2016-02-13T15:02:15-06:00 2015-05-31 320043599 LEGACY PROFESSIONALS LLP 311 S WACKER DRIVE STE 4000 CHICAGO IL 60606 990 2014-06-01 510210922 NATIONAL ROOFERS UNION & EMPLOYERS JOINT HEALTH & WELFARE FUND NATI 3034264984 PO BOX 21240 DENVER CO 80221 JOHN PLESCIA TRUSTEE 3034264984 2016-02-13 1 CRAIG RESCH P00844633 3123680500 2014 2016-08-17 19:52:53Z JOHN PLESCIA PO BOX 21240 DENVER CO 80221 11078509 0 X N/A X 1976 CO TO PROVIDE HEALTH BENEFITS 6 4 0 0 0 0 0 0 6810416 7601851 625189 374179 7450 4451 7443055 7980481 0 0 6510913 6424189 0 0 0 0 0 452205 678471 6963118 7102660 479937 877821 11975315 12922558 16839 68516 11958476 12854042 PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 1 0 0 0 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 0 0 0 0 0 0 0 0 0 X 6 4 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X FRINGE BENEFIT SERVICES INC 3034264984 PO BOX 21240 DENVER CO 80221 KINSEY ROBINSON TRUSTEE 1.00 35.00 X 0 312863 45279 JOHN PLESCIA TRUSTEE 1.00 X 0 0 0 DENNIS CONWAY TRUSTEE 1.00 X 0 0 0 MARK REEVES TRUSTEE 1.00 X 0 0 0 PAUