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ObjectId: 202011129349300836 - Submission: 2020-04-21
TIN: 95-2500201
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Attach to Form 990.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
18
Open to Public Inspection
Name of the organization
WESTERN GROWERS ASSURANCE TRUST FUND
Employer identification number
95-2500201
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
First-class or charter travel
Housing allowance or residence for personal use
Travel for companions
Payments for business use of personal residence
Tax idemnification and gross-up payments
Health or social club dues or initiation fees
Discretionary spending account
Personal services (e.g., maid, chauffeur, chef)
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain
.........
1b
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a?
..
2
Yes
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
Compensation committee
Written employment contract
Independent compensation consultant
Compensation survey or study
Form 990 of other organizations
Approval by the board or compensation committee
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment?
.............
4a
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan?
.........
4b
No
c
Participate in, or receive payment from, an equity-based compensation arrangement?
.........
4c
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization?
....................
5a
b
Any related organization?
.......................
5b
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization?
..................
6a
b
Any related organization?
......................
6b
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III
............
7
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III
..........................
8
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)?
.........................
9
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2018
Page 2
Schedule J (Form 990) 2018
Page
2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees.
Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note.
The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A)
Name and Title
(B)
Breakdown of W-2 and/or 1099-MISC compensation
(C)
Retirement and other deferred compensation
(D)
Nontaxable
benefits
(E)
Total of columns
(B)(i)-(D)
(F)
Compensation in column (B) reported as deferred on prior Form 990
(i)
Base
compensation
(ii)
Bonus & incentive
compensation
(iii)
Other
reportable compensation
1
THOMAS A NASSIF
PRESIDENT/CEO
(i)
(ii)
704,701
-------------
96,096
278,159
-------------
37,931
61,673
-------------
8,410
24,200
-------------
3,300
10,634
-------------
1,450
1,079,367
-------------
147,187
0
-------------
0
2
DAVID ZANZE
EXECUTIVE VP
(i)
(ii)
221,407
-------------
147,604
43,084
-------------
28,723
1,406
-------------
937
16,500
-------------
11,000
4,568
-------------
3,046
286,965
-------------
191,310
0
-------------
0
3
WARD KENNEDY
SENIOR VICE PRESIDENT/CFO
(i)
(ii)
240,980
-------------
26,776
35,198
-------------
3,911
5,400
-------------
600
24,750
-------------
2,750
17,132
-------------
1,904
323,460
-------------
35,941
0
-------------
0
4
LESSLIE D WILLIAMS
VP - INSURANCE OPERATIONS
(i)
(ii)
133,106
-------------
57,046
10,954
-------------
4,695
0
-------------
0
14,406
-------------
6,174
9,578
-------------
4,105
168,044
-------------
72,020
0
-------------
0
5
JONATHAN ALEXANDER
GENERAL LEGAL COUNSEL
(i)
(ii)
237,270
-------------
0
22,122
-------------
0
0
-------------
0
25,939
-------------
0
19,036
-------------
0
304,367
-------------
0
0
-------------
0
6
ROBERT TWIDWELL
ASST. VP ADMINISTRATION
(i)
(ii)
106,500
-------------
87,137
6,059
-------------
4,958
0
-------------
0
11,256
-------------
9,209
4,188
-------------
3,426
128,003
-------------
104,730
0
-------------
0
7
LAWRENCE LABRIOLA
VP UNDERWRITING
(i)
(ii)
181,501
-------------
0
10,746
-------------
0
0
-------------
0
19,225
-------------
0
13,683
-------------
0
225,155
-------------
0
0
-------------
0
8
CANDIS KLIEWER THRU 32119
DIRECTOR OF MANAGED CARE
(i)
(ii)
157,875
-------------
0
0
-------------
0
0
-------------
0
15,787
-------------
0
19,036
-------------
0
192,698
-------------
0
0
-------------
0
9
KATHY NGUYN
DIRECTOR - BUS. PROCESSES & SYSTEM D
(i)
(ii)
135,849
-------------
0
0
-------------
0
0
-------------
0
13,585
-------------
0
19,036
-------------
0
168,470
-------------
0
0
-------------
0
Schedule J (Form 990) 2018
Page 3
Schedule J (Form 990) 2018
Page
3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference
Explanation
SCHEDULE J, PART I, LINE 1A:
FIRST CLASS OR CHARTER TRAVEL THE CEO IS PERMITTED TO FLY FIRST CLASS ON LONGER BUSINESS TRIPS AND CHARTER AIRPLANE TRAVEL WHEN CIRCUMSTANCES DICTATE, USUALLY FOR TRAVEL INTO RURAL AREAS OF CALIFORNIA AND ARIZONA. THIS IS NOT TREATED AS TAXABLE COMPENSATION. HEALTH AND SOCIAL CLUB DUES CERTAIN EMPLOYEES HAVE ACCESS TO SOCIAL CLUB MEMBERSHIPS FOR THE BUSINESS PURPOSE OF CULTIVATING MEMBER/TRUSTEE AND OTHER BUSINESS RELATIONSHIPS, THROUGH DINING AND BEVERAGE ONLY (NO ENTERTAINMENT COMPONENT NOR PERSONAL USE). FOR THIS FISCAL YEAR, SOCIAL CLUB DUES OF $7,475 WERE PAID TO SOCIAL CLUBS WHERE THE CEO WAS A MEMBER. THIS WAS DETERMINED TO BE NONTAXABLE BENEFITS SINCE IT HAD A BONA FIDE BUSINESS PURPOSE. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE PRESIDENT IS PROVIDED A SECONDARY RESIDENCE FOR HIS PERSONAL USE WHILE WORKING AT THE COMPANY HEADQUARTERS IN IRVINE, CALIFORNIA. THE FAIR MARKET VALUE OF THIS BENEFIT IS REPORTED AS TAXABLE COMPENSATION ON HIS W-2. TAX INDEMNIFICATION AND GROSS UP PAYMENTS THE PRESIDENT RECEIVED GROSS UP PAYMENTS ON HOUSING BENEFIT AND LIFE INSURANCE POLICY. THE VALUE IS INCLUDED IN W2 AS TAXABLE COMPENSATION.
SCHEDULE J, PART I, LINE 4:
RELATED ORGANIZATION COMPENSATION PRACTICES FOR CEO COMPENSATION FOR THE CEO IS DETERMINED BY A RELATED ORGANIZATION USING THE FOLLOWING METHODS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
Schedule J (Form 990) 2018
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