2017-11-02T17:35:00-05:00 2015-12-31 510435869 Needles & Associates LLC 350 Interlocken Blvd STE 360 Broomfield CO 80021 990 2015-01-01 840456274 Pipe Industry Health and Welfare Fund of Colorado PIPE 3034301118 5511 W 56th Ave No 250 Arvada CO 80002 Dave Davia Chairman 3037451596 2017-11-02 1 Kurt D Needles P00850236 3034304225 2017-11-02 2015 2018-03-14 21:41:22Z X X Dave Davia 5511 W 56th Ave No 250 Arvada CO 80002 28212134 0 X N/A X 1955 CO Provide major medical, prescription drug, vision, death and accidental death and dismemberment, and accident and sickness benefits for eligible participants and their dependents. 12 0 0 0 0 0 0 0 22905378 25523192 173777 226977 0 4332 23079155 25754501 0 0 17992943 22781757 0 0 0 0 0 1798444 2024912 19791387 24806669 3287768 947832 14376108 18209458 9366669 12343123 5009439 5866335 Provide major medical, prescription drug, vision, death and accidental death and dismemberment, and accident and sickness benefits for eligible participants and their dependents. 0 0 Provide major medical, prescription drug, vision, death and accidental death and dismemberment, and accident and sickness benefits for eligible participants and their dependents. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 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 0 0 0 0 0 0 0 0 0 0 0 X 12 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X Board of Trustees 3034301118 5511 W 56th Ave Arvada CO 80002 X Kurt Steenhoek Chairman 1.00 X 0 0 0 Howard Arnold Trustee 1.00 X 0 0 0 James C Keif Trustee 1.00 X 0 0 0 Ron Lenz Trustee 1.00 X 0 0 0 Tom Tuttle Trustee 1.00 X 0 0 0 Steven Callahan Trustee 1.00 X 0 0 0 Dave Davia Secretary 1.00 X 0 0 0 Charlie Lee Trustee 1.00 X 0 0 0 David Kixmiller Trustee 1.00 X 0 0 0 Todd VonLintel Trustee 1.00 X 0 0 0 Dick O'Brecht Trustee 1.00 X 0 0 0 Allen C Stone Trustee 1.00 X 0 0 0 0 0 0 0 0 0 0 CIGNA 8505 E Orchard Rd 5T1 Greenwood Village CO 80111 Administrative 1204695 Fringe Benefit Services Inc 7010 N Broadway STE 106 Denver CO 80221 Administrative 188801 Berenbaum Weinshienk PC 370 17th Street STE 4800 Denver CO 80202 Legal 115003 3 Employer Contributions 525100 25195498 25195498 Reciprocity (net) 525100 176829 176829 Participant Contributions 525100 150865 150865 25523192 216482 216482 2468128 2457633 10495 10495 10495 Misc. revenue-Related-990 525100 4332 4332 4332 25754501 25523192 0 231309 22781757 188801 115003 43786 34461 1382520 36924 20772 13164 ACA Fees 180745 Misc. 8736 24806669 693098 2561930 1503423 129036 2488658 4522479 314332 465382 385147 9225547 10296534 14376108 18209458 445937 327717 8920732 12015406 9366669 12343123 X 5009439 5866335 5009439 5866335 14376108 18209458 947832 -90936 0 X 0 1 X 1 0 0 Hour Bank Reserve 7578597 Claims Incurred but Not Reported 4436809 12015406 X 25663565 -90936 -90936 25754501 0 25754501 21711995 0 21711995 3094674 3094674 24806669 Part X, Line 2: The Internal Revenue Service has determined that the Plan is exempt from federal income tax under Internal Revenue Code Section 501(c)(9). The Trust established to hold the Plan's assets obtained its original determination letter in 1955, 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 determination letter. However, the Plan's Administrator and the Plan's tax counsel believe that the Trust is currently designed and being operated in compliance with the applicable requirements of the Internal Revenue Code. Management has evaluated the Plan's tax positions and concluded that the Plan has maintained its tax exempt status and had taken no uncertain tax positions that would require financial statement adjustment or disclosure for the years ended December 31, 2015 and 2014. The Plan is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. With few exceptions, the Plan is no longer subject to income tax examinations by tax authorities for years preceding December 31, 2011. Part XII, Line 4b - Other Adjustments: Change in Benefit Obligation 3,094,674. Form 990, Part VI, Section B, line 11 Form 990 was provided to the Trustees prior to filing. Form 990, Part VI, Section B, line 12c The Trustees review and assess the conflicts of interest policy and its enforcement at meetings. Form 990, Part VI, Section C, line 18 Form 990 is available for public inspection upon request. Form 990, Part VI, Section C, line 19 The organization makes its governing documents available to the public upon request. Form 990 Item B The form was amended to adjust for accruals made after form was filed. Amended lines include: Part VII Lines 2a, 2b, and 2c; Part IX Lines 4 and 24b; and Part X Line 4. Colorado Pipe Industry Annuity and Salary Deferral Trust 5511 W 56th Ave STE 250 Arvada CO 80002 846041803 Provide defined contribution benefits to participants. CO 401(b) 0 Contact the administrator for a list of contributing contractors Contact the administrator for a list of contributing contractors 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0