2020-02-18T14:23:25-06:00 2019-05-31 470900880 CALIBRE CPA GROUP PLLC 230 WEST MONROE STREET SUITE 310 CHICAGO IL 60606 990 2018-06-01 363251688 ARCH IRONWORKERS LOCAL 63 WELFARE FUND ARCH 6304720627 1520 KENSINGTON NO 200 OAKBROOK IL 60523 PAUL WENDE TRUSTEE 6304720627 2020-02-18 1 HOWARD SIMON P00158008 3126550037 38.100.43.100 2020-02-18 14:22:56 CS P 1B630F5BDED52C109BDB55E0B78CFB3A5956A11E 099BB351ED5C43DB8E4A0DD96B056B1430213725 2018 2020-09-23 17:36:50Z PAUL WENDE 1520 KENSINGTON NO 200 OAKBROOK IL 60523 56665428 0 X N/A X 1983 IL TO PROVIDE MEDICAL, DENTAL, DISABILITY, AND DEATH BENEFITS. 6 3 36 0 0 0 0 0 25836977 27197165 1707716 3111734 2795 6406 27547488 30315305 0 0 22277843 22530533 23123 14007 0 0 0 1706569 1570722 24007535 24115262 3539953 6200043 85516106 94665001 20499342 22388727 65016764 72276274 X TO PROVIDE MEDICAL,DENTAL,VISION, DISABLITY AND DEATH BENEFITS 0 0 THE FUND PROVIDES MEDICAL, DENTAL, VISION, DISABILITY, AND DEATH BENEFITS TO ELIGIBLE PARTICIPANTS. THE FUND PROVIDES MEDICAL, DENTAL, VISION, DISABILITY, AND DEATH BENEFITS TO ELIGIBLE PARTICIPANTS. 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 4 0 1 36 1 0 0 0 0 0 0 0 0 X 6 3 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X CHRIS KRZYSKO AT BENEFITS MGMT GROUP 6304720627 1520 KENSINGTON OAKBROOK IL 60523 MICHAEL SWANBERG TRUSTEE 3.00 X 0 0 0 PAUL WENDE CHAIRMAN 3.00 40.00 X 0 151813 130503 TIM BELL TRUSTEE 3.00 X 0 0 0 LAWRENCE MCNIFF FORMER CHAIRMAN 3.00 40.00 X 0 119175 42652 JACK CANNIFF TRUSTEE 3.00 40.00 X 0 145413 123206 MARK LEBUZ TRUSTEE 3.00 X 0 0 0 DAVE MURRAY TRUSTEE 3.00 40.00 X 0 91351 123497 0 507752 419858 0 0 1 0 BCBS 300 E RANDOLPH CHICAGO IL 60601 CLAIMS PAYOR 623927 BENEFITS MANAGEMENT GROUP 903 COMMERCE DRIVE STE 304 OAK BROOK IL 60523 THIRD PARTY ADMIN. 323211 2 EMPLOYER CONTRIBUTIONS 900099 25905818 25905818 EMPLOYEE CONTRIBUTIONS 900099 1090539 1090539 MEDICARE PART D SUBSIDY 900099 200808 200808 27197165 2026535 2026535 27435322 26350123 1085199 1085199 1085199 LIQUIDATED DAMAGES 900099 6406 6406 6406 30315305 27203571 0 3111734 22530533 14007 318375 49303 56339 270280 801886 60451 3171 5016 ACA FEES 5901 24115262 9813216 5736961 2929681 3195404 72581264 85588573 191945 144063 85516106 94665001 109618 125042 20389724 22263685 20499342 22388727 X 0 0 0 0 65016764 72276274 65016764 72276274 85516106 94665001 6200043 1059467 0 X X 0 1 X 1 0 0 EXTENDED ELIGIBILITY 14719000 CLAIMS INCURRED BUT NOT PAID 1590000 ACCUMULATED MRA ACCOUNT BALANCES 5954685 22263685 X 30903684 1059467 1059467 29844217 270280 200808 471088 30315305 21770213 0 21770213 270280 2074769 2345049 24115262 PART X, LINE 2: AS OF MAY 31, 2019, THERE WERE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIOD IN PROGRESS. AT MAY 31, 2019, THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS PRIOR TO THE FISCAL YEAR ENDED MAY 31, 2016. PART XI, LINE 4B - OTHER ADJUSTMENTS: MEDICARE PART D SUBSIDY 200,808. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS 1,873,961. MEDICARE PART D SUBSIDY 200,808. 0 0 0 PAUL WENDE CHAIRMAN 0 150780 0 0 0 1033 0 103450 0 27053 0 282316 0 0 LAWRENCE MCNIFF FORMER CHAIRMAN 0 116762 0 0 0 2413 0 33634 0 9018 0 161827 0 0 JACK CANNIFF TRUSTEE 0 144887 0 0 0 526 0 96153 0 27053 0 268619 0 0 DAVE MURRAY TRUSTEE 0 91095 0 0 0 256 0 96444 0 27053 0 214848 0 0 FORM 990, PART VI, SECTION A, LINE 3 LINE 3 EXPLANATION - BENEFITS MANAGEMENT GROUP, INC. IS THE THIRD PARTY ADMINISTRATOR HIRED TO ADMINISTER THE FUND'S DAY-TO-DAY OPERATIONS. FORM 990, PART VI, SECTION B, LINE 11B THE TRUSTEES AUTHORIZE THE FUND'S THIRD-PARTY ADMINISTRATOR AND A DESIGNATED TRUSTEE TO REVIEW THE FORM 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE TRUSTEES ARE GOVERNED BY THE TRUST DOCUMENT AND A WRITTEN POLICY AND HAVE A FIDUCIARY RESPONSIBILITY UNDER ERISA TO ADMINISTER THE PLAN IN THE BEST INTEREST OF THE MEMBERSHIP. THE U.S. DEPARTMENT OF LABOR REQUIRES ALL LABOR TRUSTEES TO REPORT ON FORM LM-30 POTENTIAL SITUATIONS WHERE THERE MAY BE CONFLICTS OF INTEREST. THIS INFORMATION IS OPEN TO THE PUBLIC. FORM 990, PART VI, SECTION C, LINE 19 A SUMMARY ANNUAL REPORT IS DISTRIBUTED TO ALL PARTICIPANTS. PARTICIPANTS ARE ABLE TO REQUEST THE AUDITOR'S REPORT AND OTHER FINANCIAL INFORMATION FROM THE PLAN ADMINISTRATOR AND/OR THE U.S. DEPARTMENT OF LABOR. ALSO, FORM 5500 IS OPEN TO PUBLIC INSPECTION THROUGH THE U.S. DEPARTMENT OF LABOR. PART XII, LINE 2C THERE HAS BEEN NO CHANGE IN THE FUND'S PROCESS FROM THE PRIOR YEAR IN REGARDS TO THE OVERSIGHT PROCESS. 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