2022-10-18T08:19:01-05:00 2021-12-31 510435869 Needles & Associates LLC 350 Interlocken Blvd STE 360 Broomfield CO 80021 990 2021-01-01 746075997 Gulf Coast Carpenters and Millwrights Health Plan GULF 8008314914 2001 Caldwell Drive Goodlettsville TN 37072 Jason Engels Chairman 4056822323 2022-10-14 1 Jason Engels 999009999 Kurt D Needles CPA P00850236 3034304225 2022-10-18 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z Jason Engels 2001 Caldwell Drive Goodlettsville TN 37072 58095544 0 X N/A X 2019 TN To provide medical benefits for eligible members and their dependents. 16 0 0 0 0 0 0 0 28464278 32466238 3924419 1291851 129332 22445 32518029 33780534 0 0 23950789 24736103 0 0 0 0 0 3361768 3053489 27312557 27789592 5205472 5990942 59944024 68909377 15287241 15049479 44656783 53859898 To provide medical benefits for eligible members and their dependents. 0 0 To provide medical benefits for eligible members and their dependents. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 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 59 0 1 0 0 0 0 0 0 0 0 0 0 0 X 16 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X BOARD OF TRUSTEES 8008314914 2001 Caldwell Drive Goodlettsville TN 37072 X Jason Engels Chairman- Union Trustee 1.00 X 0 0 0 David Bonds Union Trustee 1.00 X 0 0 0 Sean Forkner Union Trustee 1.00 X 0 0 0 John Roberts Union Trustee 1.00 X 0 0 0 Kavin Griffin Union Trustee 1.00 X 0 0 0 Mike Hines Union Trustee 1.00 X 0 0 0 Wayne Jennings Trustee 1.00 X 0 0 0 James Rowland Union Trustee 1.00 X 0 0 0 Mike O'Connor Secretary- Employer Truste 1.00 X 0 0 0 Harold Baur III Employer Trustee 1.00 X 0 0 0 Bill Grimm Employer Trustee 1.00 X 0 0 0 Kerry Fisher Employer Trustee 1.00 X 0 0 0 Paul Oliver Employer Trustee 1.00 X 0 0 0 Bill Warren Employer Trustee 1.00 X 0 0 0 John Hanks Employer Trustee 1.00 X 0 0 0 Richard Travis Employer Trustee 1.00 X 0 0 0 0 0 0 0 0 0 0 Blue Cross Blue Shield South 1000 Houston TX 77027 Access and Admin Fees 1255048 Southern Benefit Administrators Inc 2001 Caldwell Dr Goodlettsville TN 37072 Administration 456000 Disa 10900 Corporate Centre Dr 250 Houston TX 77041 Drug Testing 280128 Zenith American Solutions 100 Crescent Center Pkwy Ste 340 Tucker GA 30084 Administration 239860 Youngdahl Law Firm 4302 Montrose Blvd Suite 280 Houston TX 77006 Legal Services 118128 5 Employer Contributions 525100 29017309 29017309 Reciprocity In 525100 3096366 3096366 Participant Contributions 525100 352563 352563 32466238 883103 883103 24723758 24315010 408748 408748 408748 22445 22445 22445 33780534 32488683 0 1291851 24736103 678517 125255 83043 84652 1854245 143145 2698 29312 TWIC 19011 PCORI fee 18971 Basic-Plus 13661 979 27789592 1443074 10405007 5224247 236260 3005344 3490534 47759488 51457652 2511871 3319924 59944024 68909377 1488511 1081147 13798730 13968332 15287241 15049479 X 44656783 53859898 44656783 53859898 59944024 68909377 5990942 3212173 0 X X 0 1 X 1 0 0 CIBNR 3788300 Hour Bank Liability 10180032 13968332 X 36992707 3212173 3212173 33780534 0 33780534 27619990 0 27619990 169602 169602 27789592 Part X, Line 2: The trust funding benefits of the Plan received an exemption letter from the Internal Revenue Service stating that the trust is tax-exempt under the provision of Section 501(c)9 of the Internal Revenue Code. The Plan and the trust are required to operate in conformity with the Internal Revenue Code to maintain the tax-exempt status of the trust. Plan management believes That the Plan is being operated in compliance with the applicable requirements of the Internal Revenue Code. Accounting principles generally accepted in the United States of America require Plan management to evaluate tax positions taken by the Plan and recognize a tax liability (or asset) if it has taken an uncertain position that more likely than not would not be sustained upon examination by the Internal Revenue Service. Plan management has evaluated the Plan's tax positions and concluded that the Plan has taken no uncertain tax positions that would requir financial statement recognition or disclosure for the years ended December 31, 2021 and 2020. The Plan is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. With few exceptions, the Plan is no longer subject to tax examinations by tax authorities for years preceding December 31, 2017. Part XII, Line 4b - Other Adjustments: Change in benefit obligations 169,602. Form 990, Part VI, Section B, line 11b TO PROVIDE MEDICAL BENEFITS FOR ELIGIBLE MEMBERS AND THEIR DEPENDENTS Form 990, Part VI, Section B, line 12c During Board of Trustee meetings, Trustees discuss and enforce compliance with the conflict of interest policy. Form 990, Part VI, Section C, line 18 Form 990 is available for public inspection upon request. Form 990, Part VI, Section C, line 19 Governing documents are available to the public upon request. Form 990, Part XII, Line 2c: No change from prior year. Contact fund administrator for info needed for Sch R Part III NA OK 73108 OK Contact fund administrator for info needed for Sch R Part III NA OK 73108 OK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0