2019-04-29T14:09:44-05:00 2018-08-31 470900880 CALIBRE CPA GROUP PLLC 230 W Monroe Street CHICAGO IL 60606 990 2017-09-01 237009055 WISCONSIN LABORERS' HEALTH FUND WISC 6088461742 4633 LIUNA WAY No 201 DEFOREST WI 535322514 john schmitt Trustee 6088461742 2019-04-29 1 COREY BILKEY P00499751 3126550037 38.100.43.100 2019-04-29 14:09:24 CD P 883CF1A9781ABDA3268701484D9C94428E8D752B 099BB351ED5C43DB8E4A0DD96B056B1430213725 2017 2019-02-21 02:37:17Z 4633 LIUNA WAY No 201 DEFOREST WI 535322514 117342614 0 X N/A X 1967 WI TO PROVIDE HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER THE PLAN. 14 5 196 0 0 0 0 0 85053358 94393063 2822229 3780121 0 0 87875587 98173184 0 0 86103348 85871183 47436 46843 0 0 0 6658978 6581027 92809762 92499053 -4934175 5674131 289426056 302142419 54964674 46596472 234461382 255545947 X TO PROVIDE HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER THE PLAN. 0 0 THE PLAN PROVIDES HOSPITAL, MEDICAL, SURGICAL, DENTAL, VISION, LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT, DISABILITY, AND SKILLED NURSING CARE BENEFITS TO ALL ELIGIBLE PARTICIPANTS. THE PLAN PROVIDES HOSPITAL,MEDICAL, SURGICAL, DENTAL, VISION, LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT, DISABILITY, AND SKILLED NURSING CARE BENEFITS TO ALL ELIGIBLE PARTICIPANTS. 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 0 0 196 1 0 0 0 0 0 0 X 14 5 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 1 0 0 0 X benefit plan administrators 6088461742 4633 LIUNA WAY SUITE 201 DEFOREST WI 535322514 MARY WILCOX Trustee 3.00 X 0 0 0 WILLIAM KENNEDY Trustee 3.00 X 0 0 0 THOMAS PTACIN FRMR Trustee 3.00 X 0 0 0 BRIAN HORNUNG Trustee 3.00 X 0 0 0 ROBERT BARKER Trustee 3.00 40.00 X 0 198443 35356 JOHN TOPP Trustee 3.00 40.00 X 0 177480 20047 TONY NEIRA Trustee 3.00 50.00 X 0 136054 77651 JEFF DEHNHOFF FRMR Trustee 3.00 40.00 X 0 89886 62872 CLARK JENSEN Trustee 3.00 40.00 X 0 92054 57801 TONY MARCELLE Trustee 3.00 40.00 X 0 84411 38837 JOHN SCHMITT Trustee 3.00 40.00 X 0 150730 81390 DAVE SMESTAD Trustee 3.00 X 0 0 0 DAN BURKE FRMR Trustee 3.00 40.00 X 0 94412 66602 KENT MILLER trustee 3.00 40.00 X 0 94311 56589 KEVIN RENLEY trustee 3.00 X 0 0 0 JAMES FOYE TRUSTEE 3.00 40.00 X 0 91628 65866 Brian Dehhoff Trustee 3.00 40.00 X 0 75262 56626 0 1284671 619637 0 0 1 0 ANTHEM BLUE CROSS BLUE SHIELD PO BOX 34210 LOUISVILLE KY 40233 PPO SERVICE FEES 2093159 BENEFIT PLAN ADMINISTRATION OF WISC 2901 WEST BELTLINE HIGHWAY MADISON WI 53713 ADMIN 1103476 ZENITH AMERICAN SOLUTIONS 4633 LIUNA WAY SUITE 201 DEFOREST WI 53532 ADMIN 877489 PREVIANT GOLDBERG UELMEN GRATZ MILLE PO BOX 12993 MILWAUKEE WI 53212 LEGAL SERVICES 242309 DELTA DENTAL INSURANCE 2801 HOOVER ROAD PO BOX 828 STEVENS POINT WI 54481 DENTAL CLAIMS ADMINISTRATOR 233918 5 EMPLOYER CONTRIBUTIONS 900099 85154267 85154267 SELF-PAY CONTRIBUTIONS 900099 8464135 8464135 Subrogation 900009 759747 759747 LIQUIDATED DAMAGES 900099 14914 14914 94393063 2534567 2534567 20414984 19169430 1245554 1245554 1245554 98173184 94393063 0 3780121 85871183 46843 1770110 453356 64438 1190506 2791857 130029 86011 1247 33495 ACA FEES AND ASSESSMENT 59978 92499053 22652412 14719367 1136800 421489 9359033 11849667 17014 0 46874899 50076868 209040616 224703080 345282 371948 289426056 302142419 5038643 3762070 49926031 42834402 54964674 46596472 X 0 0 0 0 234461382 255545947 234461382 255545947 289426056 302142419 5674131 15410434 0 X X 0 1 X 1 0 0 COMMON COLLECTIVE TRUSTS 110762185 F POOLED SEPARATE ACCOUNTS 11966232 F LIMITED PARTNERSHIPS 56010293 F 103-12 INVESTMENT ENTITY 24670933 F REAL ESTATE INVESTMENT TRUST 21293437 F 224703080 EST FOR EXTENDED ELIG 30500000 EST FOR INCUR BUT NOT RPTD 7420000 EST FOR BANKED HOURS 244000 ACCUM BALANCE IN PART HSA ACCTS 4670402 42834402 X 112393112 15410434 15410434 96982678 1190506 1190506 98173184 99538076 0 99538076 1190506 -8229529 -7039023 92499053 Part X, Line 2: AS OF AUGUST 31, 2018, THERE WERE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIOD IN PROGRESS. AT AUGUST 31, 2018 THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO THE FISCAL YEAR ENDED AUGUST 31, 2015. Part XII, Line 4b - Other Adjustments: DECREASE IN INBR -2,042,200. DECREASE IN ACCUM ELIGIBILITY -6,000,000. DECREASE IN CLAIMS PAYABLE -1,137,900. INCREASE IN BANKED HOURS 84,000. INCREASE IN PART HSA ACCUM BALANCE 866,571. 0 0 0 ROBERT BARKER Trustee 0 198443 0 0 0 0 0 19134 0 16222 0 233799 0 0 JOHN TOPP Trustee 0 177480 0 0 0 0 0 18951 0 1096 0 197527 0 0 TONY NEIRA Trustee 0 136054 0 0 0 0 0 60659 0 16992 0 213705 0 0 JEFF DEHNHOFF FRMR Trustee 0 89886 0 0 0 0 0 43128 0 19744 0 152758 0 0 JOHN SCHMITT Trustee 0 146966 0 0 0 3764 0 64128 0 17262 0 232120 0 0 DAN BURKE FRMR Trustee 0 93080 0 0 0 1332 0 45362 0 21240 0 161014 0 0 KENT MILLER trustee 0 87235 0 0 0 7076 0 39605 0 16984 0 150900 0 0 JAMES FOYE TRUSTEE 0 90406 0 0 0 1222 0 44626 0 21240 0 157494 0 0 Form 990, Part VI, Section B, line 11b THE TRUSTEES AUTHORIZE THE FUND'S THIRD PARTY ADMINISTRATOR AND A DESIGNATED TRUSTEE TO REVIEW THE FORM 990 BEFORE IT IS FILED. Form 990, Part VI, Section B, line 12c THE TRUSTEES ARE GOVERNED BY THE TRUST DOCUMENT AND HAVE A FIDUCIARY RESPONSIBILITY UNDER ERISA TO ADMINISTER THE PLAN IN THE BEST INTEREST OF THE MEMBERSHIP. THE US DEPARTMENT OF LABOR REQUIRES ALL LABOR TRUSTEES TO REPORT ON FORM LM-30 POTENTIAL SITUATIONS WHERE THERE MAY BE CONFLICTS OF INTEREST. THIS INFORMATION IS OPEN TO THE PUBLIC. Form 990, Part VI, Section C, line 19 A SUMMARY ANNUAL REPORT IS DISTRIBUTED TO ALL PARTICIPANTS. PARTICIPANTS ARE ABLE TO REQUEST THE AUDITOR'S REPORT AND OTHER FINANCIAL INFORMATION FROM THE PLAN ADMINISTRATOR AND/OR DEPARTMENT OF LABOR. ALSO, THE FORM 5500 IS OPEN TO PUBLIC INSPECTION. Form 990, Part XII, line 2c: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. WISCONSIN LABORERS PENSION FUND 4633 LIUNA WAY SUITE 201 DEFOREST WI 53532 396198530 TO PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS WI 401 A 0 WISCONSIN LABORERS APPR & TRAINING FUND 4633 LIUNA WAY 100 DEFOREST WI 53532 391161160 TO PROVIDE TRAINING AND IMPROVE THE SKILLS OF MEMBERS WI 501C 3 0 LABORERS UNION LOCAL #464 1438 n stoughton rd madison WI 53714 390189279 improve condition of workers WI 501c5 0 LABORERS UNION LOCAL 113 6310 w appleton ave milwaukee WI 53210 390367985 improve condition of workers WI 501c5 0 LABORERS UNION LOCAL 140 2771 george st lacrosse WI 54603 390367733 improve condition of workers WI 501c5 0 LABORERS UNION LOCAL 330 886 w airport rd menasha WI 54952 201169193 improve condition of workers WI 501c5 0 LABORERS UNION-LOCAL 268 2233 birch st eau claire WI 54703 562460681 improve condition of workers WI 501c5 0 WIS LABORERS DISTRICT COUNC 4633 LIUNA WAY 100 DEFOREST WI 53532 391142477 improve condition of workers WI 501C5 0 WISCONSIN LABORERS LECET 4633 LIUNA WAY 100 DEFOREST WI 53532 391705116 improved labor mgmt cooperation WI 501c5 0 agc of wisconsin 4814 e broadway madison WI 53716 390712400 improved labor mgmt cooperation WI 501c6 0 allied construction employers assn 17100 w bluemound rd brookfield WI 53005 390189310 improved labor mgmt cooperation WI 501c6 0 A-1 EXCAVATING A&J CONCRETE SERVICES LLC AL LTD LANDSCAPING ABCO BUILDING CORP ADKINS CONSTRUCTION INC ADVANTAGE SCAFFOLDING-TRADE ACCESS AECOM ENERGY AND CONSTRUCTION INC AJ HEINEN INC ALBERICI CONSTRUCTORS INC ALBRIGHTSON EXCAVATING ALFREDSON BROTHERS CONSTRUCTION COM ALL FIVE CONCRETE CUTTING INC AMERICAN DEMOLITION CORPORATION AMERICAN SEWER SERVICES INC APCOMPOWER INC API CONSTRUCTION COMPANY INC APPLIED ECOLOGICAL SERVICE APPLIED FLOORING SOLUTIONS LLC ARBOR GREEN INC ARNIE MACKEY CONSTRUCTION INC ARROW-CRETE CONSTRUCTION LLC ARTEAGA CONSTRUCTION INC ASBESTROL INC ASC INSULATION & FIREPROOFING INC ASSOC PIPELINE CONSTRUCTION IN ASSOCIATED GENERAL CONTRACTORS ASTI 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