2018-11-12T10:21:19-06:00 2017-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2017-01-01 366090694 BOILERMAKERS NATIONAL HEALTH & WELFARE FUND BOIL 9133426555 754 MINNESOTA AVENUE NO 110 KANSAS CITY KS 66101 RONNIE TRAXLER CHAIRMAN 9133426555 2018-11-01 1 DOUG BERTOSSI P00637990 6123764500 67.137.57.251 2018-11-01 08:55:24 CD P DBE5E9100BD705C5801F05FB9419F1388E8E9FDA 0F6CED516730F26F6D929EFCCC55701A57CAC9CA 2017 2019-02-21 02:37:17Z RONNIE TRAXLER 754 MINNESOTA AVENUE NO 110 KANSAS CITY KS 66101 960813592 0 X WWW.BNF-KC.COM X 1954 KS TO PROVIDE HEALTH AND WELFARE BENEFITS 15 15 0 0 0 0 0 0 251218440 241237119 53237773 21427155 220165 225282 304676378 262889556 0 0 246190945 238305227 851370 899536 0 0 0 8031596 7588719 255073911 246793482 49602467 16096074 955180857 1009425985 77355659 55177317 877825198 954248668 TO PROVIDE HEALTH AND WELFARE BENEFITS 0 0 PROVIDE HEALTH AND WELFARE BENEFITS FOR PARTICIPANTS AND THEIR DEPENDENTS 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 1 0 0 0 0 0 0 0 0 0 1 0 0 1 11 0 1 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X TONYA PAVELAC-WALKER 9139067497 754 MINNESOTA AVENUE NO 110 KANSAS CITY KS 66101 X RONNIE TRAXLER MANAGEMENT TRUSTEE - CHAIR 1.77 40.00 X X 0 0 0 JOHN FULTZ SEE SCHEDULE O 1.19 40.00 X X 0 0 0 PATRICK GALLAGHER SEE SCHEDULE O 1.92 40.00 X X 0 0 0 JOHN CAMMUSO MANAGEMENT TRUSTEE 0.62 40.00 X 0 0 0 J MICHAEL CARROLL MANAGEMENT TRUSTEE 1.69 40.00 X 0 0 0 MIKE DOLAN MANAGEMENT TRUSTEE 0.85 40.00 X 0 0 0 JOSEPH REYNOLDS MANAGEMENT TRUSTEE 0.69 40.00 X 0 0 0 NELSON JORDAN MANAGEMENT TRUSTEE-VICE 0.73 40.00 X X 0 0 0 MARK KEFFELER SEE SCHEDULE O 1.08 40.00 X 0 0 0 JOHN CLARK JR SEE SCHEDULE O 0.31 40.00 X 0 0 0 CLAY HERFORD SEE SCHEDULE O 0.62 40.00 X 0 0 0 JEFFREY HUGHES SEE SCHEDULE O 1.15 40.00 X 0 0 0 JOSEPH LEWANDOWSKI SEE SCHEDULE O 0.31 40.00 X 0 0 0 SHELDON TRAXLER MANAGEMENT TRUSTEE 1.08 40.00 X 0 0 0 MICHAEL WEST SEE SCHEDULE O 0.77 40.00 X 0 0 0 WILLIAM MULCONNERY SEE SCHEDULE O 0.77 40.00 X 0 0 0 CHRISTOPHER O'NEILL SEE SCHEDULE O 1.00 40.00 X 0 0 0 LORI JASPERSON CHIEF OPERATIONS OFFICER 23.30 46.70 X 70992 171787 80794 MARIO RODRIQUEZ CHIEF INVESTMENT OFFICER 10.00 40.00 X 50025 209554 75636 121017 381341 156430 0 0 1 0 CIGNA HEALTH AND LIFE INSURANCE COMPANY 900 COTTAGE GROVE RD BLOOMFIELD C BLOOMFIELD CT 06002 ADMINISTRATIVE SERVICES 11279798 WILSON-MCSHANE CORPORATION 754 MINNESOTA AVE KANSAS CITY KS 66101 MANAGEMENT SERVICES 2296359 INVESCO CORE REAL ESTATE 1101 CALIFORNIA ST SUITE 475 KANSAS CITY KS 66101 INVESTMENT MANAGER 749997 NATIONAL INVESTMENT SERVICES 777 E WISCONSIN AVE SUITE 2350 MILWAUKEE WI 53202 INVESTMENT MANAGER 537702 AMERICAN CORE REALTY FUND LLC 801 N BRAND BLVD SUITE 800 GLENDALE CA 91203 INVESTMENT MANAGER 463187 17 EMPLOYER CONTRIBUTIONS 525100 187520049 187520049 EMPLOYEE CONTRIBUTIONS 525100 44971885 44971885 PRESCRIPTION REBATES 525100 8523071 8523071 DELINQUENT EMPLOYER INTEREST 525100 218249 218249 MEDICARE SUBSIDY 525100 3865 3865 241237119 18069354 18069354 701281837 697924036 3357801 3357801 3357801 MISCELLANEOUS INCOME 525100 225282 225282 225282 262889556 241237119 0 21652437 238305227 121017 406904 180461 146126 45028 1825662 306223 1002970 3681793 274291 226035 58049 42987 67781 25578 77325 JOINT COMMITTEE ON ADMI 25 246793482 89463 0 52020512 43191874 11940000 8784979 1062021 21533 41333 0 0 350909660 360340306 517008581 577181479 23191108 18823993 955180857 1009425985 2311363 1231610 4672400 4802568 70371896 49143139 77355659 55177317 X 0 0 0 0 877825198 954248668 877825198 954248668 955180857 1009425985 16096074 60327396 0 X 0 1 X 1 0 0 LIMITED PARTNERSHIPS 85451883 F LIMITED LIABILITY COMPANIES 211116921 F 103-12 INVESTMENT ENTITIES 136269825 F COMMON COLLECTIVE TRUST 102361765 F CAYMAN ISLANDS EXEMPTED COMPANIES 41981085 F 577181479 DUE TO RELATED ORGANIZATION 46094 LIABILITY FOR SECURITIES ON LOAN 30904542 DUE TO BROKER 16524638 CHECKS IN EXCESS OF CASH 1667865 49143139 X 319535159 60327396 60327396 259207763 3681793 3681793 262889556 243111689 0 243111689 3681793 3681793 246793482 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE FUND TO HOLD THE FUND'S ASSETS IS INTENDED TO QUALIFY PURSUANT TO SECTION 501(C)(9) UNDER THE INTERNAL REVENUE CODE (IRC) AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE TRUST OBTAINED ITS LATEST TAX EXEMPTION LETTER, DATED OCTOBER 27, 1977, IN WHICH THE INTERNAL REVENUE SERVICE STATED THAT THE TRUST, AS THEN DESIGNED, WAS IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THE TRUST HAS BEEN AMENDED SINCE RECEIVING THE TAX EXEMPTION LETTER. HOWEVER, THE PLAN ADMINISTRATOR AND THE PLAN'S COUNSEL BELIEVE THAT THE TRUST IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THEREFORE, THEY BELIEVE THAT THE TRUST WAS QUALIFIED AND THE RELATED TRUST WAS TAX EXEMPT AS OF THE FINANCIAL STATEMENT DATE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE THE TAX POSITIONS TAKEN BY THE PLAN AND TO RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 0 0 0 LORI JASPERSON CHIEF OPERATIONS OFFICER 67318 157074 0 0 3674 14713 21669 50561 2569 5995 95230 228343 0 0 MARIO RODRIQUEZ CHIEF INVESTMENT OFFICER 47518 190075 0 0 2507 19479 13414 53657 1713 6852 65152 270063 0 0 PART I, LINE 3 THE RELATED ORGANIZATION USED THE FOLLOWING METHODS TO DETERMINE COMPENSATION: WRITTEN EMPLOYMENT CONTRACT AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 13871 13871 1 1 1 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 14982 14982 1 1 1 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 335661 335661 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 119416 119416 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 12029 12029 1 1 1 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 44607 44607 1 1 1 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 16815 16815 1 1 1 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 18426 18426 1 1 1 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 10458 10458 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 28132 28132 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 1414 1414 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 7343 7343 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 4070 4070 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 189628 189628 1 1 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 245153 245153 1 1 1 SUBSTANTIAL CONTRIBUTOR CONTRIBUTOR DELINQUENT CONTRIBUTIONS X 16 16 1 1 0 1062021 FORM 990, PART VI, SECTION A, LINE 7A THE BARGAINING ORGANIZATIONS, THE EMPLOYER AND UNION, BOTH APPOINT 50% OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES THAT HAVE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B COPIES OF FORM 990 WERE PROVIDED TO THE GOVERNING BODY MEMBERS BY EMAIL PRIOR TO THE FORM 990 BEING FILED, AND IS REVIEWED BY TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION DOES REQUIRE ANNUAL DISCLOSURES FOR POTENTIAL CONFLICTS OF INTEREST OF ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST, WHICH ARE REVIEWED BY THE ORGANIZATION. THE AFFECTED TRUSTEE OR EMPLOYEE MUST CEASE PARTICIPATION IN THE DECISION OR TRANSACTION UNTIL IT IS DETERMINED THAT THE AFFECTED TRUSTEE OR EMPLOYEE MAY CONTINUE TO PARTICIPATE IN THE DECISION OR TRANSACTION. POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE ALSO REVIEWED FOR COMPLIANCE WITH ERISA REQUIREMENTS. THE ORGANIZATION DOES REQUIRE FULL DISCLOSURE FOR POTENTIAL CONFLICTS OF INTEREST WHEN CONDUCTING SEARCHES FOR NEW VENDORS AND SERVICE PROVIDERS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. THE PLAN AND TRUST DOCUMENTS AND SUMMARY ANNUAL REPORT ARE ON THE WEBSITE AND AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A THE FOLLOWING TRUSTEES ARE COMPENSATED BY A NON-PROFIT RELATED ORGANIZATION AND COMPENSATION INFORMATION WILL BE MADE AVAILABLE UPON REQUEST. JOHN T. FULTZ, UNION TRUSTEE - SECRETARY PATRICK M. GALLAGHER, UNION TRUSTEE - ASST. SECRETARY MARK KEFFELER, UNION TRUSTEE JOHN CLARK JR., UNION TRUSTEE CLAY HERFORD, UNION TRUSTEE JEFFREY HUGHES, UNION TRUSTEE JOSEPH LEWANDOWSKI, UNION TRUSTEE MICHAEL WEST, UNION TRUSTEE WILLIAM MULCONNERY, UNION TRUSTEE CHRISTOPHER O'NEILL, UNION TRUSTEE BOILERMAKERS LOCAL 1 SOUTHEAST DISTRICT LODGE 3 BOILERMAKERS L 4 NAVAJO NATION BOILERMAKERS LOCAL 5 BOILERMAKERS LOCAL 7 BOILERMAKERS LOCAL 11 BOILERMAKERS LOCAL 13 BOILERMAKERS LOCAL 26 BOILERMAKERS LOCAL 27 BOILERMAKERS LOCAL 28 BOILERMAKERS LOCAL 29 BOILERMAKERS LOCAL 37 BOILERMAKERS LOCAL 40 BOILERMAKERS LOCAL 45 BOILERMAKERS DISTRICT 57 BOILERMAKERS LOCAL 60 BOILERMAKERS LOCAL 83 BOILERMAKERS LOCAL 85 BOILERMAKERS LOCAL 92 BOILERMAKERS LOCAL 101 BOILERMAKERS LOCAL 105 BOILERMAKERS LOCAL 107 BOILERMAKERS LOCAL 108 BOILERMAKERS LOCAL 110 BOILERMAKERS LOCAL 154 BOILERMAKERS LOCAL 169 BOILERMAKERS LOCAL 237 BOILERMAKERS LOCAL 242 BOILERMAKERS LOCAL 363 BOILERMAKERS LOCAL 374 BOILERMAKERS LOCAL 433 BOILERMAKER LOCAL 455 BOILERMAKERS 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