2021-11-10T10:20:38-06:00 2020-12-31 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2020-01-01 396069788 NORTH CENTRAL STATES REGIONAL COUNCIL OF CARPENTERS' HEALTH FUND NORT 7158353174 PO BOX 4002 EAU CLAIRE WI 54702 BURT JOHNSON CHAIRMAN 7158353174 2021-11-03 1 BURT JOHNSON 999009999 DOUGLAS BERTOSSI P00637990 6123764500 2021-11-02 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z BURT JOHNSON PO BOX 4002 EAU CLAIRE WI 54702 125374127 0 X WWW.NCSCBF.COM X 1963 WI TO PROVIDE HEALTH AND WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 18 1 0 18 0 0 0 0 71193666 69720691 5147710 5584858 50734 7924 76392110 75313473 0 0 78856009 74857968 711249 803908 0 0 0 1873915 1814269 81441173 77476145 -5049063 -2162672 187206552 192578987 27444012 25873073 159762540 166705914 TO PROVIDE HEALTH AND WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 0 0 PROVIDE SELF FUNDED BENEFITS FOR APPROXIMATELY 5,584 UNION MEMBERS AND THEIR DEPENDENTS. TO PAY FOR INSURANCE PREMIUMS FOR TRANSPLANT COVERAGE FOR MEMBERS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 270 0 1 0 1 0 0 0 0 0 0 0 0 X 18 1 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X NICOLE FALKNER 7158353174 PO BOX 4002 EAU CLAIRE WI 54702 JOHN RAINES TRUSTEE 1.00 40.00 X 0 303533 148095 JERRY SHEA TRUSTEE 1.00 40.00 X 0 0 0 SID SAMUELS TRUSTEE 1.00 40.00 X 0 0 0 JEFF MCLEAN TRUSTEE 1.00 40.00 X 0 0 0 F WILLIAM HARVAT TRUSTEE 1.00 0.00 X 0 0 0 BRAD DEPREZ TRUSTEE 1.00 40.00 X 0 0 0 ERIC BALLWEG TRUSTEE 1.00 40.00 X 0 0 0 DAVE SMESTAD TRUSTEE 1.00 40.00 X 0 0 0 SCOTT WATSON TRUSTEE 1.00 40.00 X 0 131469 86673 MICHAEL ADAMAVICH TRUSTEE 1.00 40.00 X 0 132044 86343 PAT RODRIGUEZ TRUSTEE 1.00 40.00 X 0 146940 92112 CHRIS HILL TRUSTEE 1.00 40.00 X 0 155169 104710 WAYNE NORDIN TRUSTEE 1.00 40.00 X 0 158051 99138 COREY BIALCIK TRUSTEE 1.00 40.00 X 0 159189 94911 BURT JOHNSON TRUSTEE, CHAIRMAN 1.00 40.00 X X 0 190829 113625 BOB BARKER TRUSTEE, SECRETARY/TREASURER 1.00 40.00 X X 0 243651 39859 CHUCK SPOEHR TRUSTEE 1.00 40.00 X 0 129532 87543 SEAN CULLEN TRUSTEE 1.00 40.00 X 0 0 0 NICOLE FALKNER ADMINISTRATIVE MANAGER 16.00 29.00 X 0 112162 41129 0 1862569 994138 0 0 1 0 ANTHEM BLUECROSS BLUESHIELD PO BOX 951254 CLEVELAND OH 44193 CLAIMS PROCESSING 1801752 CASE MANAGEMENT SPECIALISTS 553 S INDUSTRIAL DR HARTLAND WI 53209 CONTRACTED MEDICAL CONSULTANT 450322 EXPRESS SCRIPTS 4600 NORTH HANLEY ROAD ST LOUIS MO 63134 CLAIMS PROCESSING 225994 DELTA DENTAL 2801 HOOVER ROAD PO BOX 828 STEVENS POINT WI 54481 CLAIMS PROCESSING 213249 THE PREVIANT LAW FIRM SC 310 W WISCONSIN AVE STE 100 MW MILWAUKEE WI 53212 LEGAL COUNSEL 152639 7 EMPLOYER CONTRIBUTIONS 525100 61271507 61271507 EMPLOYEE CONTRIBUTIONS 525100 8449184 8449184 69720691 3438860 3438860 52206652 50060654 2145998 2145998 2145998 MISCELLANEOUS 525100 7924 7924 7924 75313473 69720691 0 5592782 74857968 153290 344437 137777 133706 34698 227756 37500 215298 730466 178115 6074 69210 197 9629 30180 40540 EDP MAINT./EDUCATION 159387 MISC EXPENSES 62937 PCORI