2022-10-25T10:06:10-05:00 2021-12-31 363168081 SIKICH LLP 13400 BISHOPS LANE SUITE 300 BROOKFIELD WI 53005 990 2021-01-01 391932533 PLUMBERS AND STEAMFITTERS LOCAL 400 AND MCA N CENTRAL WI HEALTH & WELFARE TRUST PLUM 9204620400 2700 NORTHRIDGE DRIVE PO BOX 530 KAUKAUNA WI 541300530 TREVOR MARTIN CHAIRMAN 9204620400 2022-10-24 1 TREVOR MARTIN 999009999 BRIDGETTE MUGGE P00671418 2627549400 2022-10-21 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z TREVOR MARTIN 2700 NORTHRIDGE DRIVE PO BOX 530 KAUKAUNA WI 541300530 44490837 0 X WWW.UA400.ORG X 1998 WI PROVIDE BENEFITS TO MEMBERS OF LOCAL 400 10 7 206 7 0 0 0 0 29437504 27510873 3623986 3854765 51889 50088 33113379 31415726 0 0 21891365 26019502 44718 70213 0 0 0 5138741 4786534 27074824 30876249 6038555 539477 76471205 75931064 935882 372289 75535323 75558775 PROVIDE BENEFITS TO MEMBERS OF LOCAL 400 0 0 PLUMBERS AND STEAMFITTERS LOCAL 400 HEALTH AND WELFARE PLAN PROVIDES MEDICAL, DENTAL, PRESCRIPTION DRUG, VISION AND OTHER BENEFITS TO APPROXIMATELY 2,100 PLAN PARTICIPANTS, THEIR DEPENDENTS AND BENEFICIARIES. 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 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 54 0 206 1 0 0 0 0 0 0 0 0 X 10 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X BENEFIT PLAN ADMINISTRATORS 4145773700 11270 WEST PARK PLACE SUITE 950 MILWAUKEE WI 53224 TREVOR MARTIN CHAIRMAN 1.00 45.00 X X 0 148965 96178 DUSTIN DELSMAN LABOR TRUSTEE 1.00 5.00 X 0 134042 86561 MIKE AUGUSTIAN LABOR TRUSTEE 1.00 45.00 X 0 0 0 JEFF GAECKE SECRETARY-TREASURER 1.00 X X 0 0 0 KIM BASSETT MANAGEMENT TRUSTEE 1.00 X 0 0 0 DAVID ALDAG MANAGEMENT TRUSTEE 1.00 X X 0 0 0 JODI MILLER-LARSON MANAGEMENT TRUSTEE 1.00 X 0 0 0 MARIA BLOCHOWIAK ALTERNATE MANAGEMENT TRUST 1.00 X 0 0 0 JOHN KENNEDY LABOR TRUSTEE 1.00 X 0 0 0 TERRY VAN EPERN ALTERNATE LABOR TRUSTEE 1.00 X 0 0 0 DAVID KLUMPP LABOR TRUSTEE 1.00 X 0 0 0 SCOTT WENGER ALTERNATE LABOR TRUSTEE 1.00 X 0 0 0 0 283007 182739 0 0 1 0 BENEFIT PLAN ADMINISTRATION 11270 W PARK PLACE SUITE 950 MILWAUKEE WI 53224 ADMINISTRATIVE SERVICES 1116189 UNITED HEALTHCARE INSURANCE COMPANY 9700 HEALTH CARE LANE MINNETONKA MN 55343 PPO NETWORK PROVIDER 811552 ELIXIR RX SOLUTIONS LLC 2181 EAST AURORA ROAD SUITE 201 TWINSBURG OH 44087 PHARMACEUTICALS 154509 UNITED MEDICAL RESOURCES 11 SCOTT ST WAUSAU WI 54403 INSURANCE 123802 REINHART BOERNER VAN DEUREN SC PO BOX 2965 MILWAUKEE WI 53201 LEGAL 118558 5 EMPLOYER CONTRIBUTIONS 900099 25667091 25667091 PARTICIPANT CONTRIBUTIONS 900099 1843782 1843782 27510873 1547684 1547684 15382192 13075111 2307081 2307081 2307081 OTHER REIMBURSEMENTS 900099 50088 50088 50088 31415726 27510873 0 3904853 26019502 70213 1019796 93734 52856 92207 28268 54261 17260 108846 MEDICARE PREMIUMS 1727696 PPO ADMIN FEES 897862 STOP LOSS PREMIUMS 270289 COST CONTAINMENT 220280 203179 30876249 2174117 1453482 607014 525953 3934030 3538999 112547 323312 69643497 70089318 76471205 75931064 369948 258261 565934 114028 935882 372289 X 0 0 0 0 75535323 75558775 75535323 75558775 76471205 75931064 539477 -516025 0 X 0 1 X 1 0 0 DUE TO OTHER PLANS 18043 PREPAID RETIREE PREMIUMS 95985 114028 X 30846845 -516025 -516025 31362870 52856 52856 31415726 30823393 0 30823393 52856 52856 30876249 PART X, LINE 2: THE TRUST ESTABLISHED TO HOLD THE PLAN'S ASSETS IS QUALIFIED PURSUANT TO SECTION 501(C)(9) OF THE IRC AND IS THEREFORE NOT SUBJECT TO TAX UNDER PRESENT INCOME TAX LAWS. THE PLAN HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER DATED APRIL 25, 2000 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. 0 0 0 TREVOR MARTIN CHAIRMAN 0 148965 0 0 0 0 0 68899 0 27279 0 245143 0 0 DUSTIN DELSMAN LABOR TRUSTEE 0 134042 0 0 0 0 0 62010 0 24551 0 220603 0 0 FORM 990, SCHEDULE J, PART I LINE 3 THE RELATED ORGANIZATION PLUMBERS AND STEAMFITTERS LOCAL 400 USES A WRITTEN EMPLOYMENT CONTRACT TO ESTABLISH THE OFFICER COMPENSATION. FORM 990, PART VI, SECTION A, LINE 6 THERE ARE APPROXIMATELY 2,000 MEMBERS OF LOCAL 400 THAT PARTICIPATE IN THE HEALTH AND WELFARE FUND. EACH MEMBER IS ALLOWED ONE VOTE. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF LOCAL 400 THAT PARTICIPATE IN THE HEALTH AND WELFARE FUND ELECT THE BOARD OF TRUSTEES FOR THE FUND. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE BOARD OF TRUSTEES ARE VOTED ON BY THE MEMBERS OF LOCAL 400 THAT PARTICIPATE IN THE HEALTH AND WELFARE FUND. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO THE RETURN BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THE OFFICERS AND DIRECTORS ARE REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST IMMEDIATELY UPON DISCOVERY. EACH PERSON HAS SIGNED AN AGREEMENT STATING THAT HE OR SHE WILL ACT IN ACCORDANCE WITH THE TRUST AGREEMENT. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTATION IS AVAILABLE UPON REQUEST. PLUMBERS AND STEAMFITTERS LOCAL 400 OF THE UNITED ASSOCIATION 2700 NORTHRIDGE DRIVE KAUKAUNA WI 54130 391915458 0 BOARD OF TRUSTEES OF THE PLUMBERS AND STEAMFITTERS LOCAL 400 HEALTH FUND 2700 NORTHRIDGE DRIVE PO BOX 530 KAUKAUNA WI 541300530 391932533 SPONSORING ORGANIZATION (JOINT BOARD OF TRUSTEES) WI 501(C)(9) 0 FOX RIVER VALLEY PIPE TRADES ED FOUNDATION WISCONSIN PIPE TRADES ASSOCIATION ILLINOIS PIPE TRADES MADISON AREA CONSTRUCTION TEXAS PIPE TRADES MEYER MECHANICAL LLC A & J MECHANICAL CONTRACTORS INC ACCESS CUSTOMER SUPPORT INC AG MECHANICAL ALDAG HONOLD MECHANICAL INC AUGUST WINTER & SONS INC AZCO INC B & P MECHANICAL INC BASSETT INC BENO PLUMBING & HEATING INC CH KOCH PLUMBING CLIMATE PROS INC COENEN MECHANICAL DAN FINNEL PLUMBING LLC DAY & ZIMMERMANN NPS INC EDWIN C GAROT COMPANY INC ENERGY CONTROL & DESIGN INC ENERPIPE INC FENNER PLUMBING & HEATING FORREST PLUMBING LLC GREAT LAKES MECHANICAL INC GROESCHEL COMPANY INC GRP MECHANICAL INC HAUCKE PLUMBING AND HEATING INC HEIM PLUMBING INC HOOPER CORPORATION HURCKMAN MECHANICAL INDUSTRIES INC HUSSMANN CORPORATION HVAC SERVICES INC ILLINGWORTH-KILGUST MECHANICAL INC JF AHERN COMPANY JAMAR COMPANY JOHN'S REFRIGERATION INC JOHNSON & JONET MECHANICAL CONTRACTORS INC JOHNSON CONTROLS INC KUHLMAN INC MANNENBACH MECHANICAL LLC MASTERS BUILDING SOLUTIONS INC MATENAER PLUMBING INC MECHANICAL TECHNOLOGIES INC MONONA PLUMBING & FIRE PROTECTION INC PIPING SERVICE INC PIPING SYSTEMS LLC PLESHEK'S AIR CONDITIONING & REFRIGERATION INC PLYMOUTH PLUMBING & HEATING INC PNEUMATIC SYSTEMS PLUS LLC R & R PLUMBING LLC RANGE LINE PLUMBING INC REEKE-MAROLD CO REFRIGERATION SERVICES OF GREEN BAY INC ROB GIESE CONSTRUCTION SERVICES INC SUMMIT REFRIGERATION GROUP INC TEAM INDUSTRIES INC TWEET-GAROT MECHANICAL INC VDH MECHANICAL SERVICES LLC WOLF & SONS PLUMBING LLC 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FORM 990, SCHEDULE R, PARTS II-IV IN 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, WHICH ARE LISTED BELOW. 1901 INC., ANDERSON HVAC LLC, BADGER BALANCING LLC, BHI ENERGY/ SPECIALTY SERVICES LLC, BIG MIKE'S PLUMBING LLC, BOLDT COMPANY (400), BUILDING TRADES PENSION FUND, CARRIER BUILDING SERVICES, CFM/VR TESCO, COLORADO PIPE INDUSTRY, COOK PLUMBING LLC, CR MEYER & SON, DULUTH BUILD TRADES #49, DULUTH BUILDING TRADES, EGI MECHANICAL, GARTMAN MECHANICAL SERVICE, HAYES COMMERCIAL, LLC, HJ PERTZBORN, HOOPER CORPORATION, HORNER PLUMBING, HOURS HOLIDAY CREDIT, LOCAL NO. 322, LOCAL NO. 572, MIRON CONSTRUCTION CO., INC., MJ ELECTRIC LLC, MMC CONTRACTORS INC, NATIONAL PENSION FUND, NAVMATIC INC, PEVCO SYSTEMS INTL INC, PIPE TRADES IND, PIPE TRADES INDUSTRY H&W, PIPE TRADES SERVICES MN, PIPEFITTERS LOCAL 597, PIPEFITTERS LOCAL NO. 120, PLBRS & PIPE LOCAL 172, PLBRS & PIPEFTRS LOC 136, PLUMBERS & PIPE 572, PLUMBERS & PIPEFTRS 131, PLUMBERS & PIPEFTRS 464, PLUMBERS & PIPEFTRS 589, PLUMBERS & STEAM 118, PLUMBERS LOCAL 137, PLUMBERS LOCAL 146, PLUMBERS LOCAL 177, PLUMBERS LOCAL 25, PLUMBERS LOCAL 290, PLUMBERS LOCAL 295, PLUMBERS LOCAL 322, PLUMBERS LOCAL 33, PLUMBERS LOCAL 353, PLUMBERS LOCAL 353/63, PLUMBERS LOCAL 357, PLUMBERS LOCAL 420, PLUMBERS LOCAL 434, PLUMBERS LOCAL 449, PLUMBERS LOCAL 452, PLUMBERS LOCAL 520, PLUMBERS LOCAL 562, PLUMBERS LOCAL 597, PLUMBERS LOCAL 598, PLUMBERS LOCAL 630, PLUMBERS LOCAL 72, PLUMBERS LOCAL 75, PLUMBERS LOCAL 85, PLUMBERS LOCAL UNION 716, PLUMBRS&STEAMFTS LOCAL 10, RIVERVIEW PLUMBING INC., RJ PARINS PLUMBING & HTG, S & S MECHANICAL, SABEL INDUSTRIAL LLC, SCHROEDER-DAVIS PLUMBING, INC, SONNTAG PLUMBING INC, STRAIGHT LINE REFRIGERATION, LLC, TECHVISIONS & SOLUTIONS LLC, TRANE TECHNOLOGIES, U A LOCAL NO 23, ON LOCAL 118, ION LOCAL 150, UNION LOCAL 524, UPPER PENINSULA PLUMBERS, VALLEY MECHANICAL, INC, VETERANS PLUMBING LLC, WASHINGTON STATE PLBG, WISCONSIN MECHANICAL SOLUTIONS, WOOLSEY PLUMBING & HEATIN, ZENTNER & SONS