2020-11-13T13:53:58-06:00 2019-12-31 320043599 LEGACY PROFESSIONALS LLP 6800 FRANCE AVENUE SO SUITE 550 EDINA MN 55435 990 2019-01-01 416187750 MINNESOTA LABORERS HEALTH AND WELFARE FUND MINN 6512561900 2520 PILOT KNOB ROAD NO 325 MENDOTA HEIGHTS MN 55120 JOEL SMITH TRUSTEE 6512561900 2020-11-11 1 ERIC C BAERTSCH P00964071 9528413950 12.235.239.120 2020-11-11 13:02:53 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 18D8E43A51057115C97B638ED8AC001B64A20B00 2019 2021-04-22 16:20:28Z JOEL SMITH 2520 PILOT KNOB ROAD NO 325 MENDOTA HEIGHTS MN 55120 271683852 0 X WWW.MINNESOTALABORERS.ORG X 1968 MN PROVIDE HEALTH AND WELFARE BENEFITS 14 1 74 0 0 0 0 0 135045205 147036219 9908180 15568392 22357 22637 144975742 162627248 0 0 114657894 122125415 0 0 0 0 0 4797630 5026998 119455524 127152413 25520218 35474835 541439116 639783478 1731652 1636479 539707464 638146999 PROVIDE HEALTH AND WELFARE BENEFITS 0 0 TO PROVIDE HEALTH, DENTAL, AND DEATH BENEFITS TO THE ELIGIBLE DEPENDENTS, BENEFICIARIES AND PARTICIPANTS OF THE PLAN. 0 0 0 0 0 0 0 0 0 0 1 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 1271 0 1 74 1 0 0 0 0 0 0 0 0 0 0 X 14 1 0 1 0 0 0 1 0 1 0 0 0 1 1 1 1 0 0 0 0 0 X ZENITH AMERICAN SOLUTIONS INC 6512561900 2520 PILOT KNOB ROAD NO 325 MENDOTA HEIGHTS MN 55120 TIM MACKEY TRUSTEE-UNION - PAST 1.00 40.00 X 0 190511 91176 JOE FOWLER TRUSTEE-UNION 1.00 40.00 X 0 170837 89276 SHELDON STEELE TRUSTEE-UNION 1.00 40.00 X 0 85065 55294 DEREK PEDERSON TRUSTEE-UNION 1.00 40.00 X 0 79599 34785 DAN OLSON TRUSTEE-UNION - PAST 1.00 20.00 X 0 31384 32060 JOEL SMITH TRUSTEE-UNION (CHAIRMAN) 1.00 40.00 X 0 123100 66450 MIKE BUBALO TRUSTEE-UNION 1.00 40.00 X 0 163312 86487 SHAWN BRAFORD TRUSTEE-UNION 1.00 40.00 X 0 111043 65685 JOHN NESSE TRUSTEE-EMPLOYER 1.00 X 0 0 0 TOM MILLER TRUSTEE-EMPLOYER 1.00 X 0 0 0 DAN SHOEMAKER TRUSTEE-EMPLOYER (SECRETARY) 1.00 X 0 0 0 HEATHER GRAZZINI TRUSTEE-EMPLOYER 1.00 X 0 0 0 JOHN BARTZ TRUSTEE-EMPLOYER 1.00 X 0 0 0 JESSE ROUSH TRUSTEE-EMPLOYER 1.00 X 0 0 0 JIM PERSON TRUSTEE-EMPLOYER 1.00 X 0 0 0 DAN BRADY TRUSTEE-UNION 1.00 40.00 X 0 118329 68485 0 1073180 589698 0 0 1 0 ZENITH AMERICAN SOLUTIONS INC 2520 PILOT KNOB ROAD STE 325 MENDOTA HTS MN 55120 CONTRACT ADMINISTRATOR 3043400 BLUECROSS BLUESHIELD MN 1200 YANKEE DOODLE ROAD EAGAN MN 55122 PREFERRED PROVIDER ORGANIZATION ACCESS 1770688 BENECARD PBF 1200 ROUTE 46 WEST CLIFTON NJ 07013 CLAIMS PROCESSING FEES 573934 MCGRANN SHEA CARNIVAL STRAUGN & LAMB 800 NICOLLET MALL SUITE 2600 MINNEAPOLIS MN 554027035 LEGAL COUNSEL 353725 DELTA DENTAL OF MINNESOTA 500 WASHINGTON AVENUE S SUITE 206 MINNEAPOLIS MN 554151163 PREFERRED PROVIDER ORGANIZATION ACCESS 319580 12 EMPLOYER CONTRIBUTIONS 900099 135831184 135831184 PARTICIPANT CONTRIBUTIONS 900099 9198686 9198686 PRESCRIPTION REBATES 900099 1336440 1336440 MEDICARE PART D SUBSIDY 900099 566749 566749 LIQUIDATED DAMAGES 900099 103160 103160 147036219 8406326 8406326 116218670 109056604 7162066 7162066 7162066 LEGAL FEES RECOVERY 900099 22637 22637 