2022-10-05T13:00:52-05:00 2019-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUT SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2019-01-01 366090694 BOILERMAKERS NATIONAL HEALTH & WELFARE FUND BOIL 9139067517 12200 N AMBASSADOR DRIVE NO 326 KANSAS CITY MO 64163 LORI JASPERSON CHIEF EXECUTIVE OFFICER 9139067517 2022-10-05 1 DOUG BERTOSSI P00637990 6123764500 2021-12-13 2019 2022-09-23 18:48:47Z X LORI JASPERSON 12200 N AMBASSADOR DRIVE NO 326 KANSAS CITY MO 64163 1341875411 0 X WWW.BNF-KC.COM X 1954 KS TO PROVIDE HEALTH AND WELFARE BENEFITS 15 15 0 0 0 0 0 0 242675607 230555638 23933309 41698901 19223 2902 266628139 272257441 0 0 233374017 218975532 1072382 1373969 0 0 0 7653094 8226489 242099493 228575990 24528646 43681451 995685760 1149045769 49074224 78169668 946611536 1070876101 TO PROVIDE HEALTH AND WELFARE BENEFITS 0 0 PROVIDE HEALTH AND WELFARE BENEFITS FOR 17,022 PARTICIPANTS AND THEIR DEPENDENTS 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 14 0 1 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X TONYA PAVELAC-WALKER 9139067497 12200 N AMBASSADOR DRIVE SUITE 326 KANSAS CITY MO 64163 X LORI JASPERSON CHIEF OPERATIONS OFFICER 23.30 46.70 X 109048 207420 117915 MARIO RODRIQUEZ CHIEF INVESTMENT OFFICER 10.00 40.00 X 63564 234315 84607 RONNIE TRAXLER MANAGEMENT TRUSTEE - CHAIR 1.88 40.00 X X 0 0 0 JOHN FULTZ SEE SCHEDULE O 0.65 40.00 X X 0 0 0 PATRICK GALLAGHER SEE SCHEDULE O 1.58 40.00 X X 0 0 0 SHELDON TRAXLER MANAGEMENT TRUSTEE 1.23 40.00 X X 0 0 0 J MICHAEL CARROLL MANAGEMENT TRUSTEE 2.04 40.00 X 0 0 0 JOSEPH REYNOLDS MANAGEMENT TRUSTEE 0.73 40.00 X 0 0 0 NELSON JORDAN MANAGEMENT TRUSTEE-VICE 0.77 40.00 X 0 0 0 MARK KEFFELER SEE SCHEDULE O 0.31 40.00 X 0 0 0 CLAY HERFORD SEE SCHEDULE O 0.31 40.00 X 0 0 0 MICHAEL WEST SEE SCHEDULE O 0.31 40.00 X 0 0 0 WILLIAM MULCONNERY SEE SCHEDULE O 1.85 40.00 X 0 0 0 CHRISTOPHER O'NEILL SEE SCHEDULE O 2.04 40.00 X 0 0 0 ANTHONY HOWELL SEE SCHEDULE O 1.38 40.00 X 0 0 0 CRAIG BELFATTO MANAGEMENT TRUSTEE 0.31 40.00 X 0 0 0 172612 441735 202522 1 0 1 0 CIGNA HEALTH AND LIFE INSURANCE COMPANY 900 COTTAGE GROVE RD BLOOMFIELD C BLOOMFIELD CT 06002 ADMINISTRATIVE SERVICES 8021732 WILSON-MCSHANE CORPORATION 754 MINNESOTA AVE KANSAS CITY KS 66101 MANAGEMENT SERVICES 2297461 INVESCO CORE REAL ESTATE 1101 CALIFORNIA ST SUITE 475 KANSAS CITY KS 66101 INVESTMENT MANAGER 725718 EXPRESS SCRIPTS PO BOX 52150 PHOENIX AZ 85072 ADMINISTRATIVE SERVICES 615204 NATIONAL INVESTMENT SERVICES 777 E WISCONSIN AVE SUITE 2350 MILWAUKEE WI 53202 INVESTMENT MANAGER 584988 18 EMPLOYER CONTRIBUTIONS 525100 174540056 174540056 EMPLOYEE CONTRIBUTIONS 525100 45332342 45332342 PRESCRIPTION REBATES 525100 10485849 10485849 DELINQUENT EMPLOYER IN 525100 176589 176589 MEDICARE SUBSIDY 525100 20802 20802 230555638 22505313 22505313 1088811558 1069617970 19193588 19193588 19193588 MISCELLANEOUS INCOME 525100 2902 2902 2902 272257441 230555638 0 41701803 218975532 172612 620131 278449 243330 59447 1864300 290495 377649 4866324 273780 229172 58240 55105 76845 49694 84770 