2024-11-11T08:21:19-06:00 2023-12-31 363168081 SIKICH LLC 17335 GOLF PARKWAY SUITE 500 BROOKFIELD WI 53045 990 2023-01-01 391932533 PLUMBERS AND STEAMFITTERS LOCAL 400 AND MCA N CENTRAL WI HEALTH & WELFARE TRUST PLUM 9204620400 2700 NORTHRIDGE DRIVE PO BOX 530 KAUKAUNA WI 541300530 DOUG DOKEY CHAIRMAN 9204620400 2024-11-09 1 0 BRIDGETTE MUGGE P00671418 2627549400 2024-11-09 2023 2024-10-15 13:58:12Z DOUG DOKEY 2700 NORTHRIDGE DRIVE PO BOX 530 KAUKAUNA WI 541300530 44444094 0 X WWW.UA400.ORG X 1998 WI PROVIDE BENEFITS TO MEMBERS OF LOCAL 400 10 7 125 9 0 0 0 0 31548510 34239494 4204272 2975343 56145 56651 35808927 37271488 0 0 27553065 31262181 122085 118127 0 0 0 4767653 4507754 32442803 35888062 3366124 1383426 68280352 72717295 632246 594551 67648106 72122744 PROVIDE BENEFITS TO MEMBERS OF LOCAL 400 0 0 PLUMBERS AND STEAMFITTERS LOCAL 400 HEALTH AND WELFARE PLAN PROVIDES MEDICAL, DENTAL, PRESCRIPTION DRUG, VISION AND OTHER BENEFITS TO APPROXIMATELY 2,100 PLAN PARTICIPANTS, THEIR DEPENDENTS AND BENEFICIARIES. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 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 69 0 125 1 0 0 0 0 0 0 0 0 X 10 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X BENEFIT PLAN ADMINISTRATORS 4145773700 11270 WEST PARK PLACE SUITE 950 MILWAUKEE WI 53224 DOUG DOKEY CHAIRMAN 1.00 45.00 X X 0 158280 85323 DUSTIN DELSMAN LABOR TRUSTEE 1.00 5.00 X 0 146330 85078 MIKE AUGUSTIAN LABOR TRUSTEE 1.00 45.00 X 0 147785 81783 JEFF GAECKE SECRETARY-TREASURER 1.00 X X 0 0 0 KIM BASSETT MANAGEMENT TRUSTEE 1.00 X 0 0 0 DAVID ALDAG MANAGEMENT TRUSTEE 1.00 X X 0 0 0 JODI MILLER-LARSON MANAGEMENT TRUSTEE 1.00 X 0 0 0 MARIA BLOCHOWIAK ALTERNATE MANAGEMENT TRUST 1.00 X 0 0 0 JOHN KENNEDY LABOR TRUSTEE 1.00 X 0 0 0 TERRY VAN EPERN ALTERNATE LABOR TRUSTEE 1.00 X 0 0 0 DAVID KLUMPP LABOR TRUSTEE 1.00 X 0 6850 0 SCOTT WENGER ALTERNATE LABOR TRUSTEE 1.00 X 0 0 0 0 459245 252184 0 0 1 0 BENEFIT PLAN ADMINISTRATION 11270 W PARK PLACE SUITE 950 MILWAUKEE WI 53224 ADMINISTRATIVE SERVICES 1203758 UNITED HEALTHCARE INSURANCE COMPANY 9700 HEALTH CARE LANE MINNETONKA MN 55343 PPO NETWORK PROVIDER 879057 UNITED MEDICAL RESOURCES 11 SCOTT ST WAUSAU WI 54403 INSURANCE 200684 PREVEA HEALTH OCCUPATIONAL HEALTH PO BOX 12734 GREEN BAY WI 543072734 MEDICAL 192149 REINHART BOERNER VAN DEUREN SC PO BOX 2965 MILWAUKEE WI 53201 LEGAL 179009 5 EMPLOYER CONTRIBUTIONS 900099 32304467 32304467 PARTICIPANT CONTRIBUTIONS 900099 1935027 1935027 34239494 2191412 2191412 7956537 7172606 783931 783931 783931 OTHER REIMBURSEMENTS 900099 56651 56651 56651 37271488 34239494 0 3031994 31262181 118127 951088 116614 46034 113242 40986 47627 11820 121113 MEDICARE PREMIUMS 1136283 PPO ADMIN FEES 979816 COST CONTAINMENT 310440 CLINIC COSTS 192149 440542 35888062 1308995 2515223 400619 807409 4155730 4125106 129100 108194 62285908 65161363 68280352 72717295 492976 437244 139270 157307 632246 594551 X 0 0 0 0 67648106 72122744 67648106 72122744 68280352 72717295 1383426 3091212 0 X 0 1 X 1 0 0 DUE TO OTHER PLANS 71589 PREPAID RETIREE PREMIUMS 85718 157307 X 40316666 3091212 3091212 