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PIONEER PRODUCTS INC EMPLOYEES HEALTH & WELFARE TRUST: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
PIONEER PRODUCTS INC EMPLOYEES HEALTH & WELFARE TRUST (EIN 39-1604675)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-10-11
IRS object ID
201802849349301675
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-10-11T16:45:49-05:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN710971219PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1VBL & ASSOCIATES SCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line16905 GREEN BAY ROAD SUITE 202AddressLine1Txt
CityKENOSHACityNm
State AbbreviationWIStateAbbreviationCd
ZIP531422967ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391604675EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PIONEER PRODUCTS INC EMPLOYEEBusinessNameLine1Txt
Business Name Line2HEALTH & WELFARE TRUSTBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlPIONBusinessNameControlTxt
Phone2626336304PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11917 SOUTH MEMORIAL DRIVEAddressLine1Txt
CityRACINECityNm
State AbbreviationWIStateAbbreviationCd
ZIP53403ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonVALERIE RATKOWSKIPersonNm
Person TitleTRUSTEEPersonTitleTxt
Phone2626336304PhoneNum
Signature2018-10-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonPAUL R HANSON CPAPreparerPersonNm
PTINP01239507PTIN
Phone2626583313PhoneNum
Preparation2018-10-11PreparationDt
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerVALERIE RATKOWSKIPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11917 SOUTH MEMORIAL DRIVEAddressLine1Txt
CityRACINECityNm
State AbbreviationWIStateAbbreviationCd
ZIP53403ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,491,177GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1988FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTHE ORGANIZATION IS CREATED TO PROVIDE FUNDS FOR THE PAYMENT OF HEALTH CARE BENEFITS TO EMPLOYEES OF PIONEER PRODUCTS, INC., U.S. COMPETITION ARMS, INC. AND TARGET ARMS, INC., ALL OF WHICH ARE WISCONSIN BUSINESS CORPORATION. BENEFITS TO BE PROVIDED INCLUDE GROUP LIFE INSURANCE, ACCIDENTIAL DEATH AND DISMEMBERMENT INSURANCE, SHORT-TERM DISABILITY AND MEDICAL BENEFITS. ALL OF THESE BENEFITS ARE DESCRIBED IN THE "SUMMARY PLAN DESCRIPTION" DOCUMENTS OF THE ORGANIZATION. THE ORGANIZATION WILL PAY THE PREMIUMS FOR THE INSURED PORTION OF THE PLAN, AND WILL DELIVER PAYMENT DIRECTLY TO MEMBERS UNDER THE SELF-INSURED PORTION OF THE PLAN.ActivityOrMissionDesc
Voting Members Governing Body2VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Gross UBI$2,491,177TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$2,490,177NetUnrelatedBusTxblIncmAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$2,604,687PYProgramServiceRevenueAmt
CY Program Service Revenue$2,491,177CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$2,604,687PYTotalRevenueAmt
CY Total Revenue$2,491,177CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$2,604,687PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$2,491,177CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
CY Other Expenses$0CYOtherExpensesAmt
PY Total Expenses$2,604,687PYTotalExpensesAmt
CY Total Expenses$2,491,177CYTotalExpensesAmt
CY Revenues Less Expenses$0CYRevenuesLessExpensesAmt
Total Assets EOY$0TotalAssetsEOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances EOY$0NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE COMPANY DESIRES TO PROMOTE HEALTH AND EFFICIENCY OF ITS EMPLOYEES. THE COMPANY FROM TIME TO TIME ADOPTS HEALTH CARE AND WELFARE PLANS FOR THE BENEFIT OF ITS EMPLOYEES. THE COMPANY DESIRES TO FUND THE BENEFITS PROVIDED FOR SUCH PLANS BY MEANS OF A VOLUNTARY EMPLOYEE BENEFIT ASSOCIATION.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$2,491,177ExpenseAmt
Revenue$2,491,177RevenueAmt
DescTO PROVIDE HEALTH CARE BENEFITS FOR THE COMPANY EMPLOYEES THROUGH A VOLUNTARY EMPLOYEE BENEFIT ASSOCIATION.Desc
Total Program Service Expenses$2,491,177TotalProgramServiceExpensesAmt