FEE 28014 BANK CHARGES 10927 8039 77476145 4071651 2515856 5200671 5243306 11329 7994 508715 30396 27268 27268 0 0 122789013 125175086 51682682 58022521 2942491 1583828 187206552 192578987 330711 377748 27113301 25495325 27444012 25873073 X 0 0 0 0 159762540 166705914 159762540 166705914 187206552 192578987 -2162672 9106046 0 X 0 1 X 1 0 27268 27268 0 0 INVESCO INSTITUTIONAL TRUST 19636151 F NTGI DAILY ALL COUNTRY 38386370 F 58022521 DUE TO BROKERS FOR SECURITIES LENDING 25495325 25495325 X 84204221 9106046 9106046 75098175 215298 215298 75313473 77260847 0 77260847 215298 215298 77476145 PART X, LINE 2: THE VEBA TRUST FUNDING CERTAIN BENEFITS OF THE FUND RECEIVED AN EXEMPTION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS) DATED JULY 24, 1964, STATING THAT THE TRUST IS TAX-EXEMPT UNDER THE PROVISIONS OF SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE (IRC). HOWEVER, AS A RESULT OF THE FUND'S FUNDING POLICY, FROM TIME TO TIME THE TRUST MAY BE SUBJECT TO INCOME TAXES. NO FEDERAL OR STATE INCOME TAXES HAVE BEEN RECORDED IN 2020 AND 2019 FOR UNRELATED BUSINESS TAXABLE INCOME. IN ADDITION, THE FUND AND TRUST ARE REQUIRED TO OPERATE IN CONFORMITY WITH THE IRC TO MAINTAIN THE TAX-EXEMPT STATUS OF THE TRUST. THE FUND ADMINISTRATOR BELIEVES THAT THE FUND IS BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC AND, THEREFORE, BELIEVES THAT THE RELATED TRUST IS TAX-EXEMPT. 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 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 JOHN RAINES TRUSTEE 0 290283 0 0 0 13250 0 119380 0 28715 0 451628 0 0 BURT JOHNSON TRUSTEE, CHAIRMAN 0 177579 0 0 0 13250 0 87303 0 26322 0 304454 0 0 BOB BARKER TRUSTEE, SECRETARY/TREASURER 0 242022 0 0 0 1629 0 22104 0 17755 0 283510 0 0 CHRIS HILL TRUSTEE 0 141919 0 0 0 13250 0 78388 0 26322 0 259879 0 0 WAYNE NORDIN TRUSTEE 0 144801 0 0 0 13250 0 75208 0 23930 0 257189 0 0 COREY BIALCIK TRUSTEE 0 145939 0 0 0 13250 0 70765 0 24146 0 254100 0 0 PAT RODRIGUEZ TRUSTEE 0 133690 0 0 0 13250 0 67857 0 24255 0 239052 0 0 MICHAEL ADAMAVICH TRUSTEE 0 118794 0 0 0 13250 0 64806 0 21537 0 218387 0 0 SCOTT WATSON TRUSTEE 0 118219 0 0 0 13250 0 64956 0 21717 0 218142 0 0 CHUCK SPOEHR TRUSTEE 0 116282 0 0 0 13250 0 65311 0 22232 0 217075 0 0 NICOLE FALKNER ADMINISTRATIVE MANAGER 0 112162 0 0 0 0 0 20930 0 20199 0 153291 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 4 4 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 823 823 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 79 79 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 1 1 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 392 392 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 79 79 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 216 216 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 217 217 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 13 13 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 153 153 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 4927 4927 