2019-10-01T13:08:54-05:00 2018-11-30 320043599 LEGACY PROFESSIONALS LLP 6800 FRANCE AVENUE SO SUITE 550 EDINA MN 55435 990 2017-12-01 237115412 MINNESOTA TEAMSTERS CONSTRUCTION DIVISION FRINGE BENEFIT FUNDS MINN 6512561900 2520 PILOT KNOB ROAD NO 325 MENDOTA HEIGHTS MN 55120 DAVID SCHRUNK TRUSTEE 6512561900 2019-09-13 1 ERIC C BAERTSCH P00964071 9528413950 12.235.239.120 2019-09-13 12:54:26 CD P 0938D8DB5C4DDE853E46E76E68F7A068926B230F 0938D8DB5C4DDE853E46E76E68F7A068926B230F 2017 2019-02-21 02:37:17Z DAVID SCHRUNK 2520 PILOT KNOB ROAD NO 325 MENDOTA HEIGHTS MN 55120 21567229 0 X N/A X 1970 MN PROVIDE HEALTH BENEFITS 8 8 0 0 0 0 0 0 14899730 14858134 559008 356429 23069 9885 15481807 15224448 0 0 16655696 16827820 0 0 0 0 0 427841 455940 17083537 17283760 -1601730 -2059312 22714739 20359065 20560 18928 22694179 20340137 TO PROVIDE HEALTH CARE, DENTAL, DISABILITY, LIFE, AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS TO MEMBERS. 0 0 PAYMENT OF HEALTH CARE, DENTAL, DISABILITY, LIFE, AND ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS FOR ELIGIBLE PARTICIPANTS AND DEPENDENTS AS PROVIDED BY THE SUMMARY PLAN DESCRIPTION. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 X 8 8 0 1 0 0 0 1 0 1 0 0 0 1 1 0 0 0 0 0 0 0 X ZENITH AMERICAN SOLUTIONS INC 6512561900 2520 PILOT KNOB ROAD SUITE 325 MENDOTA HEIGHTS MN 55120 X CHAD NELSON TRUSTEE 1.00 X 0 0 0 ANDREW ERICHSON ALTERNATE TRUSTEE 1.00 X 0 0 0 STEVE SAUER SECRETARY 2.00 X 0 0 0 JASON ZINS TRUSTEE 1.00 X 0 0 0 NICK JOHNSON ALTERNATE TRUSTEE 1.00 X 0 0 0 ABBEY BRYDUCK TRUSTEE - PAST 1.00 X 0 0 0 MOLLY BARNES TRUSTEE - NEW 1.00 X 0 0 0 DAVE SCHRUNK CHAIRMAN 2.00 X 0 0 0 WAYNE PERLEBERG TRUSTEE 1.00 X 0 0 0 JEFF DIEDE TRUSTEE 1.00 X 0 0 0 ZACHARY RADZAK TRUSTEE 1.00 X 0 0 0 TOM NELTON ALTERNATE TRUSTEE 1.00 X 0 0 0 JOE BATTAGLIA ALTERNATE TRUSTEE - PAST 1.00 X 0 0 0 CHAD WARD ALTERNATE TRUSTEE 1.00 X 0 0 0 SHANE BLOCK ALTERNATE TRUSTEE 1.00 X 0 0 0 RICH FREDERICK ALTERNATE TRUSTEE - NEW 1.00 X 0 0 0 0 0 0 0 0 0 0 ZENITH AMERICAN SOLUTIONS INC 2520 PILOT KNOB ROAD SUITE 325 MENDOTA HEIGHTS MN 55120 ADMINISTRATIVE, CLAIMS PROCESSING, AUDIT 400666 BLUELINK TPA 1200 YANKEE DOODLE ROAD PO BOX 6 ST PAUL MN 55164 PPO ACCESS FEES 285891 2 EMPLOYER CONTRIBUTIONS 900099 13897630 13897630 PRESCRIPTION REBATES 900099 510333 510333 PARTICIPANT CONTRIBUTIONS 900099 380915 380915 SUBROGATION SETTLEMENTS 900099 50628 50628 STOP LOSS RECOVERIES 900099 15815 15815 2813 2813 14858134 399210 399210 6300000 6342781 -42781 -42781 -42781 OTHER INCOME 900099 9885 9885 9885 15224448 14858134 0 366314 16827820 163108 73457 39465 13115 79711 70506 2391 6784 FEES MANDATED BY ACA 6737 GOVERNMENT COMPLIANCE 666 17283760 1376511 1030452 3486456 2010647 1292835 1825887 16180384 15476357 378553 15722 22714739 20359065 10051 10480 10509 8448 20560 18928 X 0 0 0 0 22694179 20340137 22694179 20340137 22714739 20359065 -2059312 -294730 0 X 0 0 0 0 X 14916603 -294730 -294730 15211333 13115 13115 15224448 17270645 0 17270645 13115 13115 17283760 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 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. FORM 990, PART VI, SECTION A, LINE 3 ALTHOUGH THE TRUSTEES RETAIN THE ULTIMATE RESPONSIBILITY, THE TRUSTEES HAVE 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 FOUR EMPLOYER ASSOCIATION TRUSTEES AND FOUR UNION TRUSTEES. THE FOUR EMPLOYER ASSOCIATION TRUSTEES SHALL BE DESIGNATED BY THE EMPLOYER ASSOCIATION. THE FOUR UNION TRUSTEES SHALL BE DESIGNATED BY THE NEGOTIATING COMMITTEE. SIX ALTERNATE TRUSTEES ARE APPOINTED, THREE FROM THE EMPLOYER ASSOCIATION AND THREE FROM THE UNIONS. EACH TRUSTEE AND ALTERNATE TRUSTEE MAY BE REMOVED ONLY BY THE PARTY WHICH APPOINTED THEM. FORM 990, PART VI, SECTION A, LINE 8B THERE IS NO COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PROVIDED TO AND REVIEWED BY THE ENTIRE BOARD OF TRUSTEES BEFORE THE FORM 990 IS FILED. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO PARTICIPANTS AT THE PLAN OFFICE. 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