2023-01-12T00:00:00-06:00 2022-03-31 550526247 KOZICKI HUGHES TICKERHOOF PLLC 32 TWENTIETH STREET SUITE 300 WHEELING WV 26003 990 2021-04-01 510168650 IRON WORKERS LOCALS 549 & 550 MEDICAL & BENEFIT FUND IRON 3043999010 3150 US ROUTE 60 ONA WV 255459507 KEVIN COULTER CO-CHAIRMAN OF THE BOARD 3042322660 2023-01-11 KEVIN COULTER 999009999 NANCY HUGHES CPA P01447261 3042322280 2023-01-09 3 AAL1 IAL1 2021 2023-03-07 01:45:13Z X KEVIN COULTER 2350 MAIN STREET WHEELING WV 26003 11059495 0 X N/A X 1975 WV TO PROVIDE ACCIDENT, HOSPITAL, MEDICAL, SURGICAL, DISABILITY, DENTAL, PRESCRIPTION AND DEATH BENEFITS TO ELIGIBLE MEMBERS OF IRON WORKERS LOCALS 549 & 550 AND THEIR SPOUSES AND DEPENDENTS. 15 7 5 0 0 0 0 0 9625403 10915529 200841 143960 30 6 9826274 11059495 0 0 8235095 9304815 0 0 0 0 0 1050081 1103693 9285176 10408508 541098 650987 12782578 13260484 154179 153768 12628399 13106716 THE TRUST FUND IS CREATED, ESTABLISHED AND MAINTAINED, (AND THE TRUSTEES AGREE TO RECEIVE, HOLD AND ADMINISTER), TO PROVIDE BENEFITS FOR MEMBERS AND THEIR BENEFICIARIES IN ACCORDANCE WITH THE PLAN DOCUMENT. 0 0 THE IRON WORKERS LOCALS 549 & 550 MEDICAL & BENEFIT PLAN IS A DEFINED BENEFIT HEALTH AND WELFARE PLAN THAT PROVIDES BENEFITS TO ELIGIBLE MEMBERS OF IRON WORKERS LOCALS 549 AND 550 WHO HAVE COMPLETED THE REQUIRED SERVICE HOURS FOR AN EMPLOYER WHO IS SUBJECT TO THE TERMS OF THE COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE INTERNATIONAL ASSOCIATION OF BRIDGE, STRUCTURAL AND ORNAMENTAL IRONWORKERS LOCALS UNIONS 549 AND 550 AND THE OHIO VALLEY CONSTRUCTION EMPLOYERS COUNCIL INC AND THE STRUCTURAL CONTRACTORS AND INDEPENDENT EMPLOYERS ASSOCIATION OF CANTON OHIO. THE PLAN PROVIDES FOR ACCIDENT, HOSPITAL, MEDICAL, SURGICAL, DISABILITY, DENTAL, PRESCRIPTION AND DEATH BENEFITS COVERING APPROXIMATELY 859 ELIGIBLE MEMBERS AND THEIR SPOUSES AND DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 4 0 1 5 1 0 0 0 0 0 0 0 0 0 0 X 15 7 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X JESSICA MINDISH (ABC) 3043999010 3150 US ROUTE 60 ONA WV 25545 KEVIN COULTER CO-CHAIRMAN/EMPLOYEE TRUST 0.50 50.00 X X 0 103893 84478 WILLIAM SHERER II CO-CHAIRMAN/EMPLOYEE TRUST 0.50 50.00 X X 0 84158 66702 KELLY DIERKES EMPLOYEE TRUSTEE 0.50 X 0 102359 84118 THERON HODGE EMPLOYEE TRUSTEE 0.50 50.00 X 0 66497 54495 SEAN DIEKMANN EMPLOYEE TRUSTEE 0.50 X 0 2345 0 GARY CRAFT EMPLOYEE TRUSTEE 0.50 X 0 8022 0 STEVE TERRY EMPLOYEE TRUSTEE 0.50 X 0 1876 0 TOM DULIN EMPLOYER TRUSTEE 0.50 X 0 0 0 THOMAS LISTON EMPLOYER TRUSTEE 0.50 X 0 0 0 GEOFF NICELY EMPLOYER TRUSTEE 0.50 X 0 0 0 JIM CHAPMAN EMPLOYER TRUSTEE 0.50 X 0 0 0 SCOTT ALLEMAN EMPLOYEE TRUSTEE 0.50 X 0 3575 0 STEVE CAFARO EMPLOYER TRUSTEE 0.50 X 0 0 0 LORI SCOTT EMPLOYER TRUSTEE 0.50 X 0 0 0 KELLY WHITE EMPLOYER TRUSTEE 0.50 X 0 0 0 0 372725 289793 0 0 1 0 ANTHEM BLUE CROSS BLUE SHIELD PO BOX 951254 CLEVELAND OH 44193 MEDICAL INSURANCE 374019 CDS ADMINISTRATORS INC 5 HOT METAL STREET SUITE 200 PITTSBURG PA 15203 ADMINISTRATION FEES 321300 PAYDHEALTH 4001 MCEWEN STE 450 DALLAS TX 75244 ADMINISTRATION FEES 145020 3 EMPLOYER CONTRIBUTION 525120 9891063 9891063 RETIREE AND MEMBER SELF-PAY 525120 1024466 1024466 10915529 143960 143960 MISCELLANEOUS INCOME 525100 6 6 6 11059495 10915535 0 143960 X 9304815 23374 34000 26430 974833 12627 12560 BANK CHARGES AND OTHER 16887 ACA TAXES & COSTS PCORI 2982 