2019-10-17T15:45:01-05:00 2018-12-31 391531945 FREYBERG HINKLE ASHLAND POWERS & STOWELL 15420 W CAPITOL DR BROOKFIELD WI 530052621 990 2018-01-01 316041107 HEARTLAND HEALTH & WELLNESS FUND HEAR 9376651900 7250 POE AVENUE NO 300 DAYTON OH 45414 JOE CHORPENNING SECRETARY/TREASURER 9376651900 2019-10-17 1 THOMAS M POWERS CPA P00241729 2627846210 70.61.53.194 2019-10-17 15:44:15 CD P CCA3FFBDE7687CE42E9EA09D506C5024DA3E21F0 CCA3FFBDE7687CE42E9EA09D506C5024DA3E21F0 2018 2020-01-14 16:20:31Z HENRY TAYLOR 7250 POE AVENUE NO 300 DAYTON OH 45414 177198351 0 X WWW.HEARTLANDWELLNESSFUND.COM X EMPLOYEE BENEFIT PLAN 1957 OH THE PLAN PROVIDES MEDICAL, DENTAL, AND LIFE BENEFITS TO ITS MEMBERS AND DEPENDENTS. 8 8 45 0 0 0 0 0 159644289 171491039 296090 300418 207994 274994 160148373 172066451 0 0 148082624 173542820 2250064 2500549 0 0 0 9461168 9963074 159793856 186006443 354517 -13939992 26635318 28481422 6717454 22796430 19917864 5684992 TO PROVIDE FOR A UNIFORM HEALTH AND WELFARE PROGRAM FOR EMPLOYEES EMPLOYED UNDER CERTAIN COLLECTIVE BARGAINING AGREEMENTS. 0 0 180716752 THE PLAN PROVIDES ACCIDENT, HEALTH, VISION, PRESCRIPTION, DENTAL, LIFE, AND DEATH BENEFITS TO ITS MEMBERS AND DEPENDENTS. 180716752 0 0 0 0 0 0 0 0 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 1 300 0 1 45 1 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 1 1 1 0 0 X JERRY EVANS 9376651900 7250 POE AVENUE SUITE 300 DAYTON OH 45414 LENNIE WYATT TRUSTEE 1.00 50.00 X 12119 11025 0 JOE CHORPENNING SECRETARY 1.00 X X 0 0 0 STEVE YANCEY TRUSTEE 1.00 X 0 0 0 KATHY WAGENKNECHT TRUSTEE 1.00 X 0 0 0 HENRY TAYLOR CHAIRPERSON 1.00 X X 0 0 0 KEVIN GARVEY TRUSTEE 1.00 50.00 X 0 283813 34670 GREG THOMPSON ALTERNATE TRUSTEE 1.00 X 0 0 0 TONY HELFER ALTERNATE TRUSTEE 1.00 40.00 X 0 216280 27442 ROB FRANCIN TRUSTEE 1.00 X 0 0 0 DON SATTLER ALTERNATE TRUSTEE 1.00 X 0 0 0 BRYON O'NEAL TRUSTEE 1.00 X 0 237412 32783 RANDY QUICKEL TRUSTEE 1.00 X 0 0 0 STEVEN SPRINGER TRUSTEE 1.00 X 0 0 0 JERRY EVANS ADMINISTRATOR 40.00 X 144830 0 23465 MELISSA STEED EMPLOYEE 40.00 X 101817 0 28768 258766 748530 147128 2 0 1 0 EPLAN LLC 22601 N 19TH AVE SUITE 240 PHOENIX AZ 85027 CLAIMS REVIEW 535047 BASYS INC 3700 KOPPERS STREET SUITE 400 BALTIMORE MD 21227 COMPUTER CONSULTING 529836 THE SEGAL COMPANY 101 NORTH WACKER DRIVE STE 500 CHICAGO IL 60606 ACTUARY 502078 REINHART BOERNER VAN DEUREN SC PO BOX 2965 MILWAUKEE WI 532012965 ATTORNEY 475701 HEALTH FITNESS CORP 1700 W 82ND ST SUITE 200 MINNEAPOLIS MN 55431 CONSULTING 249438 8 EMPLOYER CONTRIBUTIONS 900099 169925034 169925034 SELF-PAYMENT CONTRIB. 