Described In Section501c3falseDescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members2GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyfalseMinutesOfGoverningBodyInd
Minutes Of CommitteesfalseMinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonVALERIE RATKOWSKIPersonNm
Phone2626336304PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11917 SOUTH MEMORIAL DRIVEAddressLine1Txt
CityRACINECityNm
State AbbreviationWIStateAbbreviationCd
ZIP53403ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (2 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
VALERIE RATKOWSKI
TRUSTEE1.00Yes (X)$0$0$0
DONALD MAINLAND
TRUSTEE1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UNITED HEALTHCARE INSURANCE COMPANYBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O BOX 30555AddressLine1Txt
CitySALT LAKE CITYCityNm
State AbbreviationUTStateAbbreviationCd
ZIP841306730ZIPCd
FieldValueIRS element (for citing)
ServicesCONTACT ADMIN.ServicesDesc
Compensation$117,294CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescHEALTH BENEFIT CONTRIBUTIONDesc
Business900099BusinessCd
Total Revenue Column$2,491,177TotalRevenueColumnAmt
Unrelated Business Revenue$2,491,177UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$2,491,177TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,491,177TotalRevenueColumnAmt
Unrelated Business Revenue$2,491,177UnrelatedBusinessRevenueAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$2,491,177TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,491,177TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$0ReconcilationRevenueExpnssAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteefalseAuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Rev Etc Audited Fincl Stmt$2,491,177TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$2,491,177RevenueSubtotalAmt
Total Revenue Per Form990$2,491,177TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$2,456,255TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$2,456,255ExpensesSubtotalAmt
Other Expenses Not Included$34,922OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$34,922ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$2,491,177TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PAGE 4, PART XII, LINE 4BFormAndLineReferenceDesc
ExplanationTO ADJUST CASH BASIS FORM 990 TO ACCRUAL BASIS 0 FINANCIAL STATEMENT 34,922ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSIONTHE COMPANY DESIRES TO PROMOTE HEALTH AND EFFICIENCY OF ITS EMPLOYEES. THE COMPANY FROM TIME TO TIME ADOPTS HEALTH CARE AND WELFARE PLANS FOR THE BENEFIT OF ITS EMPLOYEES. THE COMPANY DESIRES TO FUND THE BENEFITS PROVIDED FOR SUCH PLANS BY MEANS OF A VOLUNTARY EMPLOYEE BENEFIT ASSOCIATION.
FORM 990, PAGE 6, PART VI, LINE 3OPERATIONAL MANAGEMENT IS DELEGATED TO THE HUMAN RESOURCE PERSONNEL.
FORM 990, PAGE 6, PART VI, LINE 7ATHE TRUSTEES ARE THE GOVERNING BODY OF THE ORGANIZATION AND ALSO DIRECTORS OF THE PLAN SPONSOR.
FORM 990, PAGE 6, PART VI, LINE 7BTHE TRUSTEES HAVE DELEGATED THE GOVERNANCE DECISIONS TO THE HUMAN RESOURCE PERSONNEL.
FORM 990, PAGE 6, PART VI, LINE 8ATHE HUMAN RESOURCE PERSONNEL MAKE THE DECISIONS ON THE PLAN/TRUST. THEY SEEK GUIDANCE ON ISSUES FROM PROFESSIONAL ADVISORS IF NEEDED.
FORM 990, PAGE 6, PART VI, LINE 8BTHE HUMAN RESOURCE PERSONNEL MAKE THE DAY TO DAY DECISIONS OF THE PLAN/TRUST.
FORM 990, PAGE 6, PART VI, LINE 11BTHE HUMAN RESOURCE PERSONNEL REVIEW FORM 990 BEFORE FILING.
FORM 990, PAGE 6, PART VI, LINE 19THE HUMAN RESOURCE PERSONNEL MAKE THE ORGANIZATION'S DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9TO ADJUST CASH BASIS FORM 990 TO ACCRUAL BASIS 0 FINANCIAL STATEMENT 34,922 TOTAL 34,922

Schedule R IRS990ScheduleR

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
PIONEER PRODUCTS INC
1917 S MEMORIAL DRIVERACINEWI53403391078454MANUFACTURWIN/AS CORPYes (true)
US COMPETITION ARMS INC
1925 ROOSEVELT AVENUERACINEWI53406391644703MANUFACTURWIN/AS CORPYes (true)
TARGET ARMS INC
1925 ROOSEVELT AVENUERACINEWI53406391371478MANUFACTURWIN/AS CORPYes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
RELATED CO ON SCH R PART IV
Q$2,491,177CASH PAYMENT
RELATED CO ON SCH R PART IV
S$2,491,177CASH PAYMENT