2022-10-11T10:13:31-05:00 2021-11-30 320043599 LEGACY PROFESSIONALS LLP 6800 FRANCE AVENUE SO SUITE 550 EDINA MN 55435 990 2020-12-01 237115412 MINNESOTA TEAMSTERS CONSTRUCTION DIVISION FRINGE BENEFIT FUNDS MINN 6512561900 2520 PILOT KNOB ROAD NO 325 MENDOTA HEIGHTS MN 55120 ZACHARY RADZAK TRUSTEE 6512561900 2022-10-10 1 ZACHARY RADZAK 999009999 ERIC C BAERTSCH P00964071 9528413950 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z ZACHARY RADZAK 2520 PILOT KNOB ROAD NO 325 MENDOTA HEIGHTS MN 55120 24689519 0 X N/A X 1970 MN PROVIDE HEALTH BENEFITS 8 8 11 0 0 0 0 0 17901969 23219659 251621 461112 17354 2572 18170944 23683343 0 0 16010509 15928400 0 0 0 0 0 394792 390951 16405301 16319351 1765643 7363992 23175929 30866404 27335 23524 23148594 30842880 TO PROVIDE HEALTH CARE, DENTAL, DISABILITY, LIFE, AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS TO MEMBERS. 0 0 PAYMENT OF HEALTH CARE, DENTAL, DISABILITY, LIFE, AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS FOR ELIGIBLE PARTICIPANTS AND DEPENDENTS AS PROVIDED BY THE SUMMARY PLAN DESCRIPTION. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 11 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 1 0 0 0 1 0 1 0 0 0 1 1 0 0 0 0 0 0 0 X ZENITH AMERICAN SOLUTIONS INC 6512561900 2520 PILOT KNOB ROAD NO 325 MENDOTA HEIGHTS MN 55120 X CHAD NELSON TRUSTEE 1.00 X 0 0 0 ANDREW ERICHSON ALTERNATE TRUSTEE 1.00 X 0 0 0 STEVEN SAUER SECRETARY 2.00 X 0 0 0 JASON ZINS TRUSTEE 1.00 X 0 0 0 NICK JOHNSON ALTERNATE TRUSTEE 1.00 X 0 0 0 MOLLY BARNES TRUSTEE - PAST 1.00 X 0 0 0 ZACHARY RADZAK CHAIRMAN 2.00 X 0 0 0 WAYNE PERLEBERG TRUSTEE - PAST 1.00 X 0 0 0 CHAD WARD TRUSTEE 2.00 X 0 0 0 SHANE BLOCK ALTERNATE TRUSTEE 1.00 X 0 0 0 RICH FREDERICK ALTERNATE TRUSTEE 1.00 X 0 0 0 JEFF DIEDE TRUSTEE 1.00 X 0 0 0 SCOTT KROONA TRUSTEE 1.00 X 0 0 0 JEFF OVESON ALTERNATE TRUSTEE 1.00 X 0 0 0 VIRGIL CHRISTOFFERSEN ALTERNATE TRUSTEE 1.00 X 0 0 0 JEFF ZAHN TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 ZENITH AMERICAN SOLUTIONS INC 2520 PILOT KNOB ROAD SUITE 325 MENDOTA HEIGHTS MN 55120 ADMINISTRATIVE, CLAIMS PROCESSING, AUDIT 397252 BLUELINK TPA 1200 YANKEE DOODLE ROAD PO BOX 6 ST PAUL MN 55164 PPO ACCESS FEES 353309 2 EMPLOYER CONTRIBUTIONS 900099 21293692 21293692 STOP-LOSS CONTRIBUTIONS 900099 796259 796259 PRESCRIPTION DRUG REBATES 900099 770249 770249 SELF PAY - EMPLOYEES 900099 343006 343006 SUBROGATION RECEIPTS 900099 16453 16453 23219659 367288 367288 1100000 1006176 93824 93824 93824 LIQUIDATED DAMAGES 900099 1289 1289 CREDIT CARD FEE CONTRIBUTIONS 900099 1283 1283 2572 23683343 23219659 0 463684 15928400 131981 77909 40109 15780 71000 40590 1202 3495 AFFORDABLE CARE ACT FEE 8773 GOVERNMENT COMPLIANCE 112 16319351 1821158 4045185 1922898 3123209 2007193 1728878 17374444 21163878 50236 805254 23175929 30866404 16573 12337 10762 11187 27335 23524 X 0 0 0 0 23148594 30842880 23148594 30842880 23175929 30866404 7363992 330294 0 X 0 1 X 1 0 0 X 23997857 330294 330294 23667563 15780 15780 23683343 16303571 0 16303571 15780 15780 16319351 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN TO EVALUATE TAX POSITIONS TAKEN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN UNCERTAIN TAX POSITIONS THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY TAX AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. FORM 990, PART VI, SECTION A, LINE 3 ALTHOUGH THE TRUSTEES RETAIN THE ULTIMATE RESPONSIBILITY, THE TRUSTEES HAVE DELEGATED THE DAY TO DAY ADMINISTRATIVE DUTIES TO ZENITH AMERICAN SOLUTIONS INC. AS THE THIRD PARTY ADMINISTRATOR OF THE PLAN. FORM 990, PART VI, SECTION A, LINE 7A THE PLAN IS ADMINISTERED BY FOUR EMPLOYER ASSOCIATION TRUSTEES AND FOUR UNION TRUSTEES. THE FOUR EMPLOYER ASSOCIATION TRUSTEES SHALL BE DESIGNATED BY THE EMPLOYER ASSOCIATION. THE FOUR UNION TRUSTEES SHALL BE DESIGNATED BY THE NEGOTIATING COMMITTEE. EIGHT ALTERNATE TRUSTEES ARE APPOINTED, FOUR FROM THE EMPLOYER ASSOCIATION AND FOUR FROM THE UNIONS. EACH TRUSTEE AND ALTERNATE TRUSTEE MAY BE REMOVED ONLY BY THE PARTY WHICH APPOINTED THEM. FORM 990, PART VI, SECTION A, LINE 8B THERE IS NO COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PROVIDED TO AND REVIEWED BY THE ENTIRE BOARD OF TRUSTEES BEFORE THE FORM 990 IS FILED. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO PARTICIPANTS AT THE OFFICE OF THE PLAN IN MENDOTA HEIGHTS, MN. MN TEAMSTERS CONSTRUCTION DIV PENSION FUND 2520 PILOT KNOB ROAD SUITE 325 MENDOTA HEIGHTS MN 55120 416187751 TO PROVIDE PENSION BENEFITS MN 401(A) 0 MN TEAMSTERS CONSTRUCTION DIV JATC FUND 2520 PILOT KNOB ROAD SUITE 325 MENDOTA HEIGHTS MN 55120 411676452 TO PROVIDE TRAINING FOR APPRENTICES MN 501(C)(9) 0 TEAMSTERS NATIONAL TRAINING CENTER CONTRIBUTING EMPLOYER 0 ABERCROMBIE PIPELINE SERVICE CONTRIBUTING EMPLOYER 0 AGGREGATE INDUSTRIES CONTRIBUTING EMPLOYER 0 ALLIED BLACKTOP CONTRIBUTING EMPLOYER 0 AMES CONSTRUCTION COMPANY CONTRIBUTING EMPLOYER 0 ANDERSON CONTRACTING INC CONTRIBUTING EMPLOYER 0 ARNT CONSTRUCTION COMPANY CONTRIBUTING EMPLOYER 0 ARROWHEAD CONCRETE WORKS INC CONTRIBUTING EMPLOYER 0 ASSOCIATED PIPELINE CONTRACTORS CONTRIBUTING EMPLOYER 0 ASPHALT PRESERVATION COMPANY CONTRIBUTING EMPLOYER 0 BELAIR EXCAVATING CONTRIBUTING EMPLOYER 0 BITUMINOUS ROADWAYS INC CONTRIBUTING EMPLOYER 0 BOLLIG & SONS CONTRIBUTING EMPLOYER 0 BROCK-WHITE CO CONTRIBUTING EMPLOYER 0 BRENNY-DAHL BLOCK 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