2022-11-15T15:17:47-06:00 2021-12-31 430765316 RUBINBROWN LLP 1200 MAIN STREET SUITE 1000 KANSAS CITY MO 64105 990 2021-01-01 440568755 CONSTRUCTION INDUSTRY LABORERS WELFARE FUND CONS 8167563313 12200 N AMBASSADOR DRIVE 400 KANSAS CITY MO 64163 JIM FITZGERALD SECRETARY 8167563313 2022-11-15 1 JIM FITZGERALD 999009999 MATTHEW C HALL P01573021 8164721122 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z JIM FITZGERALD 12200 N AMBASSADOR DRIVE 400 KANSAS CITY MO 64163 67247061 0 X N/A X 1952 MO PROVIDE HEALTH & WELFARE BENEFITS 15 15 0 15 0 0 0 0 54683028 55134059 3153399 3031903 1892710 2731381 59729137 60897343 0 0 52667747 56642425 0 0 0 0 0 5942165 5841262 58609912 62483687 1119225 -1586344 151896140 159375234 953038 2561810 150943102 156813424 PROVIDE HEALTH & WELFARE BENEFITS 0 0 THE FUND PROVIDES HEALTH AND WELFARE BENEFITS FOR APPROXIMATELY 5750 COVERED PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1045 0 0 0 0 0 0 0 0 0 0 X 15 15 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 X WILSON MCSHANE CORPORATION 8167563313 12200 N AMBASSADOR DRIVE SUITE 400 KANSAS CITY MO 64162 X X TRENT ELY TRUSTEE 0.00 X 0 0 0 GABRIEL T JONES TRUSTEE 0.00 X 0 0 0 JASON P MENDENHALL CHAIRMAN 0.00 X X 0 0 0 PATRICK P PRYOR TRUSTEE 0.00 X 0 0 0 BILL TILLMAN TRUSTEE 0.00 X 0 0 0 MITCHELL ROWLEY TRUSTEE 0.00 X 0 0 0 BRAD TURNER TRUSTEE 0.00 X 0 0 0 BRYON HORNUNG TRUSTEE 0.00 X 0 0 0 DAVID KAESTNER TRUSTEE 0.00 X 0 0 0 JIM FITZGERALD SECRETARY 0.00 X X 0 0 0 DEXTER PHILLIPS TRUSTEE 0.00 X 0 0 0 JOE GARRISON TRUSTEE 0.00 X 0 0 0 WYATT PHILLIPS TRUSTEE 0.00 X 0 0 0 PAUL IDEKER TRUSTEE 0.00 X 0 0 0 NATE ROSE TRUSTEE 0.00 X 0 0 0 0 0 0 0 0 0 0 BLUE CROSS BLUE SHIELD PO BOX 219454 KANSAS CITY MO 64121 ADMINISTRATIVE SERVICES 2303607 WILSON-MCSHANE CORPORATION 12200 N AMBASSADOR DRIVE SUITE 40 KANSAS CITY MO 64163 ADMINISTRATIVE SERVICES 892406 ARNOLD NEWBOLD SOLLARS & HOLLINS 1100 MAIN STREET SUITE 2001 KANSAS CITY MO 64105 LEGAL SERVICES 280923 3 EMPLOYER CONTRIBUTIONS 900099 50504014 50504014 PARTICIPANT CONTIBUTIONS 900099 4630045 4630045 55134059 2826494 2826494 6555127 6349718 205409 205409 205409 REBATE INCOME 900099 1606132 1606132 STOP LOSS REIMBURSEMENT 900099 1057489 1057489 LIQUIDATED DAMAGES 900099 53564 53564 14196 14196 2731381 60897343 57865440 0 3031903 56642425 56642425 769200 769200 280923 280923 141100 141100 327124 327124 2921569 2921569 38285 38285 3225 3225 39590 39590 STOP LOSS PREMIUMS 1291433 1291433 PCORI FEES 27185 27185 DUES AND SUBSCRIPTIONS 1520 1520 BANK SERVICE FEES 108 108 62483687 62483687 0 0 7415311 6841099 6355793 6891237 68398 103248 41548 41548 71772810 77585346 66017546 67688180 224734 224576 151896140 159375234 422458 1084174 526016 1448270 4564 29366 953038 2561810 X 0 0 0 0 150943102 156813424 150943102 156813424 151896140 159375234 -1586344 7456666 0 X 0 1 X 1 0 0 1 X 0 BAIRD CORE PLUS 35592664 F ULLICO W-1 ACCOUNT 14551964 F NEUBERGER BERMAN US EQUITY INDEX 3413649 F PARAMETRIC DEFENSIVE EQUITY 3398295 F PACIFIC ASSET MGMT LOAN FD 7355709 F HARDING LOEVNER FD 3375899 F 67688180 68354009 7456666 7456666 60897343 0 60897343 62483687 0 62483687 0 62483687 PART IV, LINE 2B: CONTRIBUTIONS ARE DEPOSITED INTO A CLEARING ACCOUNT TO BE SPREAD TO SEVERAL DIFFERENT FUNDS AND LOCALS. THIS AMOUNT REPRESENTS MONIES DUE TO THOSE FUNDS AND LOCALS. SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 20953 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 15526 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 10615 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 8022 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 6611 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 4767 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 4228 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 3364 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 2698 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 2656 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 2488 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 2480 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 2274 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 2109 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 1839 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 1793 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 1530 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 1504 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 1263 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 819 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 797 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 765 