2024-11-15T14:52:18-06:00 2023-12-31 320043599 LEGACY PROFESSIONALS LLP 6800 FRANCE AVENUE SO SUITE 550 EDINA MN 55435 990 2023-01-01 416023462 MINNESOTA CEMENT MASONS HEALTH AND WELFARE FUND MINN 6512561900 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 CHAD MORRIS TRUSTEE 6512561900 2024-11-06 1 0 JACOB D EKLUND P01455813 9528413950 2023 2024-10-15 13:58:12Z CHAD MORRIS 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 19895119 0 X N/A X 1960 MN TO PROVIDE HEALTH BENEFITS 8 2 7 0 0 0 0 0 13566235 14426380 82354 631482 0 0 13648589 15057862 0 0 12857187 14774756 0 0 0 0 0 577965 652527 13435152 15427283 213437 -369421 22754532 23439653 94402 93060 22660130 23346593 TO PROVIDE HEALTH BENEFITS 0 0 TO PROVIDE HEALTH CARE, DENTAL, DEATH AND DISABILITY BENEFITS FOR ELIGIBLE MEMBERS AND THEIR DEPENDENTS OR BENEFICIARIES ON A SELF-INSURED BASIS. 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 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 7 1 0 0 0 0 0 0 0 0 0 0 X 8 2 0 1 0 0 0 1 0 1 0 0 0 1 1 1 1 0 0 0 0 0 X ZENITH AMERICAN SOLUTIONS 6512561900 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 DAVE SCHUTTA TRUSTEE - PAST 2.00 46.00 X 0 78473 52023 MIKE SYVERSRUD TRUSTEE - PAST 2.00 44.00 X 0 56121 37373 BRIAN GULLICKSON TRUSTEE 2.00 44.00 X 0 127953 74077 JARROD ASLESON TRUSTEE 2.00 2.00 X 0 7156 2348 CHAD MORRIS TRUSTEE 2.00 46.00 X 0 128045 75237 BRIAN FARMER TRUSTEE 2.00 0.50 X 0 239 0 TIM WORKE TRUSTEE 2.00 X 0 0 0 STEVE BULACH TRUSTEE 2.00 X 0 0 0 SUBEN KANAGARATNAM TRUSTEE - PAST 2.00 X 0 0 0 ERIC KELENY TRUSTEE 2.00 X 0 0 0 SAM LIBKE ALTERNATE TRUSTEE 2.00 X 0 0 0 MARTHA HENRICKSON TRUSTEE 2.00 X 0 0 0 0 397987 241058 0 0 1 0 HEALTHPARTNERS 8170 - 33RD AVENUE SO BLOOMINGTON MN 55425 CLAIMS ADMINISTRATION 665438 ZENITH AMERICAN SOLUTIONS 2520 PILOT KNOB ROAD SUITE 325 MENDOTA HTS MN 55120 THIRD PARTY ADMINISTRATOR 335928 CEMENT MASONS SERVICE CORPORATION 2520 PILOT KNOB ROAD SUITE 325 MENDOTA HTS MN 55120 COLLECT AND DISTRIBUTE CONTRIBUTIONS 194131 3 EMPLOYER CONTRIBUTIONS 900099 11753165 11753165 HRA EMPLOYER CONTRIBUTIONS 900099 1311454 1311454 PRESCRIPTION DRUG REBATES 900099 603788 603788 SUBROGATION SETTLEMENT 900099 516483 516483 PARTICIPANT CONTRIBUTIONS 900099 226772 226772 14718 14718 14426380 551496 551496 4917243 4837257 79986 79986 79986 15057862 14426380 0 631482 14774756 394120 83314 19200 51463 58970 15872 10005 11022 FEES MANDATED BY ACA 6561 DUES AND SUBSCRIPTIONS 2000 15427283 3084595 2363111 4891395 4660527 881872 1090907 10739 126745 13885931 15198363 22754532 23439653 94402 93060 94402 93060 X 0 0 0 0 22660130 23346593 22660130 23346593 22754532 23439653 -369421 1055884 0 X 0 1 X 1 0 0 X 16062283 1055884 1055884 15006399 51463 51463 15057862 15375820 0 15375820 51463 51463 15427283 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. 