2017-11-10T09:03:55-06:00 2017-03-31 550526247 WILSON KOZICKI & GWYNN PLLC 32 TWENTIETH STREET SUITE 300 WHEELING WV 26003 990 2016-04-01 510168650 IRON WORKERS LOCALS 549 & 550 MEDICAL & BENEFIT FUND IRON 4122244453 60 BLVD OF THE ALLIES FIFTH FLOOR PITTSBURGH PA 152221219 BENGY SWANSON CO-CHAIRMAN OF THE BOARD 3042322660 2017-10-25 NANCY J GWYNN CPA P00726879 3042322280 2017-10-25 50.73.168.161 2017-10-25 14:42:49 ED P A750DAADF84FC480507117C937BA848B1354C102 DD3B745099E28F0770B79EF317CF45DE0C6BA033 2016 2017-02-10 21:41:12Z BENGY SWANSON 2350 MAIN STREET WHEELING WV 26003 19156731 0 X N/A X 1975 WV TO PROVIDE ACCIDENT, HOSPITAL, MEDICAL, SURGICAL, DISABILITY, DENTAL, PRESCRIPTION AND DEATH BENEFITS TO ELIGIBLE MEMBERS OF IRON WORKERS LOCALS 549 & 550 AND THEIR SPOUSES AND DEPENDENTS. 12 9 11 0 0 0 0 0 6852633 8104510 169532 264946 848 75 7023013 8369531 0 0 8275394 8938566 0 0 0 0 0 997957 931401 9273351 9869967 -2250338 -1500436 11632700 10221070 132046 151141 11500654 10069929 THE TRUST FUND IS CREATED, ESTABLISHED AND MAINTAINED, (AND THE TRUSTEES AGREE TO RECEIVE, HOLD AND ADMINISTER), TO PROVIDE BENEFITS FOR MEMBERS AND THEIR BENEFICIARIES IN ACCORDANCE WITH THE PLAN DOCUMENT. 0 0 THE IRON WORKERS LOCALS 549 & 550 MEDICAL & BENEFIT PLAN IS A DEFINED BENEFIT HEALTH AND WELFARE PLAN THAT PROVIDES BENEFITS TO ELIGIBLE MEMBERS OF IRON WORKERS LOCALS 549 AND 550 WHO HAVE COMPLETED THE REQUIRED SERVICE HOURS FOR AN EMPLOYER WHO IS SUBJECT TO THE TERMS OF THE COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE INTERNATIONAL ASSOCIATION OF BRIDGE, STRUCTURAL AND ORNAMENTAL IRONWORKERS LOCALS UNIONS 549 AND 550 AND THE OHIO VALLEY CONSTRUCTION EMPLOYERS COUNCIL INC AND THE STRUCTURAL CONTRACTORS AND INDEPENDENT EMPLOYERS ASSOCIATION OF CANTON OHIO. THE PLAN PROVIDES FOR ACCIDENT, HOSPITAL, MEDICAL, SURGICAL, DISABILITY, DENTAL, PRESCRIPTION AND DEATH BENEFITS COVERING APPROXIMATELY 834 ELIGIBLE MEMBERS AND THEIR SPOUSES AND DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1 0 1 11 1 0 0 0 0 0 0 0 0 X 12 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X JENNIFER L DEKLEVER (CDS ADMINISTRATIONS INC) 4122244453 60 BLVD OF THE ALLIES FIFTH FLOOR PITTSBRUGH PA 152221219 BENGY SWANSON CO-CHAIRMAN/EMPLOYEE TRUST 0.50 48.00 X X 0 79896 56883 WILLIAM SHERER II CO-CHAIRMAN/EMPLOYEE TRUST 0.50 48.00 X X 0 74780 66589 KELLY DIERKES EMPLOYEE TRUSTEE 0.50 X 0 0 0 KRISTOFER FORBES EMPLOYEE TRUSTEE 0.50 X 0 0 0 THERON HODGE EMPLOYEE TRUSTEE 0.50 X 0 0 0 RICK MOSS EMPLOYEE TRUSTEE 0.50 48.00 X 0 67945 64538 KEITH LEPAGE SECRETARY/ EMPLOYER TRUSTE 0.50 X 0 0 0 JOHN HUMPE EMPLOYER TRUSTEE 0.50 X 0 0 0 BRIAN SELINKSY EMPLOYER TRUSTEE 0.50 X 0 0 0 KIM CARFAGNA EMPLOYER TRUSTEE 0.50 X 0 0 0 THOMAS LISTON EMPLOYER TRUSTEE 0.50 X 0 0 0 GEOFF NICELY EMPLOYEE TRUSTEE 0.50 X 0 0 0 0 222621 188010 0 0 0 0 ANTHEM BLUE CROSS BLUE SHIELD PO BOX 951254 CLEVELAND OH 44193 MEDICAL INSURANCE ADMINISTRATION FEES 240935 BENESYS INC 700 TOWER DRIVE SUITE 300 TROY MI 48098 ADMINISTRATION FEES 152117 CDS ADMINISTRATORS INC 60 BOULEVARD OF THE ALLIES FIFTH F PITTSBURGH PA 15222 ADMINISTRATION FEES 144356 CONDUENT HR CONSULTING 120 SOUTH SIXTH STREET SUITE 2260 MINNEAPOLIS MN 55042 CONSULTING AND ACTUARIAL FEES 105259 4 EMPLOYER CONTRIBUTION 525120 6786751 6786751 RETIREE AND MEMBER SELF-PAY 525120 1317759 1317759 8104510 222560 222560 10829586 10787200 42386 42386 42386 MISCELLANEOUS INCOME 525120 75 75 75 8369531 8104585 0 264946 8938566 33375 51831 25435 732731 17510 15159 16512 TRANSITIONAL REINSURANC 36547 BANK CHARGES 2301 9869967 924403 1191168 1553755 1374185 544530 644288 9054 151361 8545276 6834299 55682 25769 