Hawaii Medical Service Association Retiree Health Benefits Tr in Honolulu, Hawaii (HI)

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Table of contents:

• Overview
• Detailed Reports
  • Checklist
  • Statements Regarding Other IRS Filings and Tax Compliance
  • Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
  • Statement of Revenue
  • Statement of Functional Expenses
  • Balance Sheet
  • Reason for Public Charity Status
  • Revenue, Expenses, and Changes in Net Assets or Fund Balances
  • Statement of Functional Expenses
  • Balance Sheets
  • Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
  • Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
  • Current Officers, Directors, Trustees, and Key Employees
  • Other Information
  • Analysis of Income-Producing Activities
  • Information Regarding Taxable Subsidiaries and Disregarded Entities
  • Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees
  • Statements About Activities
  • Reason for Non-Private Foundation Status
  • Support Schedule
  • Lobbying Expenditures by Electing Public Charities
• Organizations performing similar types of work

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Hawaii Medical Service Association Retiree Health Benefits Tr
Employer Identification Number (EIN)	776235574
Name of Organization	Hawaii Medical Service Association Retiree Health Benefits Tr
In Care of Name	Steve Van Ribbink
Address	PO BOX 860, Honolulu, HI 96808-0860
Subsection	Voluntary Employees' Beneficiary Association (Non-Govt. Emps.)
Ruling Date	02/2006
Deductibility	Contributions are not deductible
Foundation	All organizations except 501(c)(3)
Organization	Trust
Exempt Organization Status	Unconditional Exemption
Tax Period	12/2013
Assets	$10,000,000 to $49,999,999
Income	$100,000 to $499,999
Filing Requirement	990 (all other) or 990EZ return
Asset Amount	$40,824,331
Amount of Income	$108,296
Form 990 Revenue Amount	$108,296
National Taxonomy of Exempt Entities (NTEE)	Mutual/Membership Benefit Organizations, Other: Voluntary Employees Beneficiary Associations (Non-Government)

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Amount of income in 2013: $108,296

This organization:	$108,296
Other organizations performing similar types of work:	$1,245,981

Assets in 2013: $40,824,331

This organization:	$40,824,331
Other organizations performing similar types of work:	$1,083,450

Expenses in 2013: $1,650,776

Hawaii Medical Service Association Retiree Health Benefits Tr:	$1,650,776
Other organizations performing similar types of work:	$729,445

Income to expenses ratio in 2013: 0.1

This organization:	0.1
Other organizations performing similar types of work:	1.1

Financial snapshot ($)