0 0 0 CHAD MORRIS TRUSTEE 0 128045 0 0 0 0 0 53108 0 22129 0 203282 0 0 BRIAN GULLICKSON TRUSTEE 0 127953 0 0 0 0 0 52299 0 21778 0 202030 0 0 FORM 990, PART VI, SECTION A, LINE 3 ALTHOUGH THE BOARD OF TRUSTEES RETAINS ULTIMATE RESPONSIBILITY, THE TRUSTEES HAVE DELEGATED THE DAY TO DAY ADMINISTRATIVE DUTIES TO ZENITH AMERICAN SOLUTIONS AS THE THIRD PARTY ADMINISTRATOR OF THE PLAN. FORM 990, PART VI, SECTION A, LINE 7A THE PLAN IS GOVERNED BY EIGHT TRUSTEES, FOUR OF WHOM ARE APPOINTED BY THE RELATED LOCAL UNION, TWO OF WHOM ARE APPOINTED BY MINNESOTA CONCRETE AND MASONRY CONTRACTORS ASSOCIATION AND TWO OF WHOM ARE APPOINTED BY ASSOCIATED GENERAL CONTRACTORS OF MINNESOTA. THE LOCAL UNION AND THE TWO ORGANIZATIONS MAY EACH DESIGNATE AN ALTERNATE TRUSTEE. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH 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 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE TRUSTEES EVALUATE ANY POSSIBLE CONFLICTS OF INTEREST ANNUALLY WITH THE PLAN'S ATTORNEY. IN ADDITION, TO ENSURE THE PLAN OPERATES IN A MANNER CONSISTENT WITH NONPROFIT PURPOSES AND DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS LAWFUL STATUS AND FIDUCIARY OBLIGATIONS, PERIODIC REVIEWS OF COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ARE CONDUCTED. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO PARTICIPANTS UPON REQUEST AT THE OFFICE OF THE PLAN'S THIRD-PARTY ADMINISTRATOR IN MENDOTA HEIGHTS, MN. CEMENT MASONS LOCAL 633 CONTRIBUTING EMPLOYER 0 CITY OF MINNEAPOLIS CONTRIBUTING EMPLOYER 0 CITY OF ST PAUL CONTRIBUTING EMPLOYER 0 MN CEMENT PLAST SHOPHANDS CONTRIBUTING EMPLOYER 0 ST PAUL PUBLIC SCHOOLS CONTRIBUTING EMPLOYER 0 UNIVERSITY OF MINNESOTA CONTRIBUTING EMPLOYER 0 CEMENT MASONS & PLAST LOCAL 518 CONTRIBUTING EMPLOYER 0 CEMENT MASONS LOCAL 526 CONTRIBUTING EMPLOYER 0 ISC P & CM H&W FUND CONTRIBUTING EMPLOYER 0 AP MIDWEST LLC CONTRIBUTING EMPLOYER 0 0 AVM CONSTRUCTION LLC CONTRIBUTING EMPLOYER 0 0 B & D ASSOCIATES LLC CONTRIBUTING EMPLOYER 0 0 CANNON VALLEY CONCRETE LLC CONTRIBUTING EMPLOYER 0 0 CMS LLC CONTRIBUTING EMPLOYER 0 0 CONCRETE UNLIMITED LLC CONTRIBUTING EMPLOYER 0 0 CONCRETE WORX LLC CONTRIBUTING EMPLOYER 0 0 CREATE CONSTRUCTION LLC CONTRIBUTING EMPLOYER 0 0 DIRTWORX LLC CONTRIBUTING EMPLOYER 0 0 ICON LLC CONTRIBUTING EMPLOYER 0 0 JEWELL SCANNING AND CORING LLC CONTRIBUTING EMPLOYER 0 0 KRAEMER NORTH AMERICA LLC CONTRIBUTING EMPLOYER 0 0 M A MORTENSON COMPANY CONTRIBUTING EMPLOYER 0 0 MCGOUGH CONSTRUCTION CO CONTRIBUTING EMPLOYER 0 0 NEWTRON LLC CONTRIBUTING EMPLOYER 0 0 NORTHLAND CONSTRUCTORS LLC CONTRIBUTING EMPLOYER 0 0 PCI ROADS LLC CONTRIBUTING EMPLOYER 0 0 REDSTONE CONSTRUCTION