11632700 10221070 132046 151141 132046 151141 X 0 0 0 0 11500654 10069929 11500654 10069929 11632700 10221070 -1500436 69711 0 X 0 1 X 1 0 0 8413807 69711 69711 8344096 25435 25435 8369531 9844532 0 9844532 25435 25435 9869967 0 0 0 BENGY SWANSON CO-CHAIRMAN/EMPLOYEE TRUST 0 68502 0 0 0 11394 0 42688 0 14195 0 136779 0 0 WILLIAM SHERER II CO-CHAIRMAN/EMPLOYEE TRUST 0 74780 0 0 0 0 0 49684 0 16905 0 141369 0 0 RICK MOSS EMPLOYEE TRUSTEE 0 67945 0 0 0 0 0 47633 0 16905 0 132483 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE TRUSTEES FOR THE FUND ENGAGED BENESYS INC TO PROVIDE ADMINISTRATIVE SERVICES FOR THE PLAN EFFECTIVE 4/1/10. EFFECTIVE SEPTEMBER 30, 2016, THE PLAN TERMINATED ITS RELATIONSHIP WITH ITS THIRD PARTY ADMINISTRATOR, BENESYS. THE PLAN'S NEW THIRD PARTY ADMINISTRATOR, CENTRAL DATA SERVICES, ASSUMED RESPONSIBILITY OF THE PLAN ON OCTOBER 1, 2016. FORM 990, PART VI, SECTION B, LINE 11B THE COMPLETED 990, IN DRAFT VERSION, IS EMAILED TO THE CO-CHAIRMEN PRIOR TO ITS FINALIZATION. ANY QUESTIONS, COMMENTS, AND CONCERNS ARE DISCUSSED AND RESOLVED PRIOR TO THE FILING OF THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ANY DIRECTOR, PRINCIPAL OFFICER, TRUSTEE OR ADMINISTRATOR OF THE ORGANIZATION HAS A DUTY TO DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST AND IS GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE GOVERNING BOARD. THE GOVERNING BOARD THEN DISCUSSES AND VOTES UPON THE DETERMINATION OF A CONFLICT OF INTEREST. IF THE BOARD BELIEVES THAT AN ACTUAL OR POSSIBLE CONFLICT WAS NOT DISCLOSED AND UPON FURTHER EXPLANATION DETERMINES THAT THERE WAS A FAILURE TO DISCLOSE, APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION WILL BE TAKEN. EACH DIRECTOR, PRINCIPAL OFFICER, TRUSTEE OR ADMINISTRATOR OF THE GOVERNING BOARD IS REQUIRED TO SIGN AN ANNUAL STATEMENT. PERIODIC REVIEWS WILL ALSO BE CONDUCTED WHICH MAY INCLUDE THE USE OF OUTSIDE EXPERTS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC BENGY SWANSON - 2350 MAIN STREET, WHEELING, WV 26003. WILLIAM SHERER II - 618 HIGH AVENUE NW, CANTON, OH 44703. KELLY DIERKES - 45565 SR 78, WOODSFIELD, OH 43793. KRISTOFER FORBES - 229 BLACKS RUN ROAD, CORE, WV 26541. THERON HODGE - 618 HIGH AVENUE NW, CANTON, OH 44703. RICK MOSS - 618 HIGH AVENUE NW, CANTON, OH 44703. KEITH LEPAGE - PO BOX 8444, CANTON, OH 44711. JOHN HUMPE - 1B-31 KINGSDALE ROAD, STEUBENVILLE, OH 43952. BRIAN SELINKSY - 2009 QUIMBY AVENUE SW, CANTON, OH 44706. KIM CARFAGNA - 200 GC & P ROAD, PO BOX 6253, WHEELING, WV 26003. THOMAS LISTON - 210 WASHINGTON, PO BOX 490, DRAVOSBURG, PA 15034. GEOFF NICELY - 1249 DUEBER AVENUE SW, CANTON, OH 44706. IRON WORKERS LOCAL 549 2350 MAIN STREET WHEELING WV 26003 550241628 LOCAL LABOR UNION PROVIDING SERVICES TO MEMBERS AND ASSISTANCE TO EMPLOYERS WV 501(C)(5) 0 IRON WORKERS LOCAL 550 618 HIGH AVENUE NW CANTON OH 44703 340225474 LOCAL LABOR UNION PROVIDING SERVICES TO MEMBERS AND ASSISTANCE TO EMPLOYERS OH 501(C)(5) 0 IRON WORKERS LOCALS 549 & 550 SECURITY PLAN 700 TOWER DRIVE SUITE 300 TROY MI 48098 341399439 DEFINED CONTRIBUTION PLAN COVERING ELIGIBLE WORKERS UNDER LOCAL AGREEMENT WV 401(A)/501(A) 0 IRON WORKERS LOCALS 549 & 550 PENSION PLAN 700 TOWER DRIVE SUITE 300 TROY MI 48098 556027928 DEFINED BENEFIT PENSION PLAN COVERING ELIGIBLE MEMBERS OF LOCAL UNIONS WV 401(A)/501(A) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 SCHEDULE R, PART V, LINE 1: P: THE IRON WORKERS LOCAL 549 & 550 SECURITY PLAN, MEDICAL AND BENEFIT PLAN, AND PENSION PLAN BEGAN REIMBURSING THE LOCALS FOR LOST WAGES OF TRUSTEES TO ATTEND MEETINGS. THE TRUSTEES WERE ISSUED A W2 FOR THEIR COMPENSATION FROM THEIR RESPECTIVE LOCALS.