STRATEGY STUDIO / PUBLIC DATA EXPLORER

LOCAL UNIONS NO 19 & 127 HEALTH AND WELFARE FUND: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
LOCAL UNIONS NO 19 & 127 HEALTH AND WELFARE FUND (EIN 39-6048209)
Tax period
2020-04-01 to 2021-03-31
Filed
2022-02-07
IRS object ID
202220389349300847
Schema version
2020v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-02-07T14:18:36-06:00ReturnTs
Tax Period End2021-03-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN363168081PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SIKICH LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line113400 BISHOPS LANE SUITE 300AddressLine1Txt
CityBROOKFIELDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53005ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-04-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN396048209EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LOCAL UNIONS NO 19 AND 127 HEALTHBusinessNameLine1Txt
Business Name Line2AND WELFARE FUNDBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlLOCABusinessNameControlTxt
Phone4145773700PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line111270 WEST PARK PLACE NO 950AddressLine1Txt
CityMILWAUKEECityNm
State AbbreviationWIStateAbbreviationCd
ZIP53224ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBRETT LARGEPersonNm
Person TitleSECRETARY/TREASURERPersonTitleTxt
Phone4145773700PhoneNum
Signature2022-02-04SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstBRETTPersonFirstNm
Person LastLARGEPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJILL M BOYLE CPAPreparerPersonNm
PTINP01246734PTIN
Phone2627549400PhoneNum
Preparation2022-02-02PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBRETT LARGEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line111270 WEST PARK PLACE SUITE 950AddressLine1Txt
CityMILWAUKEECityNm
State AbbreviationWIStateAbbreviationCd
ZIP53224ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$10,145,447GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1952FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTO PROVIDE DIFFERENT HEALTH COVERAGES TO ELIGIBLE PARTICIPANTS, THEIR DEPENDENTS AND RETIREES.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee16TotalEmployeeCnt
Total Volunteers4TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$9,099,275PYProgramServiceRevenueAmt
CY Program Service Revenue$9,021,288CYProgramServiceRevenueAmt
PY Investment Income$37,231PYInvestmentIncomeAmt
CY Investment Income$25,923CYInvestmentIncomeAmt
PY Other Revenue$70,404PYOtherRevenueAmt
CY Other Revenue$42CYOtherRevenueAmt
PY Total Revenue$9,206,910PYTotalRevenueAmt
CY Total Revenue$9,047,253CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$8,375,471PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$8,253,107CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$315,265PYOtherExpensesAmt
CY Other Expenses$383,600CYOtherExpensesAmt
PY Total Expenses$8,690,736PYTotalExpensesAmt
CY Total Expenses$8,636,707CYTotalExpensesAmt
PY Revenues Less Expenses$516,174PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$410,546CYRevenuesLessExpensesAmt
Total Assets BOY$3,935,842TotalAssetsBOYAmt
Total Assets EOY$4,215,584TotalAssetsEOYAmt
Total Liabilities BOY$4,443,945TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,167,969TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$508,103NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$47,615NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE ACCIDENT, HEALTH, DENTAL, PRESCRIPTION DRUG, AND LOSS OF TIME BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS AND CERTAIN RETIREES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescPROVIDED ACCIDENT, HEALTH, DENTAL, PRESCRIPTION DRUG, AND LOSS OF TIME BENEFITS TO APPROXIMATELY 545 MEMBERS.Desc
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document28IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee16EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BENESYS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2625499190PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1N27 W23233 ROUNDY DRIVEAddressLine1Txt
CityPEWAUKEECityNm
State AbbreviationWIStateAbbreviationCd
ZIP53072ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
FRANK RODRIGUEZ
TRUSTEE0.1040.00Yes (X)$0$91,377$94,834
BRETT LARGE
SECRETARY/TREASURER0.1040.00Yes (X)$0$91,931$86,481Yes (X)
WILLIAM NARETTA
CHAIRMAN0.10Yes (X)$0$0$0Yes (X)
JIM BARTELT
TRUSTEE0.10Yes (X)$0$0$0
MARK BORCHARDT
TRUSTEE0.10Yes (X)$0$0$0
JEREMY WICKE
TRUSTEE0.10Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$183,308TotReportableCompRltdOrgAmt
Total Other Compensation$181,315TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
BENEFIT PLAN ADMINISTRATION OF WISCONSIN
11270 WEST PARK PLACE SUITE 950MILWAUKEEWI53224ADMINISTRATION$271,799
UNITED HEALTHCARE
115 W WAUSAU AVEWAUSAUWI54401CLAIMS PROCESSING$216,393
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYER CONTRIBUTIONS-NET900099$8,191,381$8,191,381
SELF-PAYMENT CONTRIBUTIONS-NET900099$829,907$829,907
FieldValueIRS element (for citing)
Total Program Service Revenue$9,021,288TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$29,974TotalRevenueColumnAmt
Exclusion$29,974ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,094,143SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,098,194SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$4,051SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$4,051TotalRevenueColumnAmt
Exclusion-$4,051ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Business900099BusinessCd
Total Revenue Column$42TotalRevenueColumnAmt
Related Or Exempt Func Income$42RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$42OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,047,253TotalRevenueColumnAmt
Related Or Exempt Func Income$9,021,330RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$25,923ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$8,253,107TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$205,775TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$12,256TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$4,081TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$75,748TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$10,839TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$62,587TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$5,860TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmt
GOVERNMENTAL FEES AND A$2,788
BANK SERVICE FEES$2,302
EDUCATIONAL PROGRAM FEE$1,065
TRUSTEE CONFERENCE & ME$299