LLC CONTRIBUTING EMPLOYER 0 0 SS CONCRETE AND MASONRY LLP CONTRIBUTING EMPLOYER 0 0 TERRENE DEVELOPMENT LLC CONTRIBUTING EMPLOYER 0 0 THE CONCRETE COMPANY LLC CONTRIBUTING EMPLOYER 0 0 ULTRA CONCRETE LLC CONTRIBUTING EMPLOYER 0 0 WEITZ INDUSTRIAL LLC CONTRIBUTING EMPLOYER 0 0 WREN WORK LLC CONTRIBUTING EMPLOYER 0 0 ACOUSTICS ASSOCIATES INC CONTRIBUTING EMPLOYER 0 ALL PHASE CONTRACTING INC CONTRIBUTING EMPLOYER 0 ALVIN E BENIKE INC CONTRIBUTING EMPLOYER 0 AMES CONSTRUCTION INC CONTRIBUTING EMPLOYER 0 ARNIE MACKEY CONST INC CONTRIBUTING EMPLOYER 0 AXEL H OHMAN INC CONTRIBUTING EMPLOYER 0 B & H CONCRETE LANDSCAPING CONTRIBUTING EMPLOYER 0 BITUMINOUS ROADWAYS INC CONTRIBUTING EMPLOYER 0 BOUGALIS INC CONTRIBUTING EMPLOYER 0 BRUCE'S CONTRACTING INC CONTRIBUTING 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EMPLOYER 0 RADOTICH INC CONTRIBUTING EMPLOYER 0 RAM CONSTRUCTION SER OF MI INC CONTRIBUTING EMPLOYER 0 RESTORATION & CONSTRUCTION CONTRIBUTING EMPLOYER 0 REYSOL CONSTRUCTION CONTRIBUTING EMPLOYER 0 RICE LAKE CONTRACTING CORP CONTRIBUTING EMPLOYER 0 RIIHILUOMA RAY INC CONTRIBUTING EMPLOYER 0 RON KASSA CONSTRUCTION INC CONTRIBUTING EMPLOYER 0 ROSTI CONSTRUCTION CONTRIBUTING EMPLOYER 0 RYAN CONTRACTING INC CONTRIBUTING EMPLOYER 0 S M HENTGES & SONS INC CONTRIBUTING EMPLOYER 0 SCHMIDT CURB COMPANY INC CONTRIBUTING EMPLOYER 0 SHAFER CONTRACTING COMPANY INC CONTRIBUTING EMPLOYER 0 SHANK CONSTRUCTORS INC CONTRIBUTING EMPLOYER 0 SHAW LUNDQUIST ASSOCIATES INC CONTRIBUTING EMPLOYER 0 SHEEHY CONSTRUCTION COMPANY CONTRIBUTING EMPLOYER 0 SIG OLSON & SONS PLASTERING CONTRIBUTING EMPLOYER 0 SNELSON COMPANIES INC CONTRIBUTING EMPLOYER 0 STANDARD SIDEWALK INC CONTRIBUTING EMPLOYER 0 STAPF CONCRETE CONST INC CONTRIBUTING EMPLOYER 0 STARTING LINE FLOOR COATINGS CONTRIBUTING EMPLOYER 0 STEENBERG-WATRUD CONST INC CONTRIBUTING EMPLOYER 0 STONE CONSTRUCTION INC CONTRIBUTING EMPLOYER 0 SUMMIT CONCRETE & MASONRY CONS CONTRIBUTING EMPLOYER 0 SURFACE PROS LLC CONTRIBUTING EMPLOYER 0 SWANSON & YOUNGDALE INC CONTRIBUTING EMPLOYER 0 T CHRISTIAN CONSTRUCTION CONTRIBUTING EMPLOYER 0 T R CONCRETE INC CONTRIBUTING EMPLOYER 0 TAG CONSTRUCTION INC CONTRIBUTING EMPLOYER 0 THE BOLDT COMPANY CONTRIBUTING EMPLOYER 0 THE JAMAR COMPANY CONTRIBUTING EMPLOYER 0 THOMAS & SONS CONST INC CONTRIBUTING EMPLOYER 0 TI-ZACK CONCRETE INC CONTRIBUTING EMPLOYER 0 TOTAL CONSTRUCTION & EQUIPMENT CONTRIBUTING EMPLOYER 0 TWIN CITIES SPECIALTIES CONTRIBUTING EMPLOYER 0 WASCHE COMMERCIAL FINISHES INC CONTRIBUTING EMPLOYER 0 WENDT MASONRY INC CONTRIBUTING EMPLOYER 0 WESTERN SPECIALTY CONTRACTORS CONTRIBUTING EMPLOYER 0 XCEL ENERGYNSP CONTRIBUTING EMPLOYER 0 3-D CONCRETE & CONSTRUCTION CONTRIBUTING EMPLOYER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1