22637 162627248 147036219 0 15591029 122125415 2542819 353725 115616 837646 255527 534295 31606 63805 DEPENDENT AUDIT FEE 218426 PCORI FEE 72918 GOVERNMENT COMPLIANCE 615 127152413 -1938023 -1019402 51633957 53372414 12215816 11574601 82238659 64105424 397288707 511750441 541439116 639783478 843703 721797 175411 183417 712538 731265 1731652 1636479 X 0 0 0 0 539707464 638146999 539707464 638146999 541439116 639783478 35474835 62964700 0 X 0 1 X 1 0 0 LIMITED PARTNERSHIPS 105621074 F MUTUAL FUND - NON PUBLICLY TRADED 24787389 F COMMON COLLECTIVE TRUST FUNDS 381341978 F 511750441 DUE TO BROKER 731265 731265 X 224731665 62964700 62964700 161766965 837646 22637 860283 162627248 126292130 0 126292130 837646 22637 860283 127152413 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN TO EVALUATE TAX POSITIONS TAKEN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN UNCERTAIN TAX POSITIONS 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. PART XI, LINE 4B - OTHER ADJUSTMENTS: LEGAL FEES RECOVERY 22637. PART XII, LINE 4B - OTHER ADJUSTMENTS: LEGAL FEES RECOVERY 22637. 0 0 0 TIM MACKEY TRUSTEE-UNION - PAST 0 190511 0 0 0 0 0 74420 0 16756 0 281687 0 0 JOE FOWLER TRUSTEE-UNION 0 170837 0 0 0 0 0 73633 0 15643 0 260113 0 0 JOEL SMITH TRUSTEE-UNION (CHAIRMAN) 0 123100 0 0 0 0 0 51060 0 15390 0 189550 0 0 MIKE BUBALO TRUSTEE-UNION 0 163312 0 0 0 0 0 70844 0 15643 0 249799 0 0 SHAWN BRAFORD TRUSTEE-UNION 0 111043 0 0 0 0 0 48929 0 16756 0 176728 0 0 DAN BRADY TRUSTEE-UNION 0 118329 0 0 0 0 0 52842 0 15643 0 186814 0 0 FORM 990, PART VI, SECTION A, LINE 3 ALTHOUGH THE TRUSTEES RETAIN THE ULTIMATE RESPONSIBILITY, THE BOARD OF TRUSTEES HAS DELEGATED THE DAY TO DAY ADMINISTRATIVE DUTIES TO ZENITH AMERICAN SOLUTIONS, INC. AS THE THIRD PARTY ADMINISTRATOR OF THE PLAN. FORM 990, PART VI, SECTION A, LINE 7A THE PLAN IS ADMINISTERED BY 7 EMPLOYER TRUSTEES AND 7 UNION TRUSTEES. OF THE 7 EMPLOYER TRUSTEES, 4 ARE APPOINTED BY ASSOCIATED GENERAL CONTRACTORS, 1 BY MECA AND 2 BY THE MASONRY CONTRACTORS. OF THE 7 UNION TRUSTEES, 3 ARE APPOINTED BY LOCAL 563, 1 FROM EACH OF THE FOLLOWING: LOCAL 1091, LOCAL 405, THE LABORERS' INTERNATIONAL UNION OF NORTH AMERICA AND THE LABORERS DISTRICT COUNCIL OF MINNESOTA AND NORTH DAKOTA. 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 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 TO ENSURE THE PLAN OPERATES IN A MANNER CONSISTENT WITH ITS PURPOSES AND DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS OR ITS FIDUCIARY OBLIGATIONS, TRUSTEES ARE REQUIRED TO FOLLOW THE CONFLICT OF INTEREST POLICY WHICH STATES THAT ANY TRUSTEE WHO SENSES THAT A COURSE OF ACTION HE OR SHE HAS PURSUED, IS PRESENTLY PURSUING, OR IS CONTEMPLATING PURSUING MAY PRESENT A CONFLICT OF INTEREST, TO IMMEDIATELY COMMUNICATE ALL THE FACTS TO THE CHAIRMAN AND SECRETARY OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO ANY PARTICIPANT IN THE PLAN UPON REQUEST AT THE THIRD PARY ADMINISTRATOR'S OFFICE. 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