Assets at the end of 2013

Functional expenses for 2013

Checklist
	2012	2013
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?	No	No
Is the organization required to complete Schedule B, Schedule of Contributors?	No	No
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office?	No	No
Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year?	No	No
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19?	No	No
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts?	No	No
Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures?	No	No
Did the organization maintain collections of works of art, historical treasures, or other similar assets?	No	No
Did the organization report an amount for escrow or custodial account liability; serve as a custodian or provide credit counseling, debt management, credit repair, or debt negotiation services?	No	No
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments?	No	No
Did the organization report an amount for land, buildings, and equipment?	No	No
Did the organization report an amount for investments-other securities that is 5% or more of its total assets?	Yes	Yes
Did the organization report an amount for investments-program related that is 5% or more of its total assets?	No	No
Did the organization report an amount for other assets that is 5% or more of its total assets?	No	No
Did the organization report an amount for other liabilities?	Yes	Yes
Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)?	Yes	Yes
Did the organization obtain separate, independent audited financial statements for the tax year?	Yes	Yes
Was the organization included in consolidated, independent audited financial statements for the tax year?	No	No
Is the organization a school described in section 170(b)(1)(A)(ii)?	No	No
Did the organization maintain an office, employees, or agents outside of the United States?	No	No
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more?	No	No
Did the organization report more than $5,000 of grants or other assistance to or for any foreign organization?	No	No
Did the organization report more than $5,000 of aggregate grants or other assistance to or for foreign individuals?	No	No
Did the organization report a total of more than $15,000 of expenses for professional fundraising services?	No	No
Did the organization report more than $15,000 total of fundraising event gross income and contributions?	No	No
Did the organization report more than $15,000 of gross income from gaming activities?	No	No
Did the organization operate one or more hospital facilities?	No	No
Did the organization attach a copy of its audited financial statements?	No	No
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government?	No	No
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals?	No	No
Did the organization answer 'Yes' about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees?	Yes	Yes
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002?	No	No
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?	No	No
Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds?	No	No
Did the organization act as an 'on behalf of' issuer for bonds outstanding at any time during the year?	No	No
Did the organization engage in an excess benefit transaction with a disqualified person during the year?	No	No
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?	No	No
Did the organization report any amount for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons?	No	No
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons?	No	No
Was the organization a party to a business transaction with one of the following parties
A current or former officer, director, trustee, or key employee?	No	Yes
A family member of a current or former officer, director, trustee, or key employee?	No	Yes
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner?	No	Yes
Did the organization receive more than $25,000 in non-cash contributions?	No	No
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions?	No	No
Did the organization liquidate, terminate, or dissolve and cease operations?	No	No
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?	No	No
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3?	No	No
Was the organization related to any tax-exempt or taxable entity?	No	Yes
Did the organization have a controlled entity within the meaning of section 512(b)(13)?	No	No
Did the organization make any transfers to an exempt non-charitable related organization?	No	No
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes?	No	No

Statements Regarding Other IRS Filings and Tax Compliance
	2011	2012	2013
The number reported in Box 3 of Form 1096		1	1
The number of Forms W-2G		0	0
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners?		Yes	Yes
The number of employees reported on Form W-3, Transmittal of Wage and Tax Statements, filed for the calendar year ending with or within the year covered by this return		0	0
Did the organization file all required federal employment tax returns?		No	No
Did the organization have unrelated business gross income of $1,000 or more during the year?	Yes	Yes	Yes
Has it filed a Form 990-T for this year?		Yes	Yes
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?		No	No
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?		No	No
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?		No	No
Did the organization file Form 8886-T?		No	No
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?		No	No
Did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?		No	No
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?		No	No
Did the organization notify the donor of the value of the goods or services provided?		No	No
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?		No	No
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?		No	No
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?		No	No
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?		No	No
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?		No	No
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?		No	No
Did the sponsoring organization make any taxable distributions under section 4966?		No	No
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?		No	No
Initiation fees and capital contributions	$0	$0	$0
Gross receipts for public use of club facilities	$0	$0	$0
Gross income from members or shareholders	$0	$0	$0
Gross income from other sources	$0	$0	$0
Is the organization filing Form 990 in lieu of Form 1041?		No	No
The amount of tax-exempt interest received or accrued during the year		$0	$0
Is the organization licensed to issue qualified health plans in more than one state?		No	No
The amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans		$0	$0
The amount of reserves on hand		$0	$0
Did the organization receive any payments for indoor tanning services during the tax year?		No	No
Has it filed a Form 720 to report these payments?		No	No

Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
	2012	2013
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
Total reportable compensation from the organization	$57,981	$63,647
Total reportable compensation from related organizations	$3,427,799	$2,119,833
Total estimated amount of other compensation from the organization and related organizations	$1,328,172	$437,208
Total number of individuals who received more than $100,000 of reportable compensation from the organization	1	1
Total number of independent contractors who received more than $100,000 of compensation from the organization	0	0

Statement of Revenue
	2011	2012	2013
Total revenue	$-277,742	$102,035	$108,296
Contributions, Gifts, Grants and Other Similar Amounts	$0	$0	$0
Program Service Revenue	$0	$0	$0
Other Revenue
Investment income (including dividends, interest, and other similar amounts)	$99,582	$102,035	$108,296
Income from investment of tax-exempt bond proceeds	$0	$0	$0
Royalties	$0	$0	$0
Net rental income	$0	$0	$0
Net gain/loss from sales of assets other than inventory	$-377,324	$0	$0
Net income/loss from fundraising events	$0	$0	$0
Net income/loss from gaming activities	$0	$0	$0
Net income/loss from sales of inventory	$0	$0	$0
Miscellaneous Revenue	$0	$0	$0