JOINT COMMITTEE ON ADMI 115 228575990 244894 1799590 57820306 74539628 11649087 9488973 741913 613027 47267 38883 346902896 437764286 569837365 607481112 8442032 17320271 995685760 1149045769 1119774 1227524 5536998 5599575 42417452 71342569 49074224 78169668 X 0 0 0 0 946611536 1070876101 946611536 1070876101 995685760 1149045769 43681451 80583114 0 X 0 1 X 1 0 0 LIMITED PARTNERSHIPS 170826309 F LIMITED LIABILITY COMPANIES 178617544 F 103-12 INVESTMENT ENTITIES 102232997 F COMMON COLLECTIVE TRUST 128628965 F CAYMAN ISLANDS EXEMPTED COMPANIES 27175297 F 607481112 DUE TO RELATED ORGANIZATION 121152 LIABILITY FOR SECURITIES ON LOAN 54447391 DUE TO BROKER 16774026 71342569 X 347974232 80583115 80583115 267391117 4866324 4866324 272257441 223709667 0 223709667 4866324 4866324 228575991 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE FUND TO HOLD THE FUND'S ASSETS IS INTENDED TO QUALIFY PURSUANT TO SECTION 501(C)(9) UNDER THE INTERNAL REVENUE CODE (IRC) AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE TRUST OBTAINED ITS LATEST TAX EXEMPTION LETTER, DATED OCTOBER 27, 1977, IN WHICH THE INTERNAL REVENUE SERVICE STATED THAT THE TRUST, AS THEN DESIGNED, WAS IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THE TRUST HAS BEEN AMENDED SINCE RECEIVING THE TAX EXEMPTION LETTER. HOWEVER, THE PLAN ADMINISTRATOR AND THE PLAN'S COUNSEL BELIEVE THAT THE TRUST IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THEREFORE, THEY BELIEVE THAT THE TRUST WAS QUALIFIED AND THE RELATED TRUST WAS TAX EXEMPT AS OF THE FINANCIAL STATEMENT DATE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE THE TAX POSITIONS TAKEN BY THE PLAN AND TO RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENT IN CAYMAN ISLAND EXEMPTED COMPANIES 27175297 0 0 0 0 0 0 27175297 0 27175297 0 0 0 0 0 0 PART III ACCOUNTING METHOD: 0 0 0 LORI JASPERSON CHIEF OPERATIONS OFFICER 99609 193358 0 0 9439 14062 37294 72395 2797 5429 149139 285244 0 0 MARIO RODRIQUEZ CHIEF INVESTMENT OFFICER 59020 209253 0 0 4544 25062 16804 59577 1810 6416 82178 300308 0 0 PART I, LINE 3 THE RELATED ORGANIZATION USED THE FOLLOWING METHODS TO DETERMINE COMPENSATION: WRITTEN EMPLOYMENT CONTRACT AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 3085 3085 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 619 619 1 1 1 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 27618 27618 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 85133 85133 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 8645 8645 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 45501 45501 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 26018 26018 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 119416 119416 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 24442 24442 1 1 1 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 13560 13560 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 3368 3368 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 1573 1573 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 8896 8896 