37225454 46034 46034 37271488 35842028 0 35842028 46034 46034 35888062 PART X, LINE 2: THE TRUST ESTABLISHED TO HOLD THE PLAN'S ASSETS IS QUALIFIED PURSUANT TO SECTION 501(C)(9) OF THE IRC AND IS THEREFORE NOT SUBJECT TO TAX UNDER PRESENT INCOME TAX LAWS. THE PLAN HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER DATED APRIL 25, 2000 FROM THE INTERNAL REVENUE SERVICE ("IRS"), AND THE TRUSTEES BELIEVE THAT THE PLAN, AS AMENDED, CONTINUES TO QUALIFY AND TO OPERATE AS DESIGNED. U.S. GAAP REQUIRES PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. 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 DOUG DOKEY CHAIRMAN 0 158280 0 0 0 0 0 58398 0 26925 0 243603 0 0 DUSTIN DELSMAN LABOR TRUSTEE 0 146330 0 0 0 0 0 59968 0 25110 0 231408 0 0 MIKE AUGUSTIAN LABOR TRUSTEE 0 147785 0 0 0 0 0 56673 0 25110 0 229568 0 0 FORM 990, SCHEDULE J, PART I, LINE 3 THE RELATED ORGANIZATION PLUMBERS AND STEAMFITTERS LOCAL 400 USES A WRITTEN EMPLOYMENT CONTRACT TO ESTABLISH THE OFFICER COMPENSATION. FORM 990, PART VI, SECTION A, LINE 6 THERE ARE APPROXIMATELY 2,000 MEMBERS OF LOCAL 400 THAT PARTICIPATE IN THE HEALTH AND WELFARE FUND. EACH MEMBER IS ALLOWED ONE VOTE. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF LOCAL 400 THAT PARTICIPATE IN THE HEALTH AND WELFARE FUND ELECT THE BOARD OF TRUSTEES FOR THE FUND. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE BOARD OF TRUSTEES ARE VOTED ON BY THE MEMBERS OF LOCAL 400 THAT PARTICIPATE IN THE HEALTH AND WELFARE FUND. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO THE RETURN BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THE OFFICERS AND DIRECTORS ARE REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST IMMEDIATELY UPON DISCOVERY. EACH PERSON HAS SIGNED AN AGREEMENT STATING THAT HE OR SHE WILL ACT IN ACCORDANCE WITH THE TRUST AGREEMENT. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTATION IS AVAILABLE UPON REQUEST. BOARD OF TRUSTEES OF THE PLUMBERS AND STEAMFITTERS LOCAL 400 HEALTH FUND 2700 NORTHRIDGE DRIVE PO BOX 530 KAUKAUNA WI 541300530 391932533 SPONSORING ORGANIZATION (JOINT BOARD OF TRUSTEES) WI 501(C)(9) 0 FOX RIVER VALLEY PIPE TRADES ED FOUNDATION ILLINOIS PIPE TRADES MADISON AREA CONSTRUCTION PLUMBERS AND STEAMFITTERS LOCAL 400 OF THE UNITED ASSOCIATION 2700 NORTHRIDGE DRIVE KAUKAUNA WI 54130 391915458 0 TEXAS PIPE TRADES WISCONSIN PIPE TRADES ASSOCIATION MEYER MECHANICAL LLC A & J MECHANICAL CONTRACTORS INC ACCESS CUSTOMER SUPPORT INC AG MECHANICAL ALDAG HONOLD MECHANICAL INC AUGUST WINTER & SONS INC AZCO INC B & P MECHANICAL INC BASSETT INC BENO PLUMBING & HEATING INC CH KOCH PLUMBING CLIMATE PROS INC COENEN MECHANICAL DAN FINNEL PLUMBING LLC EDWIN C GAROT COMPANY INC ENERGY CONTROL & DESIGN INC ENERPIPE INC FENNER PLUMBING & HEATING FORREST PLUMBING LLC GREAT LAKES MECHANICAL INC GROESCHEL COMPANY INC GRP MECHANICAL INC HAUCKE PLUMBING AND HEATING INC HEIM PLUMBING INC HOOPER CORPORATION HURCKMAN MECHANICAL INDUSTRIES INC ILLINGWORTH-KILGUST MECHANICAL INC JF AHERN COMPANY JAMAR COMPANY JOHN'S REFRIGERATION INC JOHNSON & JONET MECHANICAL CONTRACTORS INC JOHNSON CONTROLS INC