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        <TotalAmt>33017</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>20779</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>11019</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>131482</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>66190</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>154884</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>1419371</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>264666</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OfficeExpensesGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>10337</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>86960</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>77181</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>FUND NURSE EXPENSES</Desc>
        <TotalAmt>30562</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>CLINIC EXPENSES</Desc>
        <TotalAmt>4059056</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>52908095</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>1000042</BOYAmt>
        <EOYAmt>7947368</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>4507774</BOYAmt>
        <EOYAmt>1616363</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>4767694</BOYAmt>
        <EOYAmt>6010477</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>1207861</BOYAmt>
        <EOYAmt>1240791</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>1753666</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>279861</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>921916</BOYAmt>
        <EOYAmt>1473805</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>14767591</BOYAmt>
        <EOYAmt>14145595</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>3386196</BOYAmt>
        <EOYAmt>3283673</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>35459</BOYAmt>
        <EOYAmt>597557</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>30594533</BOYAmt>
        <EOYAmt>36315629</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>374417</BOYAmt>
        <EOYAmt>1945268</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>15176670</BOYAmt>
        <EOYAmt>21729873</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>15551087</BOYAmt>
        <EOYAmt>23675141</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrgDoesNotFollowFASB117Ind>X</OrgDoesNotFollowFASB117Ind>
      <RtnEarnEndowmentIncmOthFndsGrp>
        <BOYAmt>15043446</BOYAmt>
        <EOYAmt>12640488</EOYAmt>
      </RtnEarnEndowmentIncmOthFndsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>15043446</BOYAmt>
        <EOYAmt>12640488</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>30594533</BOYAmt>
        <EOYAmt>36315629</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-1907745</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-495213</NetUnrlzdGainsLossesInvstAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleD documentId="IRS990ScheduleD-01" softwareId="22015534">
      <LandGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <BookValueAmt>0</BookValueAmt>
      </LandGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>1614294</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>204373</DepreciationAmt>
        <BookValueAmt>1409921</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>139372</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>75488</DepreciationAmt>
        <BookValueAmt>63884</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>1473805</TotalBookValueLandBuildingsAmt>
      <OtherSecuritiesGrp>
        <Desc>COMMON COLLECTIVE TRUSTS</Desc>
        <BookValueAmt>3283673</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>3283673</TotalBookValueSecuritiesAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>RECIPROCITY PAYABLE</Desc>
        <Amt>385212</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>BENEFIT OBLIGATION</Desc>
        <Amt>20732512</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO OTHER FUNDS</Desc>
        <Amt>43009</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>RIGHT OF USE ASSETS LEASE LIABILITY</Desc>
        <Amt>569140</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>21729873</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>49050871</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-495213</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>-495213</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>49546084</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>154884</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>1299382</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>1454266</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>51000350</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>45683576</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>-1299382</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>-1299382</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>46982958</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>154884</InvestmentExpensesNotIncld2Amt>
      <OtherExpensesNotIncludedAmt>5770253</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>5925137</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>52908095</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XI, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>STOP LOSS RECOVERIES</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XII, Line 2d</FormAndLineReferenceDesc>
        <ExplanationTxt>BENEFIT OBLIGATION</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XII, Line 2d</FormAndLineReferenceDesc>
        <ExplanationTxt>STOP LOSS RECOVERIES</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt XII, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGE IN BENEFIT OBLIGATION</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ-01">
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CANDACE FACIO</PersonNm>
        <BaseCompensationFilingOrgAmt>144037</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>33018</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>20779</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>197834</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO-01" softwareId="22015534">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>COPIES OF FORM 990 WERE PROVIDED TO THE GOVERNING BODY PRIOR TO THE FORM 990 BEING FILED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>THE GOVERNING BODY DISCLOSES ANY CONFLICTS THAT HAVE ARISEN.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>PURSUANT TO ERISA.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR-01" softwareId="22015534">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>IBEW LOCAL UNION NO 357 PENSION PLAN A</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>8311 W SUNSET RD SUITE 250</AddressLine1Txt>
          <CityNm>LAS VEGAS</CityNm>
          <StateAbbreviationCd>NV</StateAbbreviationCd>
          <ZIPCd>89113</ZIPCd>
        </USAddress>
        <EIN>886023284</EIN>
        <PrimaryActivitiesTxt>TO PROVIDE PENSION BENEFITS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>401(a)</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>IBEW LOCAL UNION NO 357 PENSION PLAN B</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>8311 W SUNSET RD SUITE 250</AddressLine1Txt>
          <CityNm>LAS VEGAS</CityNm>
          <StateAbbreviationCd>NV</StateAbbreviationCd>
          <ZIPCd>89113</ZIPCd>
        </USAddress>
        <EIN>886023284</EIN>
        <PrimaryActivitiesTxt>TO PROVIDE PENSION BENEFITS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>401(a)</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART IV</FormAndLineReferenceDesc>
        <ExplanationTxt>SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS. THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH &amp; WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF CONTRIBUTING EMPLOYERS HOWEVER, CERTAIN INFORMATION THAT IS REQUIRED TO BE REPORTED ON SCHEDULE R IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. THE CONTRIBUTING EMPLOYERS HAVE NOT BEEN INCLUDED ON SCHEDULE R.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