Statement of Functional Expenses
	2011	2012	2013
Total functional expenses	$673,780	$1,271,249	$1,650,776
Grants and other assistance to domestic organizations and domestic governments		$0	$0
Grants and other assistance to domestic individuals		$0	$0
Grants and other assistance to foreign organizations, foreign governments, and foreign individuals		$0	$0
Benefits paid to or for members		$934,536	$970,787
Compensation of current officers, directors, trustees, and key employees	$0	$0	$0
Compensation not included above, to disqualified persons		$0	$0
Other salaries and wages	$0	$0	$0
Pension plan accruals and contributions		$0	$0
Other employee benefits		$0	$0
Payroll taxes	$0	$0	$0
Fees for services (non-employees)
Management		$0	$0
Legal		$0	$0
Accounting		$0	$0
Lobbying		$0	$0
Professional fundraising services	$0	$0	$0
Investment management fees		$0	$0
Other		$0	$0
Advertising and promotion		$0	$0
Office expenses		$0	$0
Information technology		$0	$0
Royalties		$0	$0
Occupancy		$0	$0
Travel		$0	$0
Payments of travel or entertainment expenses for any federal, state, or local public officials		$0	$0
Conferences, conventions, and meetings		$0	$0
Interest		$0	$0
Payments to affiliates		$0	$0
Depreciation, depletion, and amortization		$0	$0
Insurance		$0	$0
Other expenses		$12,140	$12,534
Other expenses		$2,581	$2,395
Other expenses		$262,743	$600,146
Other expenses		$57,981	$63,647
Other expenses		$1,268	$1,267

Balance Sheet
	2011	2012	2013
Total assets	$32,416,047	$34,621,625	$40,824,331
Cash - non-interest-bearing		$0	$0
Savings and temporary cash investments		$5,641,785	$4,593,398
Pledges and grants receivable, net		$0	$0
Accounts receivable, net		$0	$0
Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees		$0	$0
Loans and other receivables from other disqualified persons, persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations		$0	$0
Notes and loans receivable, net		$0	$0
Inventories for sale or use		$0	$0
Prepaid expenses and deferred charges		$0	$0
Land, buildings, and equipment: cost or other basis		$0	$0
Investments - publicly traded securities		$4,962,858	$6,491,020
Investments - other securities		$24,016,982	$29,739,913
Investments - program-related		$0	$0
Intangible assets		$0	$0
Other assets		$0	$0
Total liabilities	$145,833	$351,310	$953,105
Accounts payable and accrued expenses		$0	$0
Grants payable		$0	$0
Deferred revenue		$0	$0
Tax-exempt bond liabilities	$0	$0	$0
Escrow or custodial account liability		$0	$0
Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons		$0	$0
Secured mortgages and notes payable to unrelated third parties	$0	$0	$0
Unsecured notes and loans payable to unrelated third parties	$0	$0	$0
Other liabilities (including federal income tax, payables to related third parties, and other liabilities)		$351,310	$953,105
Total net assets or fund balances	$32,270,214	$34,270,315	$39,871,226
Unrestricted net assets		$0	$0
Temporarily restricted net assets		$0	$0
Permanently restricted net assets		$0	$0
Capital stock or trust principal, or current funds		$32,270,214	$34,270,315
Paid-in or capital surplus, or land, building, or equipment fund		$2,000,101	$5,600,911
Retained earnings, endowment, accumulated income, or other funds	$0	$0	$0

Reason for Public Charity Status (for 2013)
The organization is not a private foundation because it is:	Not provided
Number of organizations supported	0
Sum of amounts of support	$0