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 1090 1090 0 0 0 7994 FORM 990, PART VI, SECTION A, LINE 7A THE ASSOCIATED GENERAL CONTRACTORS OF WISCONSIN, INC. AND THE NORTH CENTRAL STATES REGIONAL COUNCIL OF CARPENTERS (THE BARGAINING PARTIES), BOTH APPOINT 50% OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES THAT HAVE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE ORGANIZATION'S INDEPENDENT PUBLIC ACCOUNTING FIRM BASED ON INFORMATION PROVIDED BY MANAGEMENT. ONCE A DRAFT OF THE FILING IS AVAILABLE, IT IS REVIEWED BY MANAGEMENT AND ANY CHANGES INCORPORATED INTO THE FILING BEFORE BEING PRESENTED TO THE HEALTH BOARD FOR APPROVAL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE TRUSTEES ARE REQUIRED TO COMPLETE AN ANNUAL QUESTIONNAIRE REGARDING ANY POSSIBLE CONFLICTS OF INTEREST. ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST MUST BE DISCLOSED TO THE APPROPRIATE BOARD OR COMMITTEE AND THEY WILL DETERMINE IF A CONFLICT EXISTS AND IF THEY CAN OBTAIN A MORE ADVANTAGEOUS ARRANGEMENT THAT WOULD NOT GIVE RISE TO A CONFLICT. IF NOT, THE BOARD OR COMMITTEE WILL DETERMINE BY A MAJORITY VOTE OF DISINTERESTED TRUSTEES WHETHER THE TRANSACTION IS IN THE FUNDS BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE AND WILL DECIDE WHETHER TO ENTER INTO THE TRANSACTION ON THAT BASIS. IF THE BOARD OR COMMITTEE BELIEVES THAT A TRUSTEE HAS FAILED TO DISCLOSE, IT WILL GIVE THE TRUSTEE AN OPPORTUNITY TO EXPLAIN. IF THE BOARD OR COMMITTEE DETERMINES THE TRUSTEE HAS FAILED TO DISCLOSE, IT WILL TAKE DISCIPLINARY AND CORRECTIVE ACTION. THE TRUSTEE WITH A CONFLICT MUST LEAVE THE MEETING WHILE THE BOARD OR COMMITTEE MAKES THE DECISION WHETHER A CONFLICT EXISTS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS NOT CHANGED THEIR PROCESS FOR THE OVERSIGHT OR THE SELECTION OF THE INDEPENDENT ACCOUNTANT FROM THE PRIOR YEAR. CARPENTERS LU #314 NORTH CENTRAL STATES REG CNCL (BA) NORTH CENTRAL STATES REG CNCL OF CARPS UBC NATIONAL JOB CORPS TRAININ NCSRCC TRAINING FUND 1704 DEVNEY DRIVE ALTOONA WI 54720 391243343 TRAINING BENEFITS WI 501(C)(3) LINE 11 N/A 0 LABOR MGMT COOPERATIVE TRUST OF THE NCSRCC & AGC OF WI INC 1704 DEVNEY DRIVE ALTOONA WI 54720 680572562 DRUG TESTING AND REIMBURSMENT FOR CLASSES WI 501(C)(6) N/A 0 NCSRCC PENSION FUND 1704 DEVNEY DRIVE ALTOONA WI 54720 396079856 PENSION BENEFITS WI 401 (A) N/A 0 NCSRCC SUPPLEMENTAL RETIREMENT PLAN 1704 DEVNEY DRIVE ALTOONA WI 54720 800234499 DEFINED CONTRIBUTIONS BENEFITS WI 401 (A) N/A 0 ACOUSTIC PROFESSIONALS LLC ADVANTAGE INDUSTRIAL SYSTEMS LLC BADGER SCAFFOLD LLC CCF LABOR LLC CECO CONCRETE CONSTRUCTION KRAEMER NORTH AMERICA LLC LIFT TECH SPECIALIST SAFWAY STEEL PRODUCTS LLC - ST PAUL SCHMITT ACOUSTICS LLC SHEET PILING SERVICES LLC U S VET GENERAL CONTRACTING LLC ACOUSTIC PROFESSIONALS LLC ADVANTAGE INDUSTRIAL SYSTEMS LLC BADGER SCAFFOLD LLC CCF LABOR LLC CECO CONCRETE CONSTRUCTION KRAEMER NORTH AMERICA LLC LIFT TECH SPECIALIST SAFWAY STEEL PRODUCTS LLC - 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