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 725 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 679 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 637 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 368 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 286 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 236 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 190 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 184 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 121 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 103 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 100 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 94 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 89 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 57 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 56 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 55 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 46 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 32 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 30 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 28 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 18 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 9 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTOR EMPLOYER CONTRIBUTION UNPAID AT YEAR END X 4 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTION OVERPAID AT YEAR END X 14 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTION OVERPAID AT YEAR END X 71 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTION OVERPAID AT YEAR END X 99 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTION OVERPAID AT YEAR END X 170 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTION OVERPAID AT YEAR END X 213 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTION OVERPAID AT YEAR END X 340 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTION OVERPAID AT YEAR END X 765 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTION OVERPAID AT YEAR END X 785 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTION OVERPAID AT YEAR END X 1026 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTION OVERPAID AT YEAR END X 1207 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTION OVERPAID AT YEAR END X 1701 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTION OVERPAID AT YEAR END X 3577 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTION OVERPAID AT YEAR END X 4669 0 0 0 SUBSTANTIAL CONTRIBUTOR EMPLOYER CONTRIBUTION OVERPAID AT YEAR END X 14729 0 0 0 132614 FORM 990, PART VI, SECTION A, LINE 3 THE FUND IS CONTRACTED WITH WILSON-MCSHANE, A TPA, WHO PAYS CLAIMS AND HANDLES THE DAY TO DAY OPERATION OF THE FUND. FORM 990, PART VI, SECTION B, LINE 11B COPIES OF FORM 990 ARE PROVIDED TO THE CHAIRMAN AND SECRETARY FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY AT A BOARD MEETING. FORM 990, PART VI, SECTION C, LINE 19 NO DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC. FORM 990, PART VII COMPENSATION OF TRUSTEES CONSTRUCTION INDUSTRY LABORERS WELFARE FUND DOES NOT COMPENSATE TRUSTEES. COMPENSATION PAID BY RELATED TAX-EXEMPT ORGANIZATIONS TO TRUSTEES IS REPORTED TO THE INTERNAL REVENUE SERVICE ON FORMS 990 FOR THE FOLLOWING ORGANIZATIONS: MISSOURI AND KANSAS LABORERS DISTRICT COUNCIL EIN: 43-0630984 JASON P. MENDENHALL MITCHELL ROWLEY PATRICK P. PRYOR TRENT ELY BRAD TURNER LABORERS INTERNATIONAL UNION OF 663 HCL EIN: 44-0412225 GABRIEL T. JONES JASON P. MENDENHALL LABORERS INTERNATIONAL UNION OF 660 LOCAL UNION EIN: 43-0522027 NATE ROSE PATRICK P. PRYOR LABORERS UNION LOCAL 1290 EIN: 48-0287794 MITCHELL ROWLEY BILL TILLMAN CONSTRUCTION INDUSTRY LABORERS PENSION FUND 12200 N AMBASSADOR DRIVE SUITE 400 KANSAS CITY MO 641631244 436060737 EMPLOYEE BENEFITS MO 401 (A) 0 LABORERS LOCAL 1104 LABORERS LOCAL 1290 LABORERS LOCAL 130 LABORERS LOCAL 579 LABORERS LOCAL 660 LABORERS LOCAL 662 LABORERS LOCAL 663 LABORERS LOCAL 840 LABORERS LOCAL 955 MISSOURI AND KANSAS LAB DIS CO AMCON MUNICIPAL CONCRETE LLC ARMSTRONG SUPPLY LLC ARNOLD MASONRY LLC B & W CONCRETE LLC BALLMAN EARTHWORKS LLC BILL THAXTON CONSTRUCTION LLC BLM PROPERTIES LLC BREIT CONSTRUCTION LLC BRK CONSTRUCTION LLC BROCK INDUSTRIAL SERVICES LLC BSE EXCAVATION LLC BUILDEX LLC BUILDTEC CONSTRUCTION LLC BURNS MECHANICAL LLC CARTER-WATERS LLC CASTLE CONTRACTING LLC CECO CONCRETE CONST LLC CHAMBERS EXCAVATING LLC CJ INDUSTRIES LLC COFFEL CONSTRUCTION LLC CONCRETE CONSTRUCTION LLC CON-TECH FOUNDATIONS LLC CONTEGRA CONSTRUCTION CO LLC COWLING-GARBO CONCRETE LLC D & M FLATWORK LLC 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