2020-10-13T12:07:38-05:00 2019-12-31 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2019-01-01 396069788 NORTH CENTRAL STATES REGIONAL COUNCIL OF CARPENTERS' HEALTH FUND NORT 7158353174 PO BOX 4002 EAU CLAIRE WI 54702 BOB BARKER CHAIRMAN 7158353174 2020-10-13 1 DOUGLAS BERTOSSI P00637990 6123764500 2020-10-13 67.137.57.251 2020-10-13 10:15:50 CD P FD302F4D5CE3C660ABAF9933EAAEEC9F457F14F9 2C69B7C3EEF759729CD0B8126030C6053D5007F7 2019 2021-04-22 16:20:28Z BOB BARKER PO BOX 4002 EAU CLAIRE WI 54702 129862607 0 X WWW.NCSCBF.COM X 1963 WI TO PROVIDE HEALTH AND WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 18 0 131 0 0 0 0 0 69754488 71193666 3984291 5147710 72788 50734 73811567 76392110 0 0 70021101 78856009 721350 711249 0 0 0 1728698 1873915 72471149 81441173 1340418 -5049063 164317819 187206552 11537764 27444012 152780055 159762540 TO PROVIDE HEALTH AND WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 0 0 PROVIDE SELF FUNDED BENEFITS FOR APPROXIMATELY 5,742 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 1 691 0 131 1 0 0 0 0 0 0 0 0 X 18 0 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 283256 131462 BOB BARKER TRUSTEE, CHAIRMAN 1.00 40.00 X X 0 233716 40482 BURT JOHNSON TRUSTEE, SECRETARY/TREASUR 1.00 40.00 X X 0 204456 106437 PAT NILSEN TRUSTEE 1.00 40.00 X 0 179456 100187 COREY BIALCIK TRUSTEE 1.00 40.00 X 0 149216 91966 WAYNE NORDIN TRUSTEE 1.00 40.00 X 0 148131 87031 CHRIS HILL TRUSTEE 1.00 40.00 X 0 145996 96370 PAT RODRIGUEZ TRUSTEE 1.00 40.00 X 0 137818 89381 MICHAEL ADAMAVICH TRUSTEE 1.00 40.00 X 0 123871 75641 CHUCK SPOEHR TRUSTEE 1.00 40.00 X 0 121701 76675 SCOTT WATSON TRUSTEE 1.00 40.00 X 0 121045 75446 NICOLE FALKNER ADMINISTRATIVE MANAGER 14.00 31.00 X 0 112148 39834 ERIC BALLWEG TRUSTEE 1.00 40.00 X 0 0 0 BRAD DEPREZ TRUSTEE 1.00 40.00 X 0 0 0 F WILLIAM HARVAT TRUSTEE 1.00 40.00 X 0 0 0 JEFF MCLEAN TRUSTEE 1.00 40.00 X 0 0 0 SID SAMUELS TRUSTEE 1.00 40.00 X 0 0 0 BARRY SCHOLZ TRUSTEE 1.00 40.00 X 0 0 0 JERRY SHEA TRUSTEE 1.00 40.00 X 0 0 0 DAVE SMESTAD TRUSTEE 1.00 40.00 X 0 0 0 SEAN CULLEN TRUSTEE 1.00 40.00 X 0 0 0 0 1960810 1010912 0 0 1 0 ANTHEM BLUECROSS BLUESHIELD PO BOX 951254 CLEVELAND OH 44193 CLAIMS PROCESSING 1692611 CASE MANAGEMENT SPECIALISTS 553 S INDUSTRIAL DR HARTLAND WI 53209 CONTRACTED MEDICAL CONSULTANT 463450 DELTA DENTAL 2801 HOOVER ROAD PO BOX 828 STEVENS POINT WI 54481 CLAIMS PROCESSING 210508 THE PREVIANT LAW FIRM SC 310 W WISCONSIN AVE STE 100 MW MILWAUKEE WI 53212 LEGAL COUNSEL 193755 EXPRESS SCRIPTS 4600 NORTH HANLEY ROAD ST LOUIS MO 63134 CLAIMS PROCESSING 118622 5 EMPLOYER CONTRIBUTIONS 525100 62015807 62015807 EMPLOYEE CONTRIBUTIONS 525100 9177859 9177859 71193666 3618793 3618793 54999414 53470497 1528917 1528917 1528917 MISCELLANEOUS 525100 50734 50734 50734 76392110 71193666 0 5198444 78856009 151980 280093 126620 119235 33321 268868 29250 223868 719979 233415 5956 69210 410 47819 27540 40391 EDP MAINT./EDUCATION 73480 SPD EXPENSE 51710 MISC EXPENSES 31344 PCORI FEE 24527 26148 81441173 0 0 3467579 4071651 5610453 5200671 7647 11329 49771 508715 27268 27268 0 0 106704219 122789013 46790120 51682682 1688030 2942491 164317819 187206552 257226 330711 11280538 27113301 11537764 27444012 X 0 0 0 0 152780055 159762540 152780055 159762540 164317819 187206552 -5049063 12031548 0 X 0 1 X 1 0 27268 27268 0 0 INVESCO INSTITUTIONAL TRUST 18853730 F NTGI DAILY ALL COUNTRY 32828952 F 51682682 DUE TO BROKERS FOR SECURITIES LENDING 27113301 27113301 X 88199790 12031548 12031548 76168242 223868 223868 76392110 81217305 0 81217305 223868 223868 81441173 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 2019 AND 2018 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 270256 0 0 0 13000 0 105160 0 26302 0 414718 0 0 BOB BARKER TRUSTEE, CHAIRMAN 0 231905 0 0 0 1811 0 22208 0 18274 0 274198 0 0 BURT JOHNSON TRUSTEE, SECRETARY/TREASUR 0 191456 0 0 0 13000 0 82327 0 24110 0 310893 0 0 PAT NILSEN TRUSTEE 0 166456 0 0 0 13000 0 76077 0 24110 0 279643 0 0 COREY BIALCIK TRUSTEE 0 136216 0 0 0 13000 0 68586 0 23380 0 241182 0 0 WAYNE NORDIN TRUSTEE 0 135131 0 0 0 13000 0 65113 0 21918 0 235162 0 0 CHRIS HILL TRUSTEE 0 132996 0 0 0 13000 0 70887 0 25483 0 242366 0 0 PAT RODRIGUEZ TRUSTEE 0 124818 0 0 0 13000 0 65894 0 23487 0 227199 0 0 MICHAEL ADAMAVICH TRUSTEE 0 110871 0 0 0 13000 0 55915 0 19726 0 199512 0 0 CHUCK SPOEHR TRUSTEE 0 108701 0 0 0 13000 0 56300 0 20375 0 198376 0 0 SCOTT WATSON TRUSTEE 0 108045 0 0 0 13000 0 55509 0 19937 0 196491 0 0 NICOLE FALKNER ADMINISTRATIVE MANAGER 0 112148 0 0 0 0 0 19291 0 20543 0 151982 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 102 102 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 531 531 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 554 554 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 453 453 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 271 271 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 17 17 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 208 208 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 6682 6682 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 2511 2511 0 0 0 11329 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 TRAINING 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 PROCESS FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF AN ACCOUNTANT HAS NOT CHANGED FORM THE PRIOR YEAR. 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