2020-11-03T09:14:27-06:00 2019-12-31 363168081 SIKICH LLP 13400 BISHOPS LANE SUITE 300 BROOKFIELD WI 53005 990 2019-01-01 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 2020-11-02 1 JAMES B BOUTELLE CPA P01794129 2627549400 2020-10-28 24.209.117.46 2020-11-02 14:51:16 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 934FC65FEE8495E85B690041CFEAE27130F8D972 2019 2021-04-22 16:20:28Z TREVOR MARTIN 2700 NORTHRIDGE DRIVE PO BOX 530 KAUKAUNA WI 541300530 49936735 0 X WWW.UA400.ORG X 1998 WI PROVIDE BENEFITS TO MEMBERS OF LOCAL 400 11 6 0 6 0 0 0 0 30233034 29608696 2227583 1770589 56216 62772 32516833 31442057 0 0 20737006 20637667 0 34577 0 0 0 5188667 4960192 25925673 25632436 6591160 5809621 58193156 67739707 524149 351033 57669007 67388674 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 2,000 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 68 0 0 0 0 0 0 0 0 0 0 X 11 6 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 JEFF KNAUS FORMER CHAIRMAN 1.00 50.00 X 0 143693 88777 MIKE AUGUSTIAN LABOR TRUSTEE 1.00 45.00 X 0 128196 79899 TREVOR MARTIN CHAIRMAN 1.00 45.00 X X 0 126925 79899 DUSTIN DELSMAN LABOR TRUSTEE 1.00 5.00 X 0 58674 28505 TERRY VAN EPERN ALTERNATE LABOR TRUSTEE 1.00 X 0 670 0 JOHN KENNEDY LABOR TRUSTEE 1.00 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 0 0 0 JODI MILLER-LARSON MANAGEMENT TRUSTEE 1.00 X 0 0 0 MARIA VANDER HEIDEN ALTERNATE MANAGEMENT TRUSTEE 1.00 X 0 0 0 0 458158 277080 0 0 1 0 BENEFIT PLAN ADMINISTRATION 11270 W PARK PLACE SUITE 950 MILWAUKEE WI 53224 ADMINISTRATIVE SERVICES 1182493 UNITED HEALTHCARE INSURANCE COMPANY 9700 HEALTH CARE LANE MINNETONKA MN 55343 PPO NETWORK PROVIDER 729120 REINHART BOERNER VAN DEUREN SC PO BOX 2965 MILWAUKEE WI 53201 LEGAL 159022 CASE MANAGEMENT SPECIALISTS INC PO BOX 102 NASHOTAH WI 53058 MEDICAL MANAGEMENT 130297 ENVISION PHARMACEUTICAL SERVICES LLC 2181 EAST AURORA ROAD SUITE 201 TWINSBURG OH 44087 PHARMACEUTICALS 108427 5 EMPLOYER CONTRIBUTIONS 900099 27236834 27236834 PARTICIPANT CONTRIBUTIONS 900099 1823032 1823032 STOP LOSS REIMBURSEMENTS 900099 385208 385208 SUBROGATION 900099 163622 163622 29608696 1613024 1613024 18652243 18494678 157565 157565 157565 OTHER REIMBURSEMENTS 900099 62772 62772 62772 31442057 29608696 0 1833361 20637667 34577 1036911 159022 51646 85656 47922 22227 36921 MEDICARE PREMIUMS 1656452 PPO ADMIN FEES 806171 STOP LOSS PREMIUMS 663657 COST CONTAINMENT 247842 145765 25632436 2161130 825537 933243 6240734 5414843 223137 313715 50903748 58916776 58193156 67739707 343491 206581 180658 144452 524149 351033 X 0 0 0 0 57669007 67388674 57669007 67388674 58193156 67739707 5809621 3910046 0 X 0 1 X 1 0 0 DUE TO OTHER PLANS 46148 PREPAID RETIREE PREMIUMS 98304 144452 X 35300457 3910046 3910046 31390411 51646 51646 31442057 25580790 0 25580790 51646 51646 25632436 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 JEFF KNAUS FORMER CHAIRMAN 0 143693 0 0 0 0 0 62648 0 26129 0 232470 0 0 MIKE AUGUSTIAN LABOR TRUSTEE 0 128196 0 0 0 0 0 56383 0 23516 0 208095 0 0 TREVOR MARTIN CHAIRMAN 0 126925 0 0 0 0 0 56383 0 23516 0 206824 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. 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. 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 IDAHO PIPE TRADES TRUST FUNDS MADISON AREA CONSTRUCTION MADISON AREA TRUST FUND MONTANA PIPE TRADES PENSION FUND OKLAHOMA STATE PIPE TRADE 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 STAINLESS SPECIALISTS 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