2019-01-09T07:59:05-06:00 2018-05-31 470900880 CALIBRE CPA GROUP PLLC 230 W MONROE STE 310 CHICAGO IL 606064701 990 2017-06-01 366219639 FOX VALLEY LABORERS HEALTH & WELFARE FND FOXV 8477420900 2371 BOWES ROAD No 500 ELGIN IL 601235523 MIKE SHALES Chairman 8477420900 2019-01-04 1 ANDREW HEIN P00499757 3126550037 38.100.43.100 2019-01-09 08:58:42 ES P 883CF1A9781ABDA3268701484D9C94428E8D752B 099BB351ED5C43DB8E4A0DD96B056B1430213725 2017 2019-02-21 02:37:17Z MIKE SHALES 2371 BOWES ROAD No 500 ELGIN IL 601235523 50394806 0 X N/A X 1968 IL TO PROVIDE MEDICAL, DENTAL, VISION, TEMPORARY DISABILITY, AND DEATH BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 6 3 63 0 0 0 0 0 35645523 37464332 2909555 4646129 300544 384264 38855622 42494725 0 0 29997167 32622834 900110 1100109 0 0 0 2246975 2270568 33144252 35993511 5711370 6501214 94092176 103869536 19950141 23471258 74142035 80398278 TO PROVIDE MEDICAL, DENTAL, VISION, TEMPORARY DISABILITY, AND DEATH BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 0 0 TO PROVIDE MEDICAL, DENTAL, VISION, TEMPORARY DISABILITY, AND DEATH BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. THERE WERE 1,837 ELIGIBLE PARTICIPANTS AT MAY 31, 2018. 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 1 823 0 1 63 1 0 0 0 0 0 0 X 6 3 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 1 1 0 0 X PAT SHALES 8477420900 2371 BOWES ROAD SUITE 500 ELGIN IL 601235523 JOHN PBRYAN TRUSTEE 3.00 X 0 0 0 MIKE SHALES Chairman 3.00 X 0 0 0 VERN BAUMAN TRUSTEE 3.00 40.00 X 0 127343 86971 AL OROSZ TRUSTEE 3.00 X 0 0 0 COREY R JOHNSON FMR SECRETARY 3.00 50.00 X 0 60649 44919 DAVE SHEAHAN FMR TRUSTEE 3.00 40.00 X 0 124554 86971 MARK CSTELVECCHI TRUSTEE 3.00 50.00 X 0 74872 44528 MARTIN D DWYER SECRETARY 3.00 50.00 X 0 151137 92850 PATRICIA M SHALES ADMINISTRATOR 40.00 X 139195 0 47318 139195 538555 403557 1 0 1 0 BLUE CROSS BLUE SHIELD 300 EAST RANDOLPH ST CHICAGO IL 60601 PPO ACCESS FEES 880696 SEI INVESTMENT ONE FREEDOM DRIVE OAKS PA 19456 INV MGMNT/CONSULTING 276321 HORIZON ACTUARIAL SERVICES LLC 6120 ROLLING ROAD DRIVE MIAMI FL 331565629 PLAN CONSULTING 123539 3 EMPLOYER CONTRIBUTIONS 900099 35007540 35007540 MEMBER CONTRIBUTIONS 900099 1503314 1503314 Stop Loss Reimbursements 900009 800768 800768 MEDICARE D SUBSIDIES 900099 152710 152710 37464332 2615233 2615233 9930977 7900081 2030896 2030896 2030896 REIMB SAL & RELATED EXPENSES FROM 900099 384264 384264 384264 42494725 37848596 0 4646129 32622834 570587 266716 172104 90702 164533 65359 491250 1240502 175512 67872 825 7943 19021 30366 PATIENT PROTECTION & AF 7385 35993511 29489 41447 3921080 3315534 79138 91227 359319 294659 70704 64660 89804083 99288039 187682 1068629 94092176 103869536 64428 83837 19885713 23387421 19950141 23471258 X 0 0 0 0 74142035 80398278 74142035 80398278 94092176 103869536 6501214 -244971 0 X X 0 1 X 1 0 336838 272178 64660 22481 22481 0 64660 EST LIAB FUTR CLAIMS EXTENDED ELIGIBLTY 19002000 EST LIAB FUTR CLAIMS INCURRED BUT UNPAID 4173000 DEPOSITS HELD 212421 23387421 X 40420762 -244971 -244971 40665733 491250 1337742 1828992 42494725 30633519 -953478 -953478 31586997 491250 3915264 4406514 35993511 Part X, Line 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGMENT TO EVALUATE TAX POSISTIONS 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 TAXING AUTHORITIES. AS OF MAY 31, 2018, THERE WERE NO UNCERTAIN TAX POSISTIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION IF 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. AT MAY 31, 2018, THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO THE FISCAL YEAR ENDED MAY 31, 2015. Part XI, Line 4b - Other Adjustments: MEDICARE D SUBSIDIES RECEIVED 152,710. REIMBURSED FV PENSION SALARY EXPENSE 384,264. STOP LOSS INSURANCE REIMBURSEMENTS 800,768. Part XII, Line 2d - Other Adjustments: MEDICARE D SUBSIDIES RECEIVED -152,710. STOP LOSS INSURANCE REIMBURSEMENTS -800,768. Part XII, Line 4b - Other Adjustments: REIMBURSED FV PENSION SALARY EXPENSE 384,264. CHANGE IN PLAN BENEFIT OBLIGATION 3,531,000. X 0 0 0 VERN BAUMAN TRUSTEE 0 123049 0 0 0 4294 0 58549 0 28422 0 214314 0 0 DAVE SHEAHAN FMR TRUSTEE 0 122845 0 0 0 1709 0 58549 0 28422 0 211525 0 0 MARTIN D DWYER SECRETARY 0 147685 0 0 0 3452 0 64144 0 28706 0 243987 0 0 PATRICIA M SHALES ADMINISTRATOR 129719 0 0 0 9476 0 26227 0 21091 0 186513 0 0 0 Form 990, Part VI, Section A, line 8b THE ORGANIZATION DOES NOT HAVE COMMITTEES TO ACT ON BEHALF OF THE GOVERNING BODY. Form 990, Part VI, Section B, line 11b THE TRUSTEES OF THE FOX VALLEY AND VICINITY LABORERS HEALTH AND WELFARE FUND HAVE AUTHORIZED THE CHAIRMAN OF THE FUND TO REVIEW THE FORM 990 PRIOR TO FILING. A COPY OF THE FILED RETURN IS MADE AVAILABLE TO ALL TRUSTEES TO REVIEW SUBSEQUENT TO FILING. Form 990, Part VI, Section B, line 12c THE ACTIONS OF THE TRUSTEES ARE GOVERNED BY THE TRUST DOCUMENT AND ERISA. BOTH ESTABLISH STANDARDS OF CONDUCT FOR PLAN FIDUCIARIES. IN ADDITION, THE ADMINISTRATOR OF THE PLAN HAS SIGNED AN EMPLOYMENT CONTRACT WITH THE FUND WHICH ALSO ESTABLISHES STANDARDS OF CONDUCT. THE TRUSTEES AND ADMINISTRATOR ARE RQUIRED TO DISCLOUSE ANY POSSIBLE CONFLICTS OF INTREST TO THE ENTIRE BOARD. Form 990, Part VI, Section B, line 15a THE TRUSTEES OF THE FUND ANNUALLY REVIEW THE PERFORMANCE OF THE FUND'S TOP MANAGEMENT OFFICIAL (ADMINISTRATOR) AND APPROVE ANY COMPENSATION ADJUSTMENTS. Form 990, Part VI, Section C, line 19 A SUMMARY ANNUAL REPORT IS DISTRIBUTED TO ALL PARTICIPANTS ANNUALLY. PARTICIPANTS ARE ABLE TO REQUEST THE AUDITOR'S REPORT AND OTHER FINANCIAL INFORMATION FROM THE FUND OFFICE AND/OR THE US DEPARTMENT OF LABOR. FORM 990 PART XII LINE 2C THERE HAS BEEN NO CHANGE IN THE PROCESS FROM THE PRIOR YEAR FOX VALLEY & VICINITY LABORERS PENSION 2371 BOWES Rd NO 500 ELGIN IL 601235523 366147409 PENSION FUND IL 401(a) 0 LABORERS LOCAL #1035 3819 N Route 23 Suite A MARENGO IL 601520211 362063944 LABOR UNION IL 501(c)(5) 0 LABORERS LOCAL #582 2400 BIG TIMBER ROAD BLDG B ELGIN IL 601247812 361265047 LABOR UNION IL 501(c)(5) 0 FOX VALLEY ASSOCIATED GENERAL CONTRACTORS 2020 DEAN ST NO I ST CHARLES IL 60174 362244731 CONTRACTORS ASSOCIATION IL 501(c)(6) 0 ILLINOIS ROAD AND TRANSPORTATION BUILDERS ASSOCIATION 500 PARK BLVD 1250 ITASCA IL 60143 361257695 CONTRACTORS ASSOCIATION IL 501(c)(6) 0 3 L K CONSTRUCTION LLC A HORN INC ABITUA SEWER WATER & PLUMB ALLEN MACK & SONS INC ALLIANCE CONCR SAW & DRILL ALLIANCE CONTRACTORS INC AMERICAN VACTOR SERVICES LL APRIL COBRA ENTERPRISES INC ARROW ROAD CONSTRUCTION CO ARTLOW SYSTEMS INC ASC INSULATION & FIREPROOFI BELROCK ASPHALT PAVING INC BENIACH CONSTRUCTION COMPANY 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PERFORMANCE CONST & ENG LL PETER BAKER & SON COMPANY PHOENIX CORP OF THE QUAD CI PLAINFIELD CONCRETE INC PLAINFIELD GRADING & EXCAVA PLOTE CONSTRUCTION INC PRECISION EXCAVATING PREFERRED CONCRETE & EXCAVA QUEENS TRUCKING & CONSTRUCT R A ABBOTT EXCAVATING INC R C WEGMAN CONST CO R OLSON CONST CO CONTR INC RAES CONCRETE INC RAGNAR BENSON LLC REED MACHINERY & TRANS CO REIL CONSTRUCTION INC RICO ENTERPRISES INC RINGLAND-JOHNSON INC RIVER CITY CONSTRUCTION RIVER VALLEY LAND IMP CO IN RIZZA CONCRETE RJ O'NEIL INC ROCK ROAD OF ILLINOIS ROCKFORD STRUCTURES RUDOLPH MASON CONTRACTORS RUIZ CONSTRUCTION SYSTEMS I RYAN COMPANIES US INC S & K EXCAVATING & TRUCKING S & K POOL SERVICE INC SCANDROLI CONSTRUCTION CO SCHAAL CONTRACTING SCHMELING CONSTRUCTION CO SCHNEIDER EXCAVATING INC SCHROEDER ASPHALT SERVICES SCORPIO CONSTRUCTION SCURTO CEMENT CONSTRUCTION SEYLLER'S INC SHALES MCNUTT LLC SJN SUBSURFACE INC SJOSTROM & SONS INC SPECIALTY BUILDERS INC STARK & SON TRENCHING INC STENSTROM EXCAV & BLACKTOP 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