900099 1566005 1566005 171491039 346330 346330 5085988 5131900 -45912 -45912 -45912 SHARED EXPENSE REIMBURSEMENT 900099 193432 193432 MISCELLANEOUS 900099 81562 81562 274994 172066451 171766033 0 300418 173542820 173542820 1658568 1658568 140711 140711 570464 570464 130806 130806 455104 455104 87064 87064 21473 21473 516628 516628 801248 801248 564997 564997 124832 124832 62135 62135 23237 23237 63596 63596 PPO FEES AND MEDICAL RE 6982243 6982243 VISION SERVICE PLAN PRO 148548 148548 PCORI FEE 62620 62620 PRESCRIPTION DRUG PROGR 43141 43141 6208 6208 186006443 180716752 5289691 0 3632102 8149155 6033381 6206499 8638652 5723929 70109 66914 218827 135968 60549 82859 7636775 7677227 563750 574839 26635318 28481422 3637267 5398232 139587 187098 2940600 17211100 6717454 22796430 X 0 0 0 0 19917864 5684992 19917864 5684992 26635318 28481422 -13939992 -292880 0 X X 0 1 X 1 0 218827 135968 82859 82859 BENEFIT OBLIGATIONS CURRENTLY PAYABLE 17211100 17211100 X 171752098 -292880 -292880 172044978 21473 21473 172066451 171714470 0 171714470 21473 14270500 14291973 186006443 PART X, LINE 2: U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XII, LINE 4B - OTHER ADJUSTMENTS: INCREASE IN CURRENT YEAR'S CLAIMS PAYABLE 14,270,500. X X 0 0 0 KEVIN GARVEY TRUSTEE 0 200542 0 83271 0 0 0 0 0 34670 0 318483 0 0 TONY HELFER ALTERNATE TRUSTEE 0 216280 0 0 0 0 0 0 0 27442 0 243722 0 0 BRYON O'NEAL TRUSTEE 0 165099 0 72313 0 0 0 0 0 32783 0 270195 0 0 JERRY EVANS ADMINISTRATOR 144830 0 0 0 0 0 0 0 23465 0 168295 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 GOES THROUGH A PRELIMINARY REVIEW BY THE ADMINISTRATIVE MANAGER AND ACCOUNTANT. ONCE THEY APPROVE THE FORM 990 IT IS PRESENTED TO A COMMITTEE OF TRUSTEES FOR APPROVAL PRIOR TO SIGNING AND FILING. FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES ARE EXPECTED TO FULLY DISCLOSE ANY OWNERSHIP OR OTHER FINANCIAL RELATIONSHIPS THEY HAVE WITH OTHER PARTIES THAT DEAL WITH THE PLAN. FORM 990, PART VI, SECTION B, LINE 15A THE ADMINISTRATIVE MANAGER'S PAY RANGE IS DETERMINED BY THE BOARD OF TRUSTEES. THE TRUSTEES HAD A SALARY STUDY PERFORMED BY THE PLAN'S CONSULTANTS. THE TRUSTEES APPROVE INCREASES IN COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THE BOARD OF TRUSTEES IS RESPONSIBLE FOR THE SELECTION OF AN INDEPENDENT ACCOUNTANT TO PERFORM THE AUDIT OF THE PLAN'S FINANCIAL STATEMENTS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, SCHEDULE R, PARTS II-IV: IN ADDITION TO THE CONTRIBUTING EMPLOYERS REPORTED AS RELATED ORGANIZATIONS ON SCHEDULE R, PARTS II-IV, THE PLAN ALSO HAD FIVE SOLE PROPRIETORS AS CONTRIBUTING EMPLOYERS DURING 2018. THE PLAN MADE A RESONABLE EFFORT TO OBTAIN THE TAX CLASSIFICATION