Revenue, Expenses, and Changes in Net Assets or Fund Balances
	2005	2006	2007
Total revenue	$903,246	$1,144,640	$1,095,859
Contributions, gifts, grants, and similar amounts received	$0	$0	$0
Contributions to donor advised funds		$0	$0
Direct public support	$0	$0	$0
Indirect public support	$0	$0	$0
Government contributions (grants)	$0	$0	$0
Program service revenue including government fees and contracts	$0	$0	$0
Membership dues and assessments	$0	$0	$0
Interest on savings and temporary cash investments	$12,381	$17,541	$11,246
Dividends and interest from securities	$890,838	$1,127,099	$1,084,613
Net rental income or (loss)	$0	$0	$0
Gross rents	$0	$0	$0
Less: rental expenses	$0	$0	$0
Other investment income	$27	$0	$0
Gain or (loss) from sales of assets other than inventory	$0	$0	$0
Gross amount from sales of assets other than inventory	$0	$0	$0
Less: cost or other basis and sales expenses	$0	$0	$0
Net income or (loss) from special events and activities	$0	$0	$0
Gross revenue	$0	$0	$0
Less: direct expenses other than fundraising expenses	$0	$0	$0
Gross profit or (loss) from sales of inventory	$0	$0	$0
Gross sales of inventory, less returns and allowances	$0	$0	$0
Less: cost of goods sold	$0	$0	$0
Other revenue	$0	$0	$0
Total expenses	$999,831	$1,423,931	$1,262,657
Program services	$0	$0	$0
Management and general	$0	$0	$0
Fundraising	$0	$0	$0
Payments to affiliates	$0	$0	$0
Net assets or fund balances at end of year	$29,202,115	$29,940,733	$30,369,196
Excess or (deficit) for the year	$-96,585	$-279,291	$-166,798
Net assets or fund balances at beginning of year	$29,007,038	$29,202,115	$29,940,733
Other changes in net assets or fund balances	$291,662	$1,017,909	$595,261

Statement of Functional Expenses (for 2007)
	Total	Program services	Management and general	Fundraising
Total functional expenses	$1,262,657	$0	$0	$0
Grants paid from donor advised funds		$0
Other grants and allocations		$0
Specific assistance to individuals		$0
Benefits paid to or for members		$590,739
Compensation of current officers, directors, key employees, etc.	$0	$0	$0	$0
Compensation of former officers, directors, key employees, etc.	$0	$0	$0	$0
Compensation and other distributions, not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)	$0	$0	$0	$0
Salaries and wages of employees not included above	$0	$0	$0	$0
Pension plan contributions not included above	$0	$0	$0	$0
Employee benefits not included above	$0	$0	$0	$0
Payroll taxes	$0	$0	$0	$0
Professional fundraising fees	$0	$0	$0	$0
Accounting fees	$0	$0	$0	$0
Legal fees	$0	$0	$0	$0
Supplies	$0	$0	$0	$0
Telephone	$0	$0	$0	$0
Postage and shipping	$0	$0	$0	$0
Occupancy	$0	$0	$0	$0
Equipment rental and maintenance	$0	$0	$0	$0
Printing and publications	$0	$0	$0	$0
Travel	$0	$0	$0	$0
Conferences, conventions, and meetings	$0	$0	$0	$0
Interest	$0	$0	$0	$0
Depreciation, depletion, etc.	$0	$0	$0	$0
Other expenses not covered above	$671,918	$0	$0	$0

