2020-06-11T12:48:48-05:00 2019-10-31 320043599 LEGACY PROFESSIONALS LLP 4 WESTBROOK CORPORATE CTR 700 WESTCHESTER IL 60154 990 2018-11-01 362265130 CONSTRUCTION INDUSTRY WELFARE FUND OF ROCKFORD ILLINOIS CONS 8153974267 1322 EAST STATE STREET ROCKFORD IL 61104 ART STURMS TRUSTEE 8153974267 2020-06-11 1 BRANDON WOLBER P01460460 3123680500 2020-05-22 12.235.239.120 2020-06-11 12:48:44 CD P 4FACE35E664BE34504C05171139E07BD5A8DA47B 013BD4BEA457AB31DE8385915B9401809CC4B7ED 2018 2020-09-23 17:36:50Z ART STURMS 1322 EAST STATE STREET ROCKFORD IL 61104 21781225 0 X N/A X 1954 IL TO PROVIDE HEALTH BENEFITS TO PARTICIPANTS. 6 0 45 0 54001 -8384 0 0 20099389 20174824 256086 319607 94251 129913 20449726 20624344 0 0 16363608 17502220 121978 129533 0 0 0 700878 728367 17186464 18360120 3263262 2264224 19453446 21527724 1256703 894748 18196743 20632976 TO PROVIDE HEALTH BENEFITS TO PARTICIPANTS. 0 0 TO PROVIDE MEDICAL, DENTAL, VISION, PRESCRIPTION DRUGS, LIFE, AND LOSS OF TIME BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 1 0 1 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 X 3 0 1 45 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 6 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X SHELLI MCPEEK - ADMINISTRATOR 8153974267 1322 EAST STATE STREET ROCKFORD IL 61104 ART STURMS LABOR CO-CHAIR 3.00 40.00 X 0 121407 81616 RICHARD BOYD LABOR TRUSTEE 3.00 40.00 X 0 94659 65887 SAMUEL GIARDONO LABOR TRUSTEE - PAST 3.00 X 0 0 0 DANIEL JANSEN LABOR TRUSTEE 3.00 40.00 X 0 116543 39850 DAVID ANSPAUGH MGMT - CO-CHAIR 3.00 40.00 X 0 121690 22410 JEFF BOCKHOP MGMT TRUSTEE 3.00 X 0 0 0 GLEN TURPOFF MGMT TRUSTEE 3.00 5.00 X 0 14400 0 SHELLI MCPEEK ADMINISTRATOR 40.00 X 64788 0 26249 64788 468699 236012 0 0 1 0 GROUP ADMINISTRATORS LTD 915 NATIONAL PARKWAY SUITE F SCHAUMBURG IL 60173 THIRD PARTY ADMINISTRATOR 374655 HINES & ASSOCIATES PO BOX 0327 ELGIN IL 60121 UTILIZATION REVIEW 125108 WILLIAMS MCCARTHY LLP 120 WEST STATE STREET PO BOX 219 ROCKFORD IL 61105 ATTORNEY 100751 3 CONTRACTOR CONTRIBUTIONS 900099 19015414 19015414 PARTICIPANT CONTRIBUTIONS 900099 929410 929410 SUBROGATION 900099 230000 230000 20174824 324794 324794 1151694 1156881 -5187 -5187 -5187 SHARED SERVICES 900099 75912 75912 PROCESSING FEES 900099 54001 54001 129913 20624344 20174824 54001 395519 17502220 73735 43105 4152 8541 379302 92888 76534 112712 14473 18108 329 720 19212 MISCELLANEOUS 7270 FEES MANDATED BY THE AC 6819 18360120 1018031 1123513 9731056 10657087 2956131 3341066 16622 16942 44617 33378 8416 11239 5721190 6375877 2000 2000 19453446 21527724 31716 30418 71818 95427 576534 362805 576635 406098 1256703 894748 X 0 0 0 0 18196743 20632976 18196743 20632976 19453446 21527724 2264224 172009 0 X 0 1 X 1 0 0 1 X 10977 7788 3189 33640 25590 8050 11239 EMPLOYER RECIPROCAL CONTRIBUTIONS 406098 406098 X 20796353 172009 172009 20624344 0 20624344 18360120 0 18360120 0 18360120 PART IV, LINE 2B: THE PLAN SERVES AS A CONDUIT TO COLLECT REMITTANCES ON BEHALF OF AFFILIATED BENEFIT FUNDS AND ORGANIZATIONS. SUCH REMITTANCES ARE INITIALLY RECEIVED THROUGH A LOCKBOX ARRANGEMENT AND TRANSFERRED INTO A SEGREGATED CHECKING ACCOUNT HELD BY THE PLAN UNTIL DISBURSEMENT TO THE AFFILIATED ENTITY IS MADE. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN 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 TAX AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. X 0 0 0 ART STURMS LABOR CO-CHAIR 0 121407 0 0 0 0 0 60672 0 20944 0 203023 0 0 RICHARD BOYD LABOR TRUSTEE 0 94359 0 0 0 300 0 44827 0 21060 0 160546 0 0 DANIEL JANSEN LABOR TRUSTEE 0 115521 0 0 0 1022 0 20890 0 18960 0 156393 0 0 FORM 990, PART V, LINE 2A THE NUMBER OF MEMBERS REPORTED ON LINE 2A INCLUDES PARTICIPANTS RECEIVING LOSS OF TIME BENEFITS. FORM 990, PART VI, SECTION A, LINE 8B THE PLAN HAS NO COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES AND PLAN ADMINISTRATOR PRIOR TO FILING. AFTER THE BOARD'S REVIEW, THE FORM IS APPROVED AND FILED. FORM 990, PART VI, SECTION B, LINE 12C ENFORCEMENT OF CONFLICT OF INTEREST POLICY - THE FUND IS A WELFARE BENEFIT PLAN GOVERNED BY THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA). UNDER ERISA, IT IS THE CONTINUING RESPONSIBILITY OF EACH MEMBER OF THE BOARD OF TRUSTEES TO REVIEW TRANSACTIONS FOR POTENTIAL CONFLICTS OF INTEREST, IMMEDIATELY DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST, AND TAKE APPROPRIATE ACTION UPON DISCOVERY OF ANY SUCH CONFLICTS. TO ASSIST THE TRUSTEES IN IDENTIFYING ACTUAL OR POTENTIAL CONFLICTS OF INTEREST, THE FUND DISTRIBUTES TO EACH TRUSTEE AN ANNUAL QUESTIONNAIRE REQUESTING INFORMATION REGARDING INTERESTS THAT COULD GIVE RISE TO A CONFLICT. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE FUND OFFICE. 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