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 245153 245153 0 1 1 613027 FORM 990, PART VI, SECTION A, LINE 7A THE BOARD IS APPOINTED BY THE BARGAINING ORGANIZATIONS, 50% BY THE EMPLOYERS AND 50% BY THE UNION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE ORGANIZATION'S PUBLIC ACCOUNTING FIRM BASED ON INFORMATION PROVIDED BY MANAGEMENT. ONCE THE RETURN IS AVAILABLE, IT IS PROVIDED TO MANAGEMENT FOR REVIEW BEFORE BEING PROVIDED TO THE GOVERNING BODY FOR REVIEW BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION DOES REQUIRE ANNUAL DISCLOSURES FOR POTENTIAL CONFLICTS OF INTEREST OF ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST, WHICH ARE REVIEWED BY THE ORGANIZATION. THE AFFECTED TRUSTEE OR EMPLOYEE MUST CEASE PARTICIPATION IN THE DECISION OR TRANSACTION UNTIL IT IS DETERMINED THAT THE AFFECTED TRUSTEE OR EMPLOYEE MAY CONTINUE TO PARTICIPATE IN THE DECISION OR TRANSACTION. POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE ALSO REVIEWED FOR COMPLIANCE WITH ERISA REQUIREMENTS. THE ORGANIZATION DOES REQUIRE FULL DISCLOSURE FOR POTENTIAL CONFLICTS OF INTEREST WHEN CONDUCTING SEARCHES FOR NEW VENDORS AND SERVICE PROVIDERS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. THE PLAN AND TRUST DOCUMENTS AND SUMMARY ANNUAL REPORT ARE ON THE WEBSITE AND AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A THE FOLLOWING TRUSTEES ARE COMPENSATED BY A NON-PROFIT RELATED ORGANIZATION AND COMPENSATION INFORMATION WILL BE MADE AVAILABLE UPON REQUEST. JOHN T. FULTZ, UNION TRUSTEE - SECRETARY PATRICK M. GALLAGHER, UNION TRUSTEE - ASST. SECRETARY MARK KEFFELER, UNION TRUSTEE CLAY HERFORD, UNION TRUSTEE MICHAEL WEST, UNION TRUSTEE WILLIAM MULCONNERY, UNION TRUSTEE CHRISTOPHER O'NEILL, UNION TRUSTEE ANTHONY HOWELL, UNION TRUSTEE 2019 FORM 990, AMENDED RETURN EXPLANATION THIS AMENDMENT IS BEING PREPARED TO ADD SCHEDULE F THAT WAS NOT ORIGINALLY FILED AND HAS BEEN ADDED AND COMPLETED ON THE AMENDED RETURN. ALSO, PART IV, LINE 14B WAS CHANGED FROM NO TO YES. BOILERMAKERS LOCAL 1 SOUTHEAST DISTRICT LODGE 3 BOILERMAKERS L 4 NAVAJO NATION BOILERMAKERS LOCAL 5 BOILERMAKERS LOCAL 11 BOILERMAKERS LOCAL 13 BOILERMAKERS LOCAL 26 BOILERMAKERS LOCAL 27 BOILERMAKERS LOCAL 28 BOILERMAKERS LOCAL 29 BOILERMAKERS LOCAL 40 BOILERMAKERS LOCAL 45 BOILERMAKERS DISTRICT 57 BOILERMAKERS LOCAL 60 BOILERMAKERS LOCAL 83 BOILERMAKERS LOCAL 85 BOILERMAKERS LOCAL 92 BOILERMAKERS LOCAL 101 BOILERMAKERS LOCAL 105 BOILERMAKERS LOCAL 107 BOILERMAKERS LOCAL 108 BOILERMAKERS LOCAL 154 BOILERMAKERS LOCAL 169 BOILERMAKERS LOCAL 237 BOILERMAKERS LOCAL 242 BOILERMAKERS LOCAL 363 BOILERMAKERS LOCAL 374 BOILERMAKERS LOCAL 433 BOILERMAKER LOCAL 455 BOILERMAKERS LOCAL 456 BOILERMAKERS LOCAL 502 BOILERMAKERS LOCAL 549 BOILERMAKERS LOCAL 627 BOILERMAKERS LOCAL 647 BOILERMAKERS LOCAL 667 BOILERMAKERS LOCAL 693 BOILERMAKERS LOCAL 744 LOCAL 1 T&E FUND LOCAL 107 DEVELOP & TRAINING WESTERN STATES JAC BM L 549 APPR & TRAIN FUND L374 DEVELOP AND TRAINING FUND LOCAL 85 JOINT TRAINING & 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