10408508 2860712 3407701 1701093 1810151 676868 1051444 82271 75066 7455470 6910105 6164 6017 12782578 13260484 154179 153768 154179 153768 X 0 0 0 0 12628399 13106716 12628399 13106716 12782578 13260484 650987 -172670 0 X X 0 1 X 1 0 0 10860395 -172670 -172670 11033065 26430 26430 11059495 10382078 0 10382078 26430 26430 10408508 0 0 0 KEVIN COULTER CO-CHAIRMAN/EMPLOYEE TRUST 0 103893 0 0 0 0 0 59458 0 25020 0 188371 0 0 KELLY DIERKES EMPLOYEE TRUSTEE 0 102359 0 0 0 0 0 59098 0 25020 0 186477 0 0 WILLIAM SHERER II CO-CHAIRMAN/EMPLOYEE TRUST 0 84158 0 0 0 0 0 44009 0 22693 0 150860 0 0 THERON HODGE EMPLOYEE TRUSTEE 0 66497 0 0 0 0 0 35584 0 18911 0 120992 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE TRUSTEES FOR THE FUND ENGAGED AMERICAN BENEFIT CORPORATION (ABC) TO PROVIDE ADMINISTRATIVE SERVICES FOR THE PLAN EFFECTIVE 06/01/2022. THE TRUSTEES FOR THE FUND PREVIOUSLY ENGAGED CENTRAL DATA SERVICES (CDS ADMINISTRATORS, INC) TO PROVIDE ADMINISTRATIVE SERVICES FOR THE PLAN EFFECTIVE 10/1/2016. FORM 990, PART VI, SECTION B, LINE 11B THE COMPLETED 990, IN DRAFT VERSION, IS EMAILED TO THE CO-CHAIRMEN PRIOR TO ITS FINALIZATION. ANY QUESTIONS, COMMENTS, AND CONCERNS ARE DISCUSSED AND RESOLVED PRIOR TO THE FILING OF THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ANY DIRECTOR, PRINCIPAL OFFICER, TRUSTEE OR ADMINISTRATOR OF THE ORGANIZATION HAS A DUTY TO DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST AND IS GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE GOVERNING BOARD. THE GOVERNING BOARD THEN DISCUSSES AND VOTES UPON THE DETERMINATION OF A CONFLICT OF INTEREST. IF THE BOARD BELIEVES THAT AN ACTUAL OR POSSIBLE CONFLICT WAS NOT DISCLOSED AND UPON FURTHER EXPLANATION DETERMINES THAT THERE WAS A FAILURE TO DISCLOSE, APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION WILL BE TAKEN. EACH DIRECTOR, PRINCIPAL OFFICER, TRUSTEE OR ADMINISTRATOR OF THE GOVERNING BOARD IS REQUIRED TO SIGN AN ANNUAL STATEMENT. PERIODIC REVIEWS WILL ALSO BE CONDUCTED WHICH MAY INCLUDE THE USE OF OUTSIDE EXPERTS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11(G) MEDICAL PROVIDER 374,019 PRESCRIPTION PROVIDER 63,017 DENTAL PROVIDER 15,996 THIRD PARTY ADMINISTRATOR 307,256 WEX HEALTH/BENNY CARD 14,044 PAYD HEALTH 145,021 PART XII, LINE C2 EXPLANATION: THE PROCESS HAS NOT CHANGED. IRON WORKERS LOCAL 549 2350 MAIN STREET WHEELING WV 26003 550241628 LOCAL LABOR UNION PROVIDING SERVICES TO MEMBERS AND ASSISTANCE TO EMPLOYERS WV 501(C)(5) 0 IRON WORKERS LOCAL 550 618 HIGH AVENUE NW CANTON OH 44703 340225474 LOCAL LABOR UNION PROVIDING SERVICES TO MEMBERS AND ASSISTANCE TO EMPLOYERS OH 501(C)(5) 0 IRON WORKERS LOCALS 549 & 550 SECURITY PLAN 5 HOT METAL STREET SUITE 200 PITTSBURGH PA 15222 341399439 DEFINED CONTRIBUTION PLAN COVERING ELIGIBLE WORKERS UNDER LOCAL AGREEMENT WV 401(A)/501(A) 0 IRON WORKERS LOCALS 549 & 550 PENSION PLAN 5 HOT METAL STREET SUITE 200 PITTSBURGH PA 15222 556027928 DEFINED BENEFIT PENSION PLAN COVERING ELIGIBLE MEMBERS OF LOCAL UNIONS WV 401(A)/501(A) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 SCHEDULE R, PART V, LINE 1: P: THE IRON WORKERS LOCAL 549 & 550 SECURITY PLAN, MEDICAL AND BENEFIT PLAN, AND PENSION PLAN BEGAN REIMBURSING THE LOCALS FOR LOST WAGES OF TRUSTEES TO ATTEND MEETINGS. THE TRUSTEES WERE ISSUED A W2 FOR THEIR COMPENSATION FROM THEIR RESPECTIVE LOCALS.