2024-03-15T13:48:32-04:00 2023-04-30 382284921 BENDA GRACE STULZ & COMPANY PC 38800 VAN DYKE AVE STE 100 STERLING HEIGHTS MI 48312 990 2022-05-01 382073681 BAC OF MICHIGAN HEALTH AND WELFARE FUND DETR 2488286000 700 TOWER DRIVE SUITE 215 TROY MI 48098 PAUL DUNFORD CHAIRMAN 2488286000 2024-01-31 true PAUL DUNFORD 999009999 false BRYAN STULZ P00265596 5868836240 2024-03-15 2022 2023-04-26 12:10:37Z PAUL DUNFORD 28713461 false X X 1974 MI THE FUND IS CREATED, ESTABLISHED, AND MAINTAINED FOR THE PURPOSE OF PROVIDING ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS AND/OR BENEFICIATIES WITH MEDICAL, SURGICAL, AND HOSPITAL CARE; BENEFITS IN THE EVENT OF SICKNESS, ACCIDENT, DISABILITY, DEATH, OR UNEMPLOYMENT; AND DENTAL, OPTICAL, AND PRESCRIPTION DRUG CARE; AND FOR THE PURPOSE OF DEFRAYING REASONABLE COSTS OF ADMINISTRATION. 16 5 8 0 0 15942560 24832755 128093 481573 353519 153645 16424172 25467973 0 12891956 20447888 478333 480060 0 0 1190578 1830465 14560867 22758413 1863305 2709560 17164198 20947453 6815622 7869849 10348576 13077604 X THE FUND IS CREATED, ESTABLISHED, AND MAINTAINED FOR THE PURPOSE OF PROVIDING ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS AND/OR BENEFICIATIES WITH MEDICAL, SURGICAL, AND HOSPITAL CARE; BENEFITS IN THE EVENT OF SICKNESS, ACCIDENT, DISABILITY, DEATH, OR UNEMPLOYMENT; AND DENTAL, OPTICAL, AND PRESCRIPTION DRUG CARE; AND FOR THE PURPOSE OF DEFRAYING REASONABLE COSTS OF ADMINISTRATION. false false THE FUND PROVIDES FOR HEALTH, MEDICAL, DENTAL, AND VISION BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. false false false false false false false false false true false false false true false true false false false false false false false false false false false false true false false false false false false false false false false false true false false true 8 0 8 true false false false false false false false false X 16 5 true false false false false true false true true false false false false false false false false false X BAC OF MICHIGAN HEALTH AND WELFARE FUND 2488286000 700 TOWER DRIVE SUITE 215 TROY MI 48098 X PAUL DUNFORD CHAIRMAN 1.00 40.00 X 0 128070 57210 BRETT GIERAK TRUSTEE 1.00 40.00 X 0 112401 50853 JAMERS BRYLOWSKI TRUSTEE 1.00 40.00 X 0 101620 49716 JIM BUDD TRUSTEE 1.00 40.00 X 0 97613 47528 GREG LOBODZINSKI TRUSTEE 1.00 40.00 X 0 97613 47528 DARYL NICHOLS TRUSTEE 1.00 40.00 X 0 97613 47528 SHAUN GAJEWSKI TRUSTEE 1.00 40.00 X 0 97924 46615 AARON PISTOR TRUSTEE 1.00 40.00 X 0 97924 46615 RAUL ZAMARRON FORMER TRUST 1.00 40.00 X 0 97606 33425 TOM BINKOWSKI SECRETARY 1.00 40.00 X 0 0 0 ANDY BRACY TRUSTEE 1.00 40.00 X 0 0 0 MARINO CENSONI TRUSTEE 1.00 40.00 X 0 0 0 MATT HARMON TRUSTEE 1.00 40.00 X 0 0 0 ROBERT MICHIELUTTI JR TRUSTEE 1.00 40.00 X 0 0 0 STEVE MEYER TRUSTEE 1.00 40.00 X 0 0 0 JAMES OLEKSINSKI TRUSTEE 1.00 40.00 X 0 0 0 ED SPENCE TRUSTEE 1.00 40.00 X 0 0 0 928384 427018 false true false BLUE CROSS BLUE SHIELD OF MICHIGAN 600 LAFAYETTE EAST DETROIT MI 48226 BENEFIT ADMIN 896703 BENESYS INC 700 TOWER DRIVE STE 300 TROY MI 48098 TPA 300110 NOVARA TESIJA PLLC 888 W BIG BEAVER RD STE 600 