Balance Sheets
	2005	2006	2007
Total assets	$29,738,757	$31,439,978	$31,450,155
Cash - non-interest-bearing	$0	$0	$0
Savings and temporary cash investments	$98,548	$221,934	$167,313
Accounts receivable less allowance for doubtful accounts	$76,344	$37,417	$23,968
Pledges receivable less allowance for doubtful accounts	$0	$0	$0
Grants receivable	$0	$0	$0
Receivables from current and former officers, directors, trustees, and key employees	$0	$0	$0
Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)		$0	$0
Other notes and loans receivable less allowance for doubtful accounts	$0	$0	$0
Inventories for sale or use	$0	$0	$0
Prepaid expenses and deferred charges	$0	$0	$0
Investments - publicly-traded securities		$27,020,805	$22,872,586
Investments - other securities	$29,563,865	$0	$0
Investments - land, buildings, and equipment less accumulated depreciation	$0	$0	$0
Investments - other	$0	$4,159,822	$8,386,288
Land, buildings, and equipment less accumulated depreciation	$0	$0	$0
Other assets, including program-related investments	$0	$0	$0
Total liabilities	$536,642	$1,499,245	$1,080,958
Accounts payable and accrued expenses	$250,932	$783,468	$113,684
Grants payable	$0	$0	$0
Deferred revenue	$0	$0	$0
Loans from officers, directors, trustees, and key employees	$0	$0	$0
Tax-exempt bond liabilities	$0	$0	$0
Mortgages and other notes payable	$0	$0	$0
Other liabilities	$285,710	$715,777	$967,274
Total liabilities and net assets/fund balances	$29,738,757	$31,439,978	$31,450,155
Total net assets or fund balances	$29,202,115	$29,940,733	$30,369,197

Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
	2005	2006	2007
Total revenue	$0	$0	$0
Total revenue, gains, and other support per audited financial statements	$0	$0	$0
Other expenses	$0	$0	$0
Net unrealized gains on investments	$0	$0	$0
Donated services and use of facilities	$0	$0	$0
Recoveries of prior year grants	$0	$0	$0
Other	$0	$0	$0
Other revenue	$0	$0	$0
Investment expenses	$0	$0	$0
Other	$0	$0	$0

Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
	2005	2006	2007
Total expenses	$0	$0	$0
Total expenses and losses per audited financial statements	$0	$0	$0
Other revenue	$0	$0	$0
Donated services and use of facilities	$0	$0	$0
Prior year adjustments	$0	$0	$0
Losses	$0	$0	$0
Other	$0	$0	$0
Other expenses	$0	$0	$0
Investment expenses	$0	$0	$0
Other	$0	$0	$0

Current Officers, Directors, Trustees, and Key Employees

Total number of officers, directors, and trustees permitted to vote on organization business at board meetings	3
Are any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, related to each other through family or business relationships?	No
Do any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, receive compensation from any other organizations, whether tax exempt or taxable, that are related to the organization?	Yes
Does the organization have a written conflict of interest policy?	No

Other Information
Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return, and has it filed a tax return on Form 990-T for this year?	Yes
Was there a liquidation, dissolution, termination, or substantial contraction during the year?	No
Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization?	Yes
Direct and indirect political expenditures	$0
Did the organization file Form 1120-POL for this year?	No
Were substantially all dues nondeductible by members?
Did the organization make only in-house lobbying expenditures of $2,000 or less?
Dues, assessments, and similar amounts from members	$0
Section 162(e) lobbying and political expenditures	$0
Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices	$0
Taxable amount of lobbying and political expenditures	$0
Does the organization elect to pay the section 6033(e) tax on the amount above?
If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount above to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year?
Initiation fees and capital contributions	$0
Gross receipts for public use of club facilities	$0
At any time during the year, did the organization, directly or indirectly, own a controlled entity within the meaning of section 512(b)(13)?	No
Amount of tax imposed on the organization during the year under: section 4911	$0
Amount of tax imposed on the organization during the year under: section 4912	$0
Amount of tax imposed on the organization during the year under: section 4955	$0
Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year?
Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958	$0
Amount of tax above, reimbursed by the organization	$0
At any time during the tax year, was the organization a party to a prohibited tax shelter transaction?	No
Did the organization acquire a direct or indirect interest in any applicable insurance contract?	No
Did the supporting organization, or a fund maintained by a sponsoring organization, have excess business holdings at any time during the year?	No
Number of employees employed in the pay period that includes March 12, 2006	0