FROM ALL CONTRIBUTING EMPLOYERS, BUT SIX OF THE CONTRIBUTING EMPLOYERS HAVE NOT YET RESPONDED TO THE MULTIPLE REQUESTS. BOARD OF TRUSTEES OF HEARTLAND HEALTH & WELLNESS FUND 7250 POE AVENUE DAYTON OH 45414 316173363 PLAN SPONSOR AND PLAN ADMINISTRATOR OH 501(C)(9) N/A 0 CHAMPAIGN RESIDENTIAL SERVICES INC GOOD SHEPHERD HOME HAMILTON COUNTY DEMOCRATIC PARTY HARBOR BEHAVIORAL HEALTH INT'L ASSOC OF MACHINISTS & AEROSPACE WORKERS LOCAL LODGE 1943 UNITED FOOD AND COMMERCIAL WORKERS UNION LOCAL NO 23 UNITED FOOD AND COMMERCIAL WORKERS UNION LOCAL NO 75 7250 POE AVENUE DAYTON OH 45414 310621221 LABOR UNION OH 501(C)(5) N/A 0 GENACROSS-LUTHERAN MEMORIAL HOME GENACROSS-WOLF CREEK CINCINNATI AFO-CIO LABOR COUNCIL CINCINNATI INTERFAITH WORKERS DAYTON AREA PLUMBERS AND PIPEFITTERS APPRENTICESHIP FUND UNITED FOOD AND COMMERCIAL WORKERS UNION LOCAL NO 1776KS NEUSOLE FOUNDATION LAWRENCE COUNTY CAREER & TECHNICAL CENTER ALLISON STREET VENTURES LLC CLERMONTS BEST DRIVING ACADEMY LLC CONSOLIDATED HEALTHCARE SOLUTIONS LLC CUNDIFF TOWN & COUNTRY TREE SERV LLC EUGENE STEWART DBA SPECTRUM PRINTING & DESIGN GRAPHIC FINISHING LLC JAS ELECTRIC LLC KROGER LIMITED PARTNERSHIP 1 LEONARD A BLEH LLC MAXWELL MEDICAL LLC MICHAEL P KELLY REALTY PIPCO LLC SNYDER & GAST LLC WEBER DICKEY BELLMAN AMERICAN BUSINESS TECHNOLOGIES AVI FOOD SYSTEMS INC BAY VALLEY FOODS LLC BILLOW CONSTRUCTION INC BLUE GRASS PROVISIONS BOROWIAKS IGA BRIDGETOWN FINER MEATS INC BRUSH & LADDER PAINTING INC C-FAB LLC FRESH ENCOUNTERS - CHIEF SUPER MARKET INC COOK & LOGOTHETIS LLC CVS PHARMACY INC DBM & SONS INC DON CARTER & ASSOC INC DR ELLEN C TORBECK DMD PSC FRANK L HARTER & SONS INC FROZEN SPECIALTIES INC G&G TRANSPORTATION SERVICE INC GR FEHR COMPANY INC GARY LORD WALL OPTIONS AND ASSOCIATES INC GOERGE F MOELLER LPA GRACE FOODS INC FRESH ENCOUNTERS - GREAT SCOT INC HILLTOP PHYSICIANS INC INDUSTRIAL MECHANICAL CONTRACTORS INC JIM BITZENHOFER REFRIGERATION AND AC INC JOHN STEHLIN & SONS CO INC KUHL TILE & MARBLE INC LANGEN MEATS INC MANLEY BURKE LPA NEWMAN & MEEKS CO LPA RITE PRICE FOODS INC ROBERT WHOLEY & CO INC RUBLE ARTISTIC FURNITURE RESTORATION INC RUDOLPH FOODS COMPANY INC SEVEN HILLS COFFEE COMPANY SILGAN CAN COMPANY SKYHAVEN FARMS INC SUGAR CREEK PACKING CO THE KROGER CO UNION EYE CARE WASSLER MEATS INC WE CARE FOOD STORES INC WUNDERLAND INC LEE WILLIAMS MEATS INC WISCONSIN VISION INC KISSEL BROS MULLEN VAN HOUTEN OUR HARVEST 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 UNITED FOOD AND COMMERCIAL WORKERS UNION LOCAL NO 75 K 124832 FAIR MARKET VALUE UNITED FOOD AND COMMERCIAL WORKERS UNION LOCAL NO 75 P 58944 ACTUAL EXPENSE REIMBURSEMENTS