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$8,636,707TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,854,070BOYAmt
EOY$1,961,784EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$14,097BOYAmt
EOY$11,961EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$738,471BOYAmt
EOY$744,441EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$103,840BOYAmt
EOY$98,179EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,225,364BOYAmt
EOY$1,399,219EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,935,842BOYAmt
EOY$4,215,584EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$112,445BOYAmt
EOY$65,691EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,331,500BOYAmt
EOY$4,102,278EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,443,945BOYAmt
EOY$4,167,969EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY-$508,103BOYAmt
EOY$47,615EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$508,103BOYAmt
EOY$47,615EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,935,842BOYAmt
EOY$4,215,584EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$410,546ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$145,172NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
CLAIMS PAYABLE$62,000
MEMBER DOLLAR BANK$331,798
UNSETTLED INVESTMENT PURCHASES$137
CLAIMS INCURRED BUT NOT REPORTED$441,000
HRA LIABILITY$3,267,343
FieldValueIRS element (for citing)
Total Liability$4,102,278TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$9,188,344TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$145,172NetUnrealizedGainsInvstAmt
Revenue Not Reported$145,172RevenueNotReportedAmt
Revenue Subtotal$9,043,172RevenueSubtotalAmt
Investment Expenses Not Incld$4,081InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$4,081RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$9,047,253TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$8,674,626TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$42,000OtherExpensesIncludedAmt
Expenses Not Reported$42,000ExpensesNotReportedAmt
Expenses Subtotal$8,632,626ExpensesSubtotalAmt
Investment Expenses Not Incld2$4,081InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$4,081ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$8,636,707TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS QUALIFIED PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE AND IS, THEREFORE, NOT SUBJECT TO TAX UNDER PRESENT INCOME TAX LAWS. THE PLAN HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER 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.
PART XII, LINE 2D - OTHER ADJUSTMENTS:CURRENT YEAR INCREASE IN BENEFIT CLAIMS PAYABLE AND IBNR 42,000.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
FRANK RODRIGUEZ
TRUSTEE$0$91,377$0$0$0$0$0$67,079$0$27,755$0$186,211$0$0
BRETT LARGE
SECRETARY/TREASURER$0$91,931$0$0$0$0$0$61,803$0$24,678$0$178,412$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE J, PART 1 LINE 3FormAndLineReferenceDesc
ExplanationTHE RELATED ORGANIZATION, INTERNATIONAL ASSOCIATION OF HEAT AND FROST INSULATORS AND ALLIED WORKERS LOCAL 19, USES EXECUTIVE BOARD APPROVAL TO ESTABLISH COMPENSATION.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS PROVIDED TO PLAN MANAGEMENT TO REVIEW AND APPROVE.
FORM 990, PART VI, SECTION B, LINE 12CTHIS IS UPDATED ANNUALLY.
FORM 990, PART VI, SECTION C, LINE 19THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE AVAILABLE UPON REQUEST AND ARE AVAILABLE FOR INSPECTION AT THE ORGANIZATION'S OFFICE.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtControlled OrganizationControlledOrganizationInd
INT'L ASSOCIATION OF HEAT & FROST INSULATORS & ALLIED WORKERS LOCAL 19
N27W23155 ROUNDY DRIVEPEWAUKEEWI53072390137350A LABOR UNION TO ORGANIZE THE EMPLOYEES IN THE PIPE INSULATING TRADEWI501(C)(5)0
BOARD OF TRUSTEES OF THE LOCAL UNIONS NO 19 AND 127 HEALTH & WELFARE FUND
11270 WEST PARK PLACEMILWAUKEEWI53224396048209SPONSORING ORGANIZATION (JOINT BOARD OF TRUSTEES)WI501(C)(9)0
HEAT AND FROST INSULATORS ST LOUIS WELFARE FUND
INT'L ASSOC OF HEAT & FROST INSULATORS LOCAL 17 PENSION FUND
HEAT AND FROST LOCAL 81
HEAT & FROST LOCAL 2
HEAT & FROST LOCAL 34
HEAT & FROST LOCAL 127
HEAT & FROST LOCAL 33
ASBESTOS WORKERS LOCAL 6
INSULATORS LOCAL 87 HEALTH FUND
LOCAL 17

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ADVANCED INDUSTRIAL SERVICEBusinessNameLine1Txt

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (21 entries)

FIRESTOP PLUS LLC
ENVIRONMENTAL PLAN SERVICES INC
DAY & ZIMMERMANN NPS INC
D & G INSULATION INC
EXPRESS INSULATION INC
MIDWEST THERMAL SERVICES INC
L & S INSULATION CO INC
TAYLOR INSULATION CO INC
CENTRAL STATE MECHANICAL INSULATION LLC
MAVO SYSTEMS INC
ALL SYSTEMS INSULATION INC
BARTELT INSULATION SUPPLY INC
SPRINKMANN SONS CORPORATION
API INC
FIBRE FAB OF LA CROSSE INC
MCDERMAID ROOFING & INSULATING CO
TEBS INSULATION
GAGNON INC
INSULATION INDUSTRIES INC
HOLIAN INSULATION CO INC
HUSSMAN CORPORATION
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE R, PARTS II-IVFormAndLineReferenceDesc
ExplanationIN 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. THE CONTRIBUTING EMPLOYERS ARE: ALLIED POWER LLC, ARM MECHANICAL, BHI SPECIALTY SERVICES, BRANDSAFWAY SERVICES LLC, BROCK INDUSTRIAL SERVICES LLC, JADE INSULATION SPECIALTIES, JAMAR COMPANY, LIFE SAFETY SYSTEMS, M & O INSULATION COMPANY, NATIONAL ASB MEDICAL FUND, NELSON INSULATION COMPANY, NORTHERN ILLINOIS INSULATION, AND RAYMER PIPE DUCT INSULATIONExplanationTxt