Analysis of Income-Producing Activities (for 2007)
	Unrelated business income		Excluded by section 512, 513, or 514		Related or exempt function income
	Business code	Amount	Exclusion code	Amount
Total		$1,095,859		$0	$0
Program service revenue
Program service revenue 1	000000	$0	00	$0	$0
Program service revenue 2	000000	$0	00	$0	$0
Program service revenue 3	000000	$0	00	$0	$0
Program service revenue 4	000000	$0	00	$0	$0
Program service revenue 5	000000	$0	00	$0	$0
Medicare/Medicaid payments	000000	$0	00	$0	$0
Fees and contracts from government agencies	000000	$0	00	$0	$0
Membership dues and assessments	000000	$0	00	$0	$0
Interest on savings and temporary cash investments	Investment activities of section 501(c)(7), (9), or (17) organizations	$11,246	00	$0	$0
Dividends and interest from securities	Investment activities of section 501(c)(7), (9), or (17) organizations	$1,084,613	00	$0	$0
Net rental income or (loss) from real estate
debt-financed property	000000	$0	00	$0	$0
not debt-financed property	000000	$0	00	$0	$0
Net rental income or (loss) from personal property	000000	$0	00	$0	$0
Other investment income	000000	$0	00	$0	$0
Gain or (loss) from sales of assets other than inventory	000000	$0	00	$0	$0
Net income or (loss) from special events	000000	$0	00	$0	$0
Gross profit or (loss) from sales of inventory	000000	$0	00	$0	$0
Other revenue	000000	$0	00	$0	$0

Information Regarding Taxable Subsidiaries and Disregarded Entities (for 2007)
EIN of corporation, partnership, or disregarded entity	Percentage of ownership interest	Total income	End-of-year assets
	0%	$0	$0
	0%	$0	$0
	0%	$0	$0
	0%	$0	$0

Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (for 2007)
Compensation	Contributions to employee benefit plans & deferred compensation	Expense account and other allowances
$0	$0	$0
$0	$0	$0
$0	$0	$0
$0	$0	$0
$0	$0	$0

Total number of other employees paid over $50,000

0

Statements About Activities (for 2007)
Expenses paid or incurred in connection with the lobbying activities	$0
Did the organization receive or hold an easement for conservation purposes, including easements to preserve open space, the environment, historic land areas or historic structures?
Did the organization provide credit counseling, debt management, credit repair, or debt negotiation services?
Did the organization maintain any donor advised funds?
Did the organization make any taxable distributions under section 4966?
Did the organization make a distribution to a donor, donor advisor, or related person?
The total number of donor advised funds owned at the end of the tax year	$0
The aggregate value of assets held in all donor advised funds owned at the end of the tax year	$0
The total number of separate funds or accounts owned at the end of the tax year (excluding donor advised funds included above) where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts	$0
The aggregate value of assets held in all funds or accounts included above at the end of the tax year	$0

Reason for Non-Private Foundation Status
The organization is not a private foundation because it is

Support Schedule
	2004	2005	2006
Total	$0	$0	$0
Gifts, grants, and contributions received	$0	$0	$0
Membership fees received	$0	$0	$0
Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is related to the organization's charitable, etc., purpose	$0	$0	$0
Gross income from interest, dividends, amounts received from payments on securities loans (section 512(a)(5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organization after June 30, 1975	$0	$0	$0
Net income from unrelated business activities not included above	$0	$0	$0
Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf	$0	$0	$0
The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge	$0	$0	$0
Other income	$0	$0	$0

Lobbying Expenditures by Electing Public Charities (for 2007)
Total exempt purpose expenditures	$0
Total lobbying expenditures	$0
Total lobbying expenditures to influence public opinion (grassroots lobbying)	$0
Total lobbying expenditures to influence a legislative body (direct lobbying)	$0
Other exempt purpose expenditures	$0
Lobbying nontaxable amount	$0
Grassroots nontaxable amount	$0

