2024-10-22T15:50:32-05:00 2023-12-31 320043599 LEGACY PROFESSIONALS LLP 222 INDIANAPOLIS BOULEVARD SCHERERVILLE IN 46375 990 2023-01-01 366599036 IRONWORKERS TRI-STATE WELFARE PLAN IRON 8473954467 20 N MARTINGALE ROAD 290 SCHAUMBURG IL 60173 DAN AUSSEM TRUSTEE 8473954467 2024-10-22 1 0 RENEE BERG-SPECK P00201492 3123680500 2024-10-22 2023 2024-10-15 13:58:12Z DAN AUSSEM 20 N MARTINGALE ROAD 290 SCHAUMBURG IL 60173 44679171 0 X WWW.TRISTATEWELFAREFUND.COM X 1957 IL PROVIDE HEALTH BENEFITS 12 6 23 0 0 0 0 0 28460396 25614009 -744476 2152226 0 511 27715920 27766746 0 0 28191885 27021626 0 0 0 0 0 1355178 1430258 29547063 28451884 -1831143 -685138 64508681 66195723 706642 547284 63802039 65648439 TO PROVIDE HEALTH BENEFITS 0 0 TO PROVIDE HEALTH & WELFARE BENEFITS, INCLUDING MEDICAL, DENTAL, VISION, DISABILITY, PRESCRIPTION DRUG AND DEATH BENEFIT COVERAGE FOR ELIGIBLE PARTICIPANTS AND THEIR BENEFICIARIES. 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 2 0 1 23 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 6 0 1 0 0 0 0 0 1 0 0 0 1 1 0 0 0 1 0 0 0 X GROUP ADMINISTRATORS LTD 8475191880 20 N MARTINGALE ROAD SUITE 290 SCHAUMBURG IL 60173 BRIAN ATKINS TRUSTEE - PAST 2.00 40.00 X 0 93271 35519 JASON EMERICK TRUSTEE 2.00 45.00 X 0 113358 91174 CHUCK BLACK TRUSTEE 2.00 40.00 X 0 99612 76002 PAUL ARAMBASICH TRUSTEE 2.00 50.00 X 0 117827 109364 KEVIN HRAY TRUSTEE 2.00 55.00 X 0 164764 136006 MARK RICHESON TRUSTEE 2.00 40.00 X 0 126478 104836 DANIEL AUSSEM TRUSTEE 2.00 X 0 0 0 CARLA JOCKSICH TRUSTEE 2.00 X 0 0 0 CODY GERDES TRUSTEE 2.00 X 0 0 0 PJ FOLEY TRUSTEE 2.00 X 0 0 0 MICHAEL TESTA TRUSTEE 2.00 X 0 0 0 DAVID ANSPAUGH TRUSTEE 2.00 X 0 0 0 MICHAEL OLVERA TRUSTEE - NEW 2.00 40.00 X 0 107198 33918 0 822508 586819 0 0 1 0 BLUE CROSS BLUE SHIELD 300 EAST RANDOLPH STREET CHICAGO IL 60601 CLAIMS PROCESSOR 649961 GROUP ADMINISTRATORS LTD 20 NORTH MARTINGALE ROAD SUITE 290 SCHAUMBURG IL 60173 THIRD PARTY ADMINISTRATOR 455496 THE SEGAL CO 101 NORTH WACKER DRIVE SUITE 500 CHICAGO IL 60606 FUND CONSULTANT 252611 MACNELL ACCOUNTING & CONSULTING 1153 SOUTH LEE STREET UNIT 137 DES PLAINES IL 60016 PAYROLL COMPLIANCE AUDITOR 179461 4 EMPLOYER CONTRIBUTIONS 900099 22848724 22848724 PRESCRIPTION DRUG REBATES 900099 1236709 1236709 STOP-LOSS INSURANCE REIMBURSEMENT 900099 646513 646513 PARTICIPANT CONTRIBUTIONS 900099 642402 642402 SUBROGATION INCOME 900099 127548 127548 112113 112113 25614009 2011191 2011191 17053460 16912425 141035 141035 141035 MISCELLANEOUS REVENUE 900099 511 511 511 27766746 25614009 0 2152737 27021626 87685 244461 171491 714720 12760 29974 31628 DISEASE MANAGEMENT 96245 UTILIZATION REVIEW 31400 FEES MANDATED BY THE AC 7409 DUES & SUBSCRIPTIONS 2485 28451884 885526 2636547 805121 3310279 3471315 38622 81932 41521119 52629112 17002114 8322717 64508681 66195723 641391 503118 65251 44166 706642 547284 X 0 0 0 0 63802039 65648439 63802039 65648439 64508681 66195723 -685138 2531538 0 X 0 1 X 1 0 0 AMERICAN STRATEGIC VALUE REALTY FUND 7097925 F INVESCO INSTITUTIONAL TRUST BALANCED RISK ALLOCATION FUND 1224792 F 8322717 X 30126793 2531538 2531538 27595255 171491 171491 27766746 28280393 0 28280393 171491 171491 28451884 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION 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 PERIOD IN PROGRESS. 0 0 0 KEVIN HRAY TRUSTEE 0 164764 0 0 0 0 0 103783 0 32223 0 300770 0 0 MARK RICHESON TRUSTEE 0 122510 0 0 0 3968 0 75536 0 29300 0 231314 0 0 PAUL ARAMBASICH TRUSTEE 0 117827 0 0 0 0 0 82511 0 26853 0 227191 0 0 JASON EMERICK TRUSTEE 0 113358 0 0 0 0 0 66907 0 24267 0 204532 0 0 CHUCK BLACK TRUSTEE 0 98832 0 0 0 780 0 51583 0 24419 0 175614 0 0 FORM 990, PART VI, SECTION A, LINE 3 ALTHOUGH THE TRUSTEES RETAIN THE ULTIMATE RESPONSIBILITY, THEY HAVE DELEGATED THE DAY TO DAY MANAGEMENT DUTIES TO GROUP ADMINISTRATORS LTD, AS THIRD PARTY ADMINISTRATOR OF THE FUND. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAS NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES PRIOR TO FILING. AFTER THE BOARD'S THOROUGH REVIEW, THE FORM IS APPROVED AND FILED. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE FUND OFFICE. FORM 990, PART V, LINE 2A: 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 INCLUDES PARTICIPANTS OF THE FUND THAT HAVE RECEIVED DISABILITY PAYMENTS DURING THE YEAR. 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