TROY MI 48084 LEGAL 172179 3 EMPLOYER CONTRIBUTIONS 230000 22880440 22880440 PARTICIPANT SELF-PAYMENTS 230000 1952315 1952315 24832755 481573 481573 3245488 3245488 OTHER 900099 153645 153645 153645 25467973 24986400 481573 20447888 404138 44075 31847 912581 204173 71870 15886 315123 159315 77661 41043 6964 23921 DUES AND SUBSCRIPTIONS 1860 HIPAA COSTS 68 22758413 0 0 0 4203128 2867697 201986 710289 2927020 2577249 114860 97071 56758 56758 9717204 14695147 17164198 20947453 387622 801849 6428000 7068000 6815622 7869849 X 10348576 13077604 10348576 13077604 17164198 20947453 2709560 19468 X false true X true false 56758 56758 ACCUMULATED ELIGIBILITY CREDITS 6153000 CLAIMS INCURRED BUT NOT REPORTED 915000 7068000 25471555 19468 19468 25452087 15886 15886 25467973 22742527 22742527 15886 15886 22758413 false false false PAUL DUNFORD CHAIRMAN 128070 57210 185280 BRETT GIERAK TRUSTEE 112401 50853 163254 JAMERS BRYLOWSKI TRUSTEE 101620 49716 151336 FORM 990 - ORGANIZATION'S MISSION THE FUND IS CREATED, ESTABLISHED, AND MAINTAINED FOR THE PURPOSE OF PROVIDING ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS AND/OR BENEFICIATIES WITH MEDICAL, SURGICAL, AND HOSPITAL CARE; BENEFITS IN THE EVENT OF SICKNESS, ACCIDENT, DISABILITY, DEATH, OR UNEMPLOYMENT; AND DENTAL, OPTICAL, AND PRESCRIPTION DRUG CARE; AND FOR THE PURPOSE OF DEFRAYING REASONABLE COSTS OF ADMINISTRATION. FORM 990, PART VI LINE 2 - FAMILY RELATIONSHIP OR BUSINESS RELATIONSHIP - THE RELATIONSHIP BETWEEN THE TRUSTEES OF THE FUNDS IS A 'BUSINESS RELATIONSHIP'. THE FUND IS ESTABLISHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED. THE FUNDS, AS A TAFT-HARTLEY FUND, IS ADMINISTERED BY A BOARD OF TRUSTEES WHICH IS COMPOSED OF AN EQUAL NUMBER OF UNION AND EMPLOYER REPRESENTATIVES. BECAUSE OF THIS ORGANIZATIONAL REQUIREMENT, THERE IS A BUSINESS RELATIONSHIP BETWEEN THE TRUSTEES. FORM 990, PAGE 6, PART VI, LINE 7A THE FUND IS A TAFT-HARTLEY FUND AND IS ADMINISTERED BY THE BOARD OF 16 TRUSTEES. THE EMPLOYER ASSOCIATIONS AND THE LOCAL UNIONS, WHO ARE THE SETTLORS OF THE FUND, APPOINT EIGHT TRUSTEES EACH. FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS PRESENTED AND APPROVED AT A MEETING OF THE BOARD OF TRUSTEES, SUBJECT TO APPROVAL BY AND REVIEW OF THE FUND'S LEGAL COUNSEL. FORM 990, PAGE 6, PART VI, LINE 19 THE FUND IS ESTABLISHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT SECURITY ACT OF 1974, AS AMENDED. IT OPERATES IN COMPLIANCE WITH THE REPORTING AND DISCLOSURE REQUIREMENTS OF SUBTITLE B, PART 1 ERISA WITH RESPECT TO DISCLOSURE OF ITS GOVERNING DOCUMENTS AND FINANCIAL INFORMATION. IT OPERATES IN COMPLIANCE WITH FIDUCIARY RESPONSIBILITY REQUIREMENTS OF SUBTITLE B, PART 4 OF ERISA. THE FUND DOES NOT HAVE A CONFLICTS OF INTEREST POLICY. FORM 990, PART VII LINE 1A - THE TRUSTEES OF THE FUND SERVE WITHOUT COMPENSATION FROM THE FUND FOR THEIR SERVICES. HOWEVER, SOME OF THE TRUSTEES WERE COMPENSATED AS EMPLOYEES OF CONTRIBUTING EMPLOYERS TO THE FUND, WHICH ARE CONSIDERED RELATED ORGANIZAITONS TO THE FUND FOR PURPOSE OF FORM 990. 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