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3	Southern Operators Health Fund, Brassell H Lynn Ttee	PO BOX 1449, Goodlettsvlle, TN 37070-1449	TN	2006-09	$15,264,585
4	San Bernardino County Retirement Medical Tr, Hoover Crystal Ttee	157 W 5th St First Fl, San Bernardino, CA 92415-0225	CA	2002-04	$13,312,822
5	Trinity Health Welfare Benefit Tr, Paul Swanson Ttee	20555 Victor Parkway, Livonia, MI 48152-7031	MI	2007-11	$8,409,345
6	Vng-Nonunion Management Retiree Veba	PO BOX 535007, Pittsburgh, PA 15253-5007	PA	2002-01	$5,196,035
7	Thunderbird Mining Co Retiree Health & Welfare Benefits Pl & Tr	250 Marquette Ave Ste 540, Minneapolis, MN 55401-2387	MN	2008-06	$3,413,882
8	Young Brothers Limited Veba For Bargaining Unit Employees	PO BOX 3288, Honolulu, HI 96801-3288	HI	2000-11	$2,680,037
9	Robbinsdale Area School Health Reimbursement Arrangement Basic Pl	230 Front St N, La Crosse, WI 54601-3219	WI	2004-12	$873,286
10	Hawaii Medical Service Association Retiree Health Benefits Tr	PO BOX 860, Honolulu, HI 96808-0860	HI	2006-02	$108,296
11	The Turner Corporation Veba Trust	375 Hudson St, New York, NY 10014-3658	NY	2008-01	$8,540
12	Ilwu Local 142 Health & Welfare Tr	1440 Kapiolani Blvd Ste 800, Honolulu, HI 96814-3613	HI	2009-03	$38,772,734
13	Ufcw-Hawaii Food Employers Health And Welfare Tr Fund, Loo Pat Et Al Ttee	200 N Vineyard Blvd Ste 100, Honolulu, HI 96817-3938	HI	2005-11	$21,524,256
14	Ilwu Local 142 General Health & Welfare Trust	1440 Kapiolani Blvd Ste 800, Honolulu, HI 96814-3613	HI	2010-01	$15,639,024
15	Hawaiian Airlines Inc Pilots Voluntary Employee Beneficiary	3375 Koapaka St Ste G-350, Honolulu, HI 96819-1804	HI	2007-11	$6,854,825
16	Safety Systems Hawaii Inc Holiday Vacation Fund	815 Waiakamilo Rd Ste C, Honolulu, HI 96817-4337	HI	2009-02	$98,984
17	Young Brother Limited Veba Non-Bargaining Unit Employees	PO BOX 3288, Honolulu, HI 96801-3288	HI	2000-11	$12,315
18	Aloha Airlines Inc Pilots Disability Plan	500 Ala Moana Blvd Bldg 2 Ste 50, Honolulu, HI 96813-4983	HI	2008-01	$0
19	Foodland Supermarket Ltd Retiree Medical Benefit Plan Tr	3536 Harding Ave, Honolulu, HI 96816-2453	HI	1999-06	$0
20	Iatse Local 665 Training Trust Fund	875 Waimanu Street Suite 610, Honolulu, HI 96814	HI	2009-05	$0

Number of organizations performing similar types of work
Alaska 7 Alabama 14 Arkansas 7 Arizona 17 California 174 Colorado 25 Connecticut 40 District of Columbia 24 Delaware 11 Florida 55 Georgia 33 Hawaii 17 Iowa 34 Idaho 5 Illinois 101 Indiana 134 Kansas 29 Kentucky 10 Louisiana 15 Massachusetts 50 Maryland 35 Maine 7 Michigan 82 Minnesota 68 Missouri 39 Mississippi 5	Montana 21 North Carolina 85 North Dakota 4 Nebraska 13 New Hampshire 11 New Jersey 54 New Mexico 7 Nevada 13 New York 198 Ohio 115 Oklahoma 20 Oregon 20 Pennsylvania 188 Rhode Island 11 South Carolina 12 South Dakota 5 Tennessee 30 Texas 107 Utah 16 Virginia 67 Vermont 1 Washington 37 Wisconsin 74 West Virginia 15 Wyoming 5 International 7
Total	2,174

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