2017-03-24T11:36:06-05:00 2016-08-31 470900880 CALIBRE CPA GROUP PLLC 566 W LAKE ST STE 300 CHICAGO IL 606611414 990 2015-09-01 237009055 WISCONSIN LABORERS' HEALTH FUND WISC 6088461742 4633 LIUNA WAY No 201 DEFOREST WI 535322514 john schmitt Trustee 6088461742 2017-03-24 1 COREY BILKEY P00499751 3126550037 2015 2021-01-29 14:40:06Z 4633 LIUNA WAY No 201 DEFOREST WI 535322514 122056547 0 X N/A X 1967 WI TO PROVIDE HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER THE PLAN. 14 5 172 0 0 0 0 0 83996642 83150788 8817483 3022983 0 0 92814125 86173771 0 0 72120563 84069170 37148 47799 0 0 0 6078027 6298005 78235738 90414974 14578387 -4241203 254583052 265978905 42004256 44835943 212578796 221142962 X TO PROVIDE HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER THE PLAN. 0 0 THE PLAN PROVIDES HOSPITAL, MEDICAL, SURGICAL, DENTAL, VISION, LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT, DISABILITY, AND SKILLED NURSING CARE BENEFITS TO ALL ELIGIBLE PARTICIPANTS. THE PLAN PROVIDES HOSPITAL,MEDICAL, SURGICAL, DENTAL, VISION, LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT, DISABILITY, AND SKILLED NURSING CARE BENEFITS TO ALL ELIGIBLE PARTICIPANTS. 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 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 172 1 0 0 0 0 0 0 X 14 5 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 1 0 0 0 X ZENITH AMERICAN SOLUTIONS 6088461742 4633 LIUNA WAY SUITE 201 DEFOREST WI 535322514 MARY WILCOX Trustee 3.00 X 0 0 0 WILLIAM KENNEDY Trustee 3.00 X 0 0 0 THOMAS PTACIN Trustee 3.00 X 0 0 0 BRIAN HORNUNG Trustee 3.00 X 0 0 0 ROBERT BARKER Trustee 3.00 40.00 X 0 195833 29483 JOHN TOPP Trustee 3.00 40.00 X 0 156650 17232 KEVIN LEE Trustee 3.00 3.00 X 0 6360 1560 TONY NEIRA Trustee 3.00 50.00 X 0 136150 72014 JEFF DEHNHOFF Trustee 3.00 40.00 X 0 88299 58696 CLARK JENSEN Trustee 3.00 40.00 X 0 80368 52386 TONY MARCELLE Trustee 3.00 40.00 X 0 85032 37614 JOHN SCHMITT Trustee 3.00 40.00 X 0 147008 76667 DAVE SMESTAD Trustee 3.00 X 0 0 0 DAN BURKE Trustee 3.00 40.00 X 0 92840 62204 DAVID BOHL FMR Trustee 3.00 40.00 X 0 143602 23821 0 1132142 431677 0 0 1 0 ANTHEM BLUE CROSS BLUE SHIELD PO BOX 34210 LOUISVILLE KY 40233 PPO SERVICE FEES 1926013 ZENITH AMERICAN SOLUTIONS 4633 LIUNA WAY SUITE 201 DEFOREST WI 53532 ADMIN 1726912 DELTA DENTAL INSURANCE 2801 HOOVER ROAD PO BOX 828 STEVENS POINT WI 54481 DENTAL CLAIMS ADMINISTRATOR 292960 PREVIANT GOLDBERG UELMEN GRATZ MILLE PO BOX 12993 MILWAUKEE WI 53212 LEGAL SERVICES 224400 ULLICO TRUST FUND ADVISORS 1625 Eye Street NW WASHINGTON DC 20006 INV MANAGER 142996 8 EMPLOYER CONTRIBUTIONS 900099 75085709 75085709 SELF-PAY CONTRIBUTIONS 900099 7506427 7506427 SUBROGATION 900099 546195 546195 LIQUIDATED DAMAGES 900099 12457 12457 83150788 2713423 2713423 36192336 35882776 309560 309560 309560 86173771 83150788 0 3022983 84069170 47799 1683088 327897 64264 901755 2434202 296600 78192 4928 30772 ACA FEES AND ASSESSMENT 476307 90414974 8911646 9393222 468488 768148 11174355 9883361 6516 6516 46467901 46491945 187086027 199080861 468119 354852 254583052 265978905 3627139 2821646 38377117 42014297 42004256 44835943 X 0 0 0 0 212578796 221142962 212578796 221142962 254583052 265978905 -4241203 12805369 0 X X 0 1 X 1 0 0 COMMON COLLECTIVE TRUSTS 100128388 F POOLED SEPARATE ACCOUNTS 11264175 F LIMITED PARTNERSHIPS 53260720 F 103-12 INVESTMENT ENTITY 20750676 F REAL ESTATE INVESTMENT TRUST 13676902 F 199080861 EST FOR EXTENDED ELIG 33000000 EST FOR INCUR BUT NOT RPTD 6430700 EST FOR BANKED HOURS 240000 ACCUM BALANCE IN PART HSA ACCTS 2310007 DUE TO AFFILIATED FUND 33590 42014297 X 98077385 12805369 12805369 85272016 901755 901755 86173771 86731376 0 86731376 901755 2781843 3683598 90414974 Part X, Line 2: AS OF AUGUST 31, 2016, THERE WERE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIOD IN PROGRESS. AT AUGUST 31, 2016 THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO THE FISCAL YEAR ENDED AUGUST 31, 2013. Part XII, Line 4b - Other Adjustments: INCREASE IN INBR 718,900. INCREASE IN ACCUM ELIGIBILITY 1,000,000. DECREASE IN CLAIMS PAYABLE -821,747. DECREASE IN BANKED HOURS -10,000. INCREASE IN PART HSA ACCUM BALANCE 1,894,690. 