2021-11-11T15:55:12-06:00 2020-12-31 363168081 SIKICH LLP 13400 BISHOPS LANE SUITE 300 BROOKFIELD WI 53005 990 2020-01-01 316041107 HEARTLAND HEALTH & WELLNESS FUND HEAR 9376651900 7250 POE AVENUE NO 300 DAYTON OH 45414 JOE CHORPENNING CHAIRPERSON 9376651900 2021-11-11 1 JOE CHORPENNING 999009999 JAMES B BOUTELLE CPA P01794129 2627549400 2021-11-10 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z HENRY TAYLOR 7250 POE AVENUE NO 300 DAYTON OH 45414 234720460 0 X WWW.HEARTLANDWELLNESSFUND.COM X EMPLOYEE BENEFIT PLAN 1957 OH THE PLAN PROVIDES MEDICAL, DENTAL, AND LIFE BENEFITS TO ITS MEMBERS AND DEPENDENTS. 10 8 58 10 0 0 0 0 192143731 233324485 548806 334985 297333 526038 192989870 234185508 0 0 196470564 221408841 2547898 2310295 0 0 0 11004046 12678183 210022508 236397319 -17032638 -2211811 33236475 39238218 31448681 39397945 1787794 -159727 TO PROVIDE FOR A UNIFORM HEALTH AND WELFARE PROGRAM FOR EMPLOYEES EMPLOYED UNDER CERTAIN COLLECTIVE BARGAINING AGREEMENTS. 0 0 THE PLAN PROVIDES ACCIDENT, HEALTH, VISION, PRESCRIPTION, DENTAL, LIFE, AND DEATH BENEFITS TO ITS MEMBERS AND DEPENDENTS. 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 362 0 58 1 0 0 0 0 0 0 0 0 X 10 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X JERRY EVANS 9376651900 7250 POE AVENUE SUITE 300 DAYTON OH 45414 KEVIN GARVEY TRUSTEE 1.00 40.00 X 0 276600 40122 TONY HELFER ALTERNATE TRUSTEE THRU 12/31/20 1.00 40.00 X 0 250337 38719 BRYON O'NEAL ALTERNATE TRUSTEE 1.00 40.00 X 0 246619 37613 RANDY QUICKEL TRUSTEE 1.00 40.00 X 0 244677 34119 JERRY EVANS ADMINISTRATOR 40.00 X 194230 0 26702 MELISSA STEED EMPLOYEE 40.00 X 120076 0 33940 RICHARD MAINS JR EMPLOYEE 40.00 X 115000 0 33737 JOE CHORPENNING CHAIRMAN 1.00 X X 0 0 0 HENRY TAYLOR SECRETARY 1.00 X X 0 0 0 STEVEN SPRINGER TRUSTEE 1.00 X 0 0 0 ROB FRANCIN TRUSTEE 1.00 X 0 0 0 STEVE YANCEY TRUSTEE 1.00 X 0 0 0 BOB BLAIR TRUSTEE 1.00 X 0 0 0 DAN PEDERSEN TRUSTEE 1.00 X 0 0 0 DAVID BLITSTEIN TRUSTEE 1.00 X 0 0 0 DON SATTLER ALTERNATE TRUSTEE 1.00 X 0 0 0 GREG THOMPSON ALTERNATE TRUSTEE THRU 12/31/20 1.00 X 0 0 0 429306 1018233 244952 3 0 1 0 EPLAN LLC 22601 N 19TH AVE SUITE 240 PHOENIX AZ 85027 CLAIMS REVIEW 770804 REINHART BOERNER VAN DEUREN SC PO BOX 2965 MILWAUKEE WI 532012965 ATTORNEY 760305 EUGENE STEWART 5671 WEBSTER ST DAYTON OH 45414 PRINTING AND DESIGN SERVICES 408275 THE SEGAL COMPANY 101 NORTH WACKER DRIVE STE 500 CHICAGO IL 60606 ACTUARY 391065 SLEVIN AND HART PC 1625 MASSACHUSETTS AVE NW SUITE 45 WASHINGTON DC 20036 ATTORNEY 219750 6 EMPLOYER CONTRIBUTIONS 900099 231940659 231940659 SELF-PAYMENT CONTRIBUTIONS 900099 1383826 1383826 233324485 334985 334985 534952 534952 0 SHARED EXPENSE REIMBURSEMENT 900099 231642 231642 SETTLEMENT ADJUSTMENT 900099 181434 181434 MISCELLANEOUS 900099 112962 112962 526038 234185508 233850523 0 334985 221408841 220932 1825868 107851 155644 893873 21800 512360 1008565 757876 232796 25191 45219 67328 PPO FEES AND MEDICAL RE 8809051 VISION SERVICE PLAN PRO 136272 PCORI FEE 91105 PRESCRIPTION DRUG PROGR 48682 28065 236397319 6848954 13037780 5360463 5155856 11611083 10663719 73630 69855 326763 128875 116344 197888 9226001 10113120 33236475 39238218 3122175 9038958 155346 168071 28171160 30190916 31448681 39397945 X 0 0 0 0 1787794 -159727 1787794 -159727 33236475 39238218 -2211811 264290 0 X X 0 1 X 1 0 326763 128875 197888 197888 BENEFIT OBLIGATIONS CURRENTLY PAYABLE 29962700 UNFUNDED PENSION OBLIGATION 228216 30190916 X 234427998 264290 264290 234163708 21800 21800 234185508 234147019 0 234147019 21800 2228500 2250300 236397319 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS INTENDED TO QUALIFY PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE (IRC) AND IS, THEREFORE, NOT SUBJECT TO TAX UNDER PRESENT INCOME TAX LAWS. THE TRUST HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS) AND THE TRUSTEES BELIEVE THAT THE TRUST AND 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 TAX 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. PART XII, LINE 4B - OTHER ADJUSTMENTS: INCREASE IN CURRENT YEAR'S CLAIMS PAYABLE 2,228,500. X X 0 0 0 KEVIN GARVEY TRUSTEE 0 201894 0 74706 0 0 0 13065 0 27057 0 316722 0 0 TONY HELFER ALTERNATE TRUSTEE THRU 12/31/20 0 224528 0 16640 0 9169 0 23159 0 15560 0 289056 0 0 BRYON O'NEAL ALTERNATE TRUSTEE 0 166450 0 80169 0 0 0 10556 0 27057 0 284232 0 0 RANDY QUICKEL TRUSTEE 0 234684 0 9993 0 0 0 0 0 34119 0 278796 0 0 JERRY EVANS ADMINISTRATOR 194230 0 0 0 0 0 17618 0 9084 0 220932 0 0 0 MELISSA STEED EMPLOYEE 120076 0 0 0 0 0 6883 0 27057 0 154016 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 GOES THROUGH A PRELIMINARY REVIEW BY THE ADMINISTRATIVE MANAGER AND ACCOUNTANT. ONCE THEY APPROVE THE FORM 990 IT IS PRESENTED TO A COMMITTEE OF TRUSTEES FOR APPROVAL PRIOR TO SIGNING AND FILING. FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES ARE EXPECTED TO FULLY DISCLOSE ANY OWNERSHIP OR OTHER FINANCIAL RELATIONSHIPS THEY HAVE WITH OTHER PARTIES THAT DEAL WITH THE PLAN. FORM 990, PART VI, SECTION B, LINE 15A THE ADMINISTRATIVE MANAGER'S PAY RANGE IS DETERMINED BY THE BOARD OF TRUSTEES. THE TRUSTEES HAD A SALARY STUDY PERFORMED BY THE PLAN'S CONSULTANTS. THE TRUSTEES APPROVE INCREASES IN COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THE BOARD OF TRUSTEES IS RESPONSIBLE FOR THE SELECTION OF AN INDEPENDENT ACCOUNTANT TO PERFORM THE AUDIT OF THE PLAN'S FINANCIAL STATEMENTS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. HEARTLAND BENEFIT PLAN ADMINISTRATORS LLC 7250 POE AVENUE NO 300 DAYTON OH 45414 475593281 PROVIDE MEDICAL AND LIFE BENEFITS TO ITS MEMBERS OH BOARD OF TRUSTEES OF HEARTLAND HEALTH & WELLNESS FUND 7250 POE AVENUE DAYTON OH 45414 316173363 PLAN SPONSOR AND PLAN ADMINISTRATOR OH 501(C)(9) N/A 0 CHAMPAIGN RESIDENTIAL SERVICES INC CINCINNATI AFO-CIO LABOR COUNCIL CINCINNATI INTERFAITH WORKERS GOOD SHEPHERD HOME HARBOR BEHAVIORAL HEALTH NEUSOLE FOUNDATION UNITED FOOD AND COMMERCIAL WORKERS UNION LOCAL NO 1776KS UNITED FOOD AND COMMERCIAL WORKERS UNION LOCAL NO 75 UNITED FOOD AND COMMERCIAL WORKERS UNION LOCAL 1059 HEARTLAND BENEFIT PLAN ADMINISTRATORS LLC UNITED FOOD AND COMMERCIAL WORKERS UNION LOCAL 23 FCU ALLISON STREET VENTURES LLC CLERMONTS BEST DRIVING ACADEMY LLC CONSOLIDATED HEALTHCARE SOLUTIONS LLC CUNDIFF TOWN & COUNTRY TREE SERV LLC GRAPHIC FINISHING LLC JAS ELECTRIC LLC MAXWELL MEDICAL LLC MICHAEL P KELLY REALTY PIPCO LLC SNYDER & GAST LLC WEBER DICKEY BELLMAN LAW LEONARD A BLEH LLC LAW OFFICES OF LEONARD SIGALL AMERICAN BUSINESS TECHNOLOGIES AVI FOOD SYSTEMS INC BILLOW CONSTRUCTION INC BLUE GRASS PROVISIONS BRIDGETOWN FINER MEATS INC BRUSH & LADDER PAINTING INC C-FAB LLC FRESH ENCOUNTERS - CHIEF SUPER MARKET INC COOK & LOGOTHETIS LLC CVS PHARMACY INC DBM & SONS INC DON CARTER & ASSOC INC DR ELLEN C TORBECK DMD PSC FROZEN SPECIALTIES INC G&G TRANSPORTATION SERVICE INC GR FEHR COMPANY INC GOERGE F MOELLER LPA GRACE FOODS INC FRESH ENCOUNTER - GREAT SCOT INC HILLTOP PHYSICIANS INC JIM BITZENHOFER REFRIGERATION AND AC INC JOHN STEHLIN & SONS CO INC KUHL TILE & MARBLE INC LANGEN MEATS INC MANLEY BURKE LPA NEWMAN & MEEKS CO LPA ROBERT WHOLEY & CO INC RUBLE ARTISTIC FURNITURE RESTORATION INC RUDOLPH FOODS COMPANY INC SEVEN HILLS COFFEE COMPANY SILGAN CAN COMPANY SKYHAVEN FARMS INC SUGAR CREEK PACKING CO THE KROGER CO UNION EYE CARE WASSLER MEATS INC WE CARE FOOD STORES INC LEE WILLIAMS MEATS INC KISSEL BROS MULLEN VAN HOUTEN OUR HARVEST FRESH ENCOUNTER - CHIEFS SMARTCAT MARKETING SOLUTIONS 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 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. THE CONTRIBUTING EMPLOYERS ARE ON FILE AT THE PLAN OFFICE.