2022-03-09T10:31:58-06:00 2021-04-30 382284921 BENDA GRACE STULZ & COMPANY PC 38800 VAN DYKE AVE STE 100 STERLING HEIGHTS MI 48312 990 2020-05-01 386098425 MICHIGAN BAC HEALTH CARE FUND MICH 5173217502 6525 CENTURION DRIVE LANSING MI 48917 ANDY BRACY SECRETARY 5173217502 2021-09-22 ANDY BRACY 999009999 BRYAN STULZ P00265596 5868836240 2022-03-09 2020 2022-09-23 18:48:47Z ANDY BRACY 9556966 false X X 1964 MI PROVIDE HEALTH AND WELFARE BENEFITS 10 2 0 0 0 8252836 8501694 -99822 32809 4131 2750 8157145 8537253 0 9399049 7646790 0 0 0 964901 1033719 10363950 8680509 -2206805 -143256 5606608 6273369 3701806 3556199 1904802 2717170 PROVIDE HEALTH AND WELFARE BENEFITS false false TO PROVIDE HEALTH CARE BENEFITS AND DISABILITY BENEFITS TO ELIGIBLE PLAN PARTICIPANTS AND THEIR DEPENDENTS. false false false false false false false false false false false false false true false true false false false false false false false false false false false false false false false false false false false false false false false false true false false true 3 0 0 false false false false false false false false X 10 2 true false false false false true false true true false false false false false false false false false X TIC INTERNATIONAL CORP 5173217502 6525 CENTURION DRIVE LANSING MI 48917 X JAMES BRYLOWSKI TRUSTEE 1.00 40.00 X 0 99189 45035 JAMES BUDD TRUSTEE 1.00 40.00 X 0 88861 42303 GREG LOBODZINSKI TRUSTEE 1.00 40.00 X 0 88861 42303 DARYL NICHOLS TRUSTEE 1.00 40.00 X 0 88861 42303 CHUCK KUKAWKA CHAIRMAN 1.00 40.00 X 0 122526 0 ANDY BRACY SECRETARY 1.00 40.00 X 0 0 0 DAMIAN HILL TRUSTEE 1.00 0.00 X 0 0 0 STEVE MEYER TRUSTEE 1.00 40.00 X 0 0 0 SCOTT PANTALEO TRUSTEE 1.00 0.00 X 0 0 0 NORM THOMAS TRUSTEE 1.00 40.00 X 0 0 0 488298 171944 false false false BLUE CROSS BLUE SHIELD OF MICHIGAN 27000 WEST 11 MILE ROAD B494 SOUTHFIELD MI 48034 HEALTH ADMIN. 673457 TIC INTERNATIONAL CORPORATION 6525 CENTURION DRIVE LANSING MI 48917 PLAN ADMIN. 150987 LEGGHIO & ISRAEL PC 306 S WASHINGTON AVENUE ROYAL OAK MI 48067 LEGAL 121024 3 EMPLOYER CONTRIBUTIONS 230000 7575925 7575925 PARTICIPANT SELF-PAYMENTS 230000 925769 925769 8501694 85318 85318 967204 1019713 -52509 -52509 -52509 LIQUIDATED DAMAGES COLLECTED 230000 2750 2750 2750 8537253 8451935 85318 7646790 791838 121921 27185 19927 12500 34464 3088 5934 MEMBER COMMUNICATIONS 13495 CONTRACT MONITORING FEE 1950 PARTICIPANT NOTICES 1417 8680509 0 0 0 764721 1188288 179835 67906 565263 776634 290734 1203 3806055 4239338 5606608 6273369 133347 281053 3568459 3275146 3701806 3556199 X 1904802 2717170 1904802 2717170 5606608 6273369 -143256 955624 X false true X true false ACCUMULATED ELIGIBILITY CREDITS 2689000 CLAIMS INCURRED BUT NOT REPORTED 467000 HEALTH CARE CLAIMS PAYABLE 119146 3275146 9472950 955624 955624 8517326 19927 19927 8537253 8660582 8660582 19927 19927 8680509 FORM 990, PART VI LINE 2 - THE RELATIONSHIP BETWEEN THE TRUSTEES OF THE FUND IS A "BUSINESS RELATIONSHIP". THE FUND IS ESTABLISHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED. THE FUND, AS A TAFT-HARTLEY TRUST FUND, IS ADMINISTERED BY A BOARD OF TRUSTEES WHICH IS COMPOSED OF AN EQUAL NUMBER OF UNION AND EMPLOYER REPRESENTATIVES. IT IS BECUASE OF THIS ORGANIZATIONAL REQUIREMENT THAT THERE IS A "BUSINESS RELATIONSHIP" BETWEEN THE TRUSTEES. LINE 12 - ANNUALLY, EACH TRUSTEE MUST ANSWER THE FIDUCIARY LIABILITY INSURANCE RENEWAL QUESTIONAIRE, WHICH CONTAINS QUESTIONS REGARDING POTENTIAL AND ACTUAL CONFLICTS OF INTEREST. LINE 15 - THE FUND DID NOT HAVE A CEO, EXECUTIVE DIRECTOR, TOP MANAGEMENT OFFICAL, OR OTHER OFFICER OR KEY EMPLOYEES, AS THOSE TERMS ARE DEFINED IN THE INSTRUCTIONS. FORM 990, PAGE 6, PART VI, LINE 7A ALL BOARD MEMBERS ARE ELECTED BY THE MEMBERSHIP INTO OFFICER POSITIONS, FROM WHICH THEY HOLD THEIR TRUSTEESHIP. FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS PRESENTED AND APPROVED AT A MEETING OF TRUSTEES, SUBJECT TO APPROVAL AND REVIEW BY THE FUND ATTORNEY. UPON COMPLETION THE TRUSTEE'S ARE PROVIDED WITH THE FINAL FORM 990 (INCLUDING ALL REQUIRED SCHEDULES), AS ULTIMATLY FILED WITH THE IRS. FORM 990, PAGE 6, PART VI, LINE 19 THE FUND IS ESTABLISHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED. IT OPERATES IN COMPLIANCE WITH THE REPORTING AND DISCLOSURE REQUIREMENTS OF SUBTITLE B, PART 1 ERISA WITH RESPECT TO DISCLOSURE OF ITS GOVERNING DOCUMENTS AND FINANCIAL INFORMATION. IT OPERATES IN COMPLIANCE WITH FIDUCIARY RESPONSIBILITY REQUIREMENTS OF SUBTITLE B, PART 4 OF ERISA. FORM 990, PART VII LINE 1A - GREG LOBODZINSKI, DARYL NICHOLS, JAMES BRYLOWSKI, JAMES BUDD AND CHARLES KUKAWKA SERVED AS TRUSTEES OF THE FUND WITHOUT COMPENSATION FROM THE FUND FOR THOSE SERVICES. HOWEVER, THERE WERE COMPENSATED AS EMPLOYEES OF MICHIGAN BAC LOCALS, WHICH WERE CONTRIBUTING EMPLOYERS TO THE FUND AND, AS SUCH, "RELATED ORGANIZATIONS" AS THAT TERM IS DEFINED IN THE INSTRUCTIONS. MICHIGAN BAC APPRENTICESHIP 6525 CENTURION DRIVE LANSING MI 48917 386158556 APPRENTICE MI 501C3 2 N/A false MICHIGAN BAC PENSION 6525 CENTURION DRIVE LANSING MI 48917 382895943 PENSION MI 401B N/A false BAC 9-MCE COOP & EDUC TRUST 6525 CENTURION DRIVE LANSING MI 48917 386771345 PROMOTION MI 501C5 N/A false MICHIGAN BAC LOCAL 9 3321 REMY DRIVE LANSING MI 48906 463778303 LOCAL MI 501C5 N/A false A&G CONSTRUCTION N/A false AKINS CONSTRUCTION N/A false AMALIO CORPORATION N/A false AMERICAN INTERNATIONAL CONST N/A false API INC N/A false ARTISAN TILE INE N/A false BAKER CONSTRUCTION N/A false BARTON MALOW CO N/A false BHI ENERGY SPECIALTY SERVICES N/A false BNE SERVICES LLC N/A false BORNER RESTORATION INC N/A false BRACY & JAHR MASONRY INC N/A false BRONNER WM AND SON CONSTR N/A false BUCKLAND JOHN CONTR INC N/A false BYERS D C COMPANY N/A false C&S MASONRY RESTORATION LLC N/A false CENTRAL TILE & TERRAZZO N/A false CLOSNER CONSTRUCTION N/A false CLS CONSTRUCTION SERVICES N/A false COMMERCIAL SPECIALTY CONT INC N/A false CONTEK INC N/A false CORNERSTONE CONTRACTOR & CONSTRUCT N/A false CR MEYER & SONS COMPANY N/A false CUSACK'S MASONRY RESTORATION N/A false DAVENPORT MASONRY INC N/A false DIXON INC N/A false DRV JOINT SEALANT CONTRACTORS N/A false EMPIRE REFACTORY SERVICES N/A false EMPIRE SOLUTIONS INC N/A false FISHER CONTRACTING N/A false FOAMS & BARRIERS LLC N/A false GEMELLI CONCRETE LLC N/A false GERACE CONSTRUCTION CO INC N/A false GLENN'S TILE N/A false GRUNWELL CASHERO COMPANY N/A false GUNDLACH CHAMPION INC N/A false HENKELS & MCCOY INC N/A false HMCHICKS MASON CONTRACTORS N/A false HOFFMAN PLASTERING N/A false IEI GENERAL CONTRACTORS INC N/A false INDUSTRIAL CONSTRUCTION SERVICE N/A false INDUSTRIAL MAINTENANCE SERVICE N/A false INDUSTRIAL SERVICES INC N/A false INDUSTRIAL SVC INC-WASHTENAW N/A false INTEGRITY INTERIORS INC N/A false KOCH GLITCH INC-KNIGHT DAVIS N/A false KRULL CONTRUCTION CO INC N/A false LARSON-DANIELSON CONSTRUCTION N/A false LEIDAL & HART MASON CONTRACTOR N/A false LEWIS CONSTRUCTION INC N/A false LONESTAR SIERRA LLC N/A false MCMATH MASONRY INC N/A false MERIDIAN RESTORATION LLC N/A false MIDLAND ENGINEERING N/A false MIDWEST INDUSTRIAL SERVICES N/A false MIRON CONSTRUCTION CO INC N/A false NC BUILDERS INC N/A false NEDROW REFRACTORIES N/A false NOTEBAERT CONSTRUCTION SERVICE N/A false PCI CONSTRUCTION SERVICES LLC N/A false PEARSON EQUIPMENT & SERVICE N/A false POLEY MASONRY CONSTRUCTION INC N/A false POMPONIO CONSTRUCTION N/A false PREMIER CAULKING INC N/A false PWP-MI LLC N/A false RANCK J ELECTRIC INC N/A false REFRACTORY SERVICE INC N/A false REFTECH INTERNATIONAL INC N/A false REICHENBACH CEILING & N/A false RESCH'S TILE INC N/A false RHODES & JOHNSON LLC N/A false SCHAD BOILER SETTING COMPANY N/A false SCHAEFER GROUP INC N/A false SCHIFFER MASON CONTRACTORS INC N/A false SIELER CONSTRUCTION INC N/A false SLATILE ROOFING & RESTORATIONS N/A false SPARTAN CONSTRUCTION CO N/A false SPENCE BROTHERS N/A false STANDARD TILE INC N/A false STEVENS PAINTON CORPORATION N/A false STEWART'S SERVICES LLC N/A false STORER S A & SONS N/A false TAILORED FOAM INC N/A false TEACHOUT'S INDUSTRIAL N/A false TEKTON ENTERPRISES N/A false THE AUSTIN COMPANY N/A false THORPE J T & SONS INC N/A false TRISCO SYSTEMS N/A false UNIVERSAL INC DBA UNIVERSAL N/A false VALCON INC DBA PIAZZA MASONRY N/A false VANDERMAY CONST INC N/A false VANSTONO'BRIEN INC N/A false WASHAW CONSTRUCTION INC N/A false WEIGAND CONSTRUCTION CO INC N/A false WELLMAN MASONRY INC N/A false WOBIG CONSTRUCTION COMPANY N/A false XTREME MASON CONTRACTORS LLC N/A false ZANETTI ENT GROUP LLC N/A false ZIOLKOWSKI CONSTRUCTION INC N/A false false false false false false false false false false false false false false false false false false false false