYERS MAY ALSO APPOINT ALTERNATE TRUSTEES WHO WILL BE QUALIFIED TO ACT ONLY IN THE ABSENCE OF A TRUSTEE. FORM 990, PART VI, SECTION A, LINE 8B THE PLAN HAS NO COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PROVIDED TO AND REVIEWED BY THE ENTIRE BOARD OF TRUSTEES PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL LETTERS ARE MAILED AND COLLECTED FROM EACH TRUSTEE. TRUST COUNSEL ASKS FOR ANY KNOWN ISSUES AT EACH TRUSTEE MEETING. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. THESE DOCUMENTS ARE LOCATED AT THE THIRD PARTY ADMINISTRATOR'S OFFICE IN SPOKANE, WA. INTERMOUNTAIN RETAIL STORE EMPLOYEES PENSION PLAN 11724 NE 195TH STREET BOTHELL WA 980118242 916187192 PROVIDES PENSION BENEFITS TO PARTICIPANTS AND BENEFICIARIES ID 401(A) N/A 0 UNITED FOOD AND COMMERCIAL WORKERS UNION LOCAL 1889 CONTRIBUTING EMPLOYER 0 BOB WARD'S & SONS INC CONTRIBUTING EMPLOYER 0 SHEEP SHEARERS MERCHANDISE AND COMMISSION COMPANY INC CONTRIBUTING EMPLOYER 0 CASCADE WHOLESALE MEATS INC CONTRIBUTING EMPLOYER 0 WESTERN MEAT & SAUSAGE BLOCK INC CONTRIBUTING EMPLOYER 0 LINCINI'S PRINT SHOP CONTRIBUTING EMPLOYER 0 SMITH'S FOOD & DRUG CENTERS CONTRIBUTING EMPLOYER 0 VAN'S THRIFTWAY INC CONTRIBUTING EMPLOYER 0 ROSAUERS SUPERMARKETS INC CONTRIBUTING EMPLOYER 0 SAFEWAY INC CONTRIBUTING EMPLOYER 0 ALBERTSONS COMPANIES INC CONTRIBUTING EMPLOYER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1