KUHLMAN INC MANNENBACH MECHANICAL LLC MASTERS BUILDING SOLUTIONS INC MATENAER PLUMBING INC MECHANICAL TECHNOLOGIES INC MONONA PLUMBING & FIRE PROTECTION INC PIPING SERVICE INC PIPING SYSTEMS LLC PLESHEK'S AIR CONDITIONING & REFRIGERATION INC PLYMOUTH PLUMBING & HEATING INC PNEUMATIC SYSTEMS PLUS LLC R & R PLUMBING LLC RANGE LINE PLUMBING INC REEKE-MAROLD CO REFRIGERATION SERVICES OF GREEN BAY INC ROB GIESE CONSTRUCTION SERVICES INC SUMMIT REFRIGERATION GROUP INC TEAM INDUSTRIES INC TWEET-GAROT MECHANICAL INC VDH MECHANICAL SERVICES LLC WOLF & SONS PLUMBING LLC 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FORM 990, SCHEDULE R, PARTS II-IV IN ADDITION TO THE CONTRIBUTING EMPLOYERS REPORTED AS RELATED ORGANIZATIONS ON SCHEDULE R, PARTS II-IV, THE FUND HAD ADDITIONAL EMPLOYERS THAT HAVE NOT YET RESPONDED TO THE FUNDS EFFORT TO OBTAIN THE TAX CLASSIFICATION, WHICH ARE LISTED BELOW. ANDERSON HVAC LLC, ARIZONA PIPE TRADES TRUST, BADGER BALANCING LLC, BEST MECHANICAL, BHI ENERGY/ SPECIALTY SERVICES LLC, BIG MIKE'S PLUMBING LLC, BMWC CONSTRUCTORS, BOLDT COMPANY (400), BUILDING TRADES PENSION FUND, CARRIER BUILDING SERVICES, CFM/VR TESCO, COLORADO PIPE INDUSTRY, CR MEYER & SON, DULUTH BUILDING TRADES, EGI MECHANICAL, GARTMAN MECHANICAL SERVICE, HAYES COMMERCIAL, LLC, HJ PERTZBORN, JOE DEBELAK PLUMBING, MIDWEST REFIGERATION CORP., MIRON CONSTRUCTION CO., INC., MJ ELECTRIC LLC, NATIONAL PENSION FUND, NORTHERN ROCKY MOUNT, NORTHWEST PLUMBING & PIPE PCI ENERGY SERVICES, PEVCO SYSTEMS INTL INC, PIPE TRADES SERVICES MN, PIPEFITTERS LOCAL 597, PIPELINE INDUSTRY BENEFIT, PLUMBERS & PIPE 572, PLUMBERS & STEAM 10, PLUMBERS & STEAM 400, PLUMBERS LOCAL 13, PLUMBERS LOCAL 25, PLUMBERS LOCAL 290, PLUMBERS LOCAL 286, PLUMBERS LOCAL 295, PLUMBERS LOCAL 350, PLUMBERS LOCAL 33, PLUMBERS LOCAL 43, PLUMBERS LOCAL 51, PLUMBERS LOCAL 52, PLUMBERS LOCAL 73, PLUMBERS LOCAL 125, PLUMBERS LOCAL 353, PLUMBERS LOCAL 357, PLUMBERS LOCAL 420, PLUMBERS LOCAL 434, PLUMBERS LOCAL 520, PLUMBERS LOCAL 562, PLUMBERS LOCAL 597, PLUMBERS LOCAL 636, PLUMBERS LOCAL 671, PLUMBERS LOCAL 75, PLUMBERS LOCAL 85, PLUMBERS LOCAL UNION 716, PLUMBRS&STEAMFTS LOCAL 10, RIVERVIEW PLUMBING INC., RJ PARINS PLUMBING & HTG, S & S MECHANICAL, SABEL INDUSTRIAL LLC, SCOUR SEWER AND DRAIN LLC, SKYWRITE GROUP LLC, SONNTAG PLUMBING INC, SOUTHERN CALIFORNIA PIPE, STATE MECHANICAL SERVICES, STEAMFITTERS 421, STRAIGHT LINE REFRIGERATION, LLC, TECHVISIONS & SOLUTIONS LLC, TRANE TECHNOLOGIES, U A LOCAL NO 23, ON LOCAL 118, U A LOCAL 125, VETERANS PLUMBING LLC, UNION LOCAL 150, UNION LOCAL 85, UNION LOCAL 94, UNION LOCAL 150, UNION LOCAL 524, UPPER PENINSULA PLUMBERS, VALLEY MECHANICAL, INC, VETERANS PLUMBING LLC, WISCONSIN PIPE TRADES ORG, WISCONSIN MECHANICAL SOLUTIONS, WOOLSEY PLUMBING & HEATIN, ZENTNER & SONS, 1901 INC, ALPINE PLUMBING, COMMERCIAL REFRIGERATION, COMPLETE CONTROL, DAY & ZIMMERMAN NPS, GRIFFITH STAINLESS WELDING, HIWAY LANDSCAPERS, INC, JM BRENNAN, LOCAL 502, LOCAL 123, LOCAL 572, MADISON AREA TRUST FUND. PIPERS MECHANICAL INC. PLUMBERS & GASFITTERS LOCAL 5, TWIN CITY PIPE TRADES, UTAH PIPE TRADES WELFARE