0 0 0 ROBERT BARKER Trustee 0 155833 0 40000 0 0 0 17668 0 11815 0 225316 0 0 JOHN TOPP Trustee 0 156650 0 0 0 0 0 17232 0 0 0 173882 0 0 TONY NEIRA Trustee 0 136150 0 0 0 0 0 55480 0 16534 0 208164 0 0 JOHN SCHMITT Trustee 0 143048 0 0 0 3960 0 59601 0 17066 0 223675 0 0 DAN BURKE Trustee 0 91237 0 0 0 1603 0 41536 0 20668 0 155044 0 0 DAVID BOHL FMR Trustee 0 131083 0 12519 0 0 0 12956 0 10865 0 167423 0 0 Form 990, Part VI, Section A, line 3 Line 3 explanation - ZENITH AMERICAN SOLUTIONS IS THE THIRD PARTY ADMINISTRATOR HIRED TO ADMINISTER THE FUND'S DAY-TO-DAY OPERATIONS. Form 990, Part VI, Section B, line 11 THE TRUSTEES AUTHORIZE THE FUND'S THIRD PARTY ADMINISTRATOR AND A DESIGNATED TRUSTEE TO REVIEW THE FORM 990 BEFORE IT IS FILED. Form 990, Part VI, Section B, line 12c THE TRUSTEES ARE GOVERNED BY THE TRUST DOCUMENT AND HAVE A FIDUCIARY RESPONSIBILITY UNDER ERISA TO ADMINISTER THE PLAN IN THE BEST INTEREST OF THE MEMBERSHIP. THE US DEPARTMENT OF LABOR REQUIRES ALL LABOR TRUSTEES TO REPORT ON FORM LM-30 POTENTIAL SITUATIONS WHERE THERE MAY BE CONFLICTS OF INTEREST. THIS INFORMATION IS OPEN TO THE PUBLIC. Form 990, Part VI, Section C, line 19 A SUMMARY ANNUAL REPORT IS DISTRIBUTED TO ALL PARTICIPANTS. PARTICIPANTS ARE ABLE TO REQUEST THE AUDITOR'S REPORT AND OTHER FINANCIAL INFORMATION FROM THE PLAN ADMINISTRATOR AND/OR DEPARTMENT OF LABOR. ALSO, THE FORM 5500 IS OPEN TO PUBLIC INSPECTION. Form 990, Part XII, line 2c: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. WISCONSIN LABORERS PENSION FUND 4633 LIUNA WAY SUITE 201 DEFOREST WI 53532 396198530 TO PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS WI 401 A 0 WISCONSIN LABORERS APPR & TRAINING FUND 4633 LIUNA WAY 100 DEFOREST WI 53532 391161160 TO PROVIDE TRAINING AND IMPROVE THE SKILLS OF MEMBERS WI 501C 3 0 LABORERS UNION LOCAL #464 1438 n stoughton rd madison WI 53714 390189279 improve condition of workers WI 501c5 0 LABORERS UNION LOCAL 113 6310 w appleton ave milwaukee WI 53210 390367985 improve condition of workers WI 501c5 0 LABORERS UNION LOCAL 140 2771 george st lacrosse WI 54603 390367733 improve condition of workers WI 501c5 0 LABORERS UNION LOCAL 330 886 w airport rd menasha WI 54952 201169193 improve condition of workers WI 501c5 0 LABORERS UNION-LOCAL 268 2233 birch st eau claire WI 54703 562460681 improve condition of workers WI 501c5 0 WIS LABORERS DISTRICT COUNC 4633 LIUNA WAY 100 DEFOREST WI 53532 391142477 improve condition of workers WI 501C5 0 WISCONSIN LABORERS LECET 4633 LIUNA WAY 100 DEFOREST WI 53532 391705116 improved labor mgmt cooperation WI 501c5 0 agc of wisconsin 4814 e broadway madison WI 53716 390712400 improved labor mgmt cooperation WI 501c6 0 allied construction employers assn 17100 w bluemound rd brookfield WI 53005 390189310 improved labor mgmt cooperation WI 501c6 0 A - 1 EXCAVATING INC AL LTDLANDSCAPING AWOAKES & SON INC ABCO BUILDING CORP ACME FIREPROOFING & INS ADKINS CONSTRUCTION INC ADVANCE BOILER & TANK CO LLC AHERN CO ALBERICI CONSTRUCTORS INC ALBRIGHTSON EXCAVATING INC ALFREDSON BROS CONST AMERICAN MASONRY REST CORP AMERICAN SEWER SERV AMES CONSTRUCTION INC ANTHONY INC J P AP COM POWER INC API APPALACHIAN PIPELINE CONTRACTO ARBOR EARTH & STONE LLC ARBOR GREEN INC ARNDT INC HAROLD E ARNIE MACKEY CONST INC ARROW-CRETE CONSTRUCTION ARTEAGA CONSTRUCTION INC ASBESTROL INC ASC INSULATION & FIREPROOFING ASSOC PIPELINE CONSTRUCTION IN ASSOCIATED GENERAL CONTRACTORS AUGELLI CONCRETE & EXCAVAT LLC AZCO INC B & D CONTRACTORS B K B 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