2019-07-22T10:16:07-05:00 2018-12-31 271235638 MCM CPAS & ADVISORS LLP 462 S FOURTH ST SUITE 2600 LOUISVILLE KY 402023445 990 2018-01-01 237017526 KENTUCKY LABORERS DISTRICT COUNCIL HEALTH & WELFARE FUND KENT 5028398166 1996 BY-PASS SOUTH LAWRENCEBURG KY 40342 JAMES BLEVINS CHAIRMAN 5028398166 2019-07-17 1 REBECCA L PHILLIPS CPA P00024055 5027491900 2019-07-17 69.135.99.226 2019-07-17 10:09:44 ED P 6FA29D37B981629268F2CD42382562A0C383985D 4F71EFB0427528A3DA06A1F74A7AF4AAECDCDE71 2018 2019-02-21 02:37:17Z MARK ISAACS 1996 BY-PASS SOUTH LAWRENCEBURG KY 40342 31295254 0 X N/A X 1967 KY EMPLOYEE BENEFIT PLAN PROVIDING ACCIDENT, SICKNESS, VISION, DENTAL, DEATH AND ACCIDENTAL DEATH & DISMEMBERMENT BENEFITS FOR ACTIVE PARTICIPANTS AND ACCIDENT, SICKNESS, VISION, DENTAL AND DEATH BENEFITS FOR RETIRED PARTICIPANTS. 9 9 10 10 0 0 0 0 22316040 21612700 1291191 1156264 59274 54188 23666505 22823152 0 0 26284423 22386944 991060 943680 0 0 0 1218505 1228476 28493988 24559100 -4827483 -1735948 25865286 23016317 1124846 1029134 24740440 21987183 EMPLOYEE BENEFIT PLAN PROVIDING ACCIDENT, SICKNESS, VISION, DENTAL, DEATH AND ACCIDENTAL DEATH & DISMEMBERMENT BENEFITS FOR ACTIVE PARTICIPANTS AND ACCIDENT, SICKNESS, VISION, DENTAL AND DEATH BENEFITS FOR RETIRED PARTICIPANTS. 0 0 EMPLOYEE BENEFIT PLAN PROVIDING ACCIDENT, SICKNESS, VISION, DENTAL, DEATH AND ACCIDENTAL DEATH & DISMEMBERMENT BENEFITS FOR ACTIVE PARTICIPANTS AND ACCIDENT, SICKNESS, VISION, DENTAL AND DEATH BENEFITS FOR RETIRED PARTICIPANTS. 0 0 0 0 0 0 0 0 0 1 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 1 869 0 1 10 1 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X D CROUCH FUND ADMINISTRATORS GRIFFIETH FUND ASSISTANT 5028398166 1996 BY-PASS SOUTH LAWRENCEBURG KY 40342 X MARK ISAACS CHAIRMAN 1.00 X X 0 0 0 DOUG HACKER SECRETARY/TREASURER 1.00 X X 0 0 0 PERRY BLADES TRUSTEE 1.00 X 0 0 0 MITCHELL ONEY ENDED 41918 TRUSTEE 1.00 X 0 0 0 DONALD TRAVIS TRUSTEE 1.00 X 0 0 0 JEFF STORY TRUSTEE 1.00 X 0 0 0 ANTHONY WICKLINE TRUSTEE 1.00 X 0 0 0 LARRY HENDERSON TRUSTEE 1.00 X 0 0 0 DWAYNE MCCAULEY BEGAN 41918 TRUSTEE 1.00 X 0 0 0 JEREMY JENKINS ALTERNATE TRUSTEE (ALTERNATE) 1.00 X 0 0 0 0 0 0 0 0 0 0 CIGNA PO BOX 644546 PITTSBURGH PA 152644546 REPRICING OF CLAIMS, PRE-CERTIFICATION 498413 BENESYS 700 TOWER DR SUITE 300 TROY MI 48098 CONSULTING AND ELIGIBILITY AND CLAIMS PR 163986 ZELIS 2 CROSSROADS DRIVE BEDMINSTER NJ 07921 REPRICING OF NON-PPO CLAIMS 139211 JOHNSON & KROL LLC 311 SOUTH WACKER DRIVE SUITE 1050 CHICAGO IL 60606 FUND ATTORNEY 105119 3 EMPLOYER CONTRIBUTIONS 900099 20043913 20043913 EMPLOYEE CONTRIBUTIONS 900099 1568787 1568787 21612700 414968 414968 9213398 8472102 741296 741296 741296 CONTRIBUTION RECORDS F 900099 54188 54188 54188 22823152 21666888 0 1156264 22386944 586734 195624 115051 46271 102680 52796 51992 612615 155532 116265 40455 45 7646 5530 13578 INTERNATIONAL FOUNDATIO 31105 EMPLOYEE ASSISTANCE PLA 28472 PCORI TAX 7995 MAINTENANCE & SERVICE C 1770 24559100 46011 192455 2216265 2296287 25475 37538 104637 94701 15466 9936 23562069 20480101 25865286 23016317 948830 1029134 176016 0 1124846 1029134 X 24740440 21987183 0 0 0 0 24740440 21987183 25865286 23016317 -1735948 -1017309 0 X X 0 1 X 1 0 28610 28610 0 76027 66091 9936 9936 X 21805843 -1017309 -1017309 22823152 0 22823152 24559100 0 24559100 0 24559100 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS INTENDED TO QUALIFY PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE ("IRC"), AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE TRUST HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER DATED MAY 14, 1969 FROM THE INTERNAL REVENUE SERVICE ("IRS"), AND THE PLAN ADMINISTRATOR AND THE PLAN'S TAX COUNSEL BELIEVE THAT THE TRUST, AS AMENDED, CONTINUES TO QUALIFY AND TO OPERATE IN ACCORDANCE WITH APPLICABLE PROVISIONS OF THE IRC. U.S. GAAP REQUIRES PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2018 AND 2017, THERE ARE NO UNCERTAIN TAX 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 TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE FUND AUDITOR. IT IS REVIEWED BY THE FUND ATTORNEY, FUND CONSULTANT AND FUND ADMINISTRATOR PRIOR TO PRESENTATION TO THE BOARD OF TRUSTEES. THE BOARD OF TRUSTEES THEN REVIEW THE FORM 990 BEFORE APPROVAL AND SIGNING. AFTER APPROVAL AND EXECUTION BY BOARD OF TRUSTEES, THE FORM 990 IS FILED. (IN THIS CASE, IT IS E-FILED BY THE FUND AUDITOR) FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE OR EMPLOYEE OF THE FUND HAS THE DUTY TO DISCLOSE ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST. EACH TRUSTEE OR EMPLOYEE MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE TRUSTEES DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, THE BOARD OF TRUSTEES WILL DISCUSS AND VOTE TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE CHAIRPERSON OF THE BOARD OF TRUSTEES SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. THE BOARD OF TRUSTEES SHALL THEN DETERMINE WHETHER THE FUND CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OF TRUSTEES SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED TRUSTEES WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE FUND'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. FORM 990, PART VI, SECTION B, LINE 15 IN DETERMINING WAGE INCREASES FOR FUND EMPLOYEES, THE TRUSTEES REVIEW THE CURRENT AND PROJECTED FINANCIAL STATUS OF THE FUND, INCLUDING CURRENT AND PROJECTED ADMINISTRATIVE COSTS, AND TAKE INTO CONSIDERATION THE WAGES FOR SIMILAR POSITIONS IN OTHER TAFT-HARTLEY TRUST FUNDS, PROJECTED COST OF LIVING TRENDS, AND EMPLOYEES' WORK HISTORIES AND JOB PERFORMANCES. THE TRUSTEES HAVE ALSO IMPLEMENTED A POLICY WHEREIN THE ADMINISTRATOR WILL PERFORM ANNUAL JOB PERFORMANCE REVIEWS FOR EACH FUND EMPLOYEE. THE FUND TRUSTEES DO NOT RECEIVE COMPENSATION OF ANY KIND. THERE IS NO CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL OF THIS FUND. FORM 990, PART VI, SECTION C, LINE 19 THEY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. THE FUND'S ADMINISTRATOR AND ASSISTANT ADMINISTRATOR CONTINUE TO OVERSEE THE AUDIT PROCESS OF ITS FINANCIAL STATEMENTS. HOWEVER, THE FULL BOARD OF TRUSTEES FOR THE FUND ASSUMES RESPONSIBILITY FOR THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE BOARD OF TRUSTEES REVIEWS AND APPROVES ALL MONTHLY FINANCIAL STATEMENTS AT THEIR QUARTERLY MEETINGS AND REVIEWS THE ANNUAL FINANCIAL REPORT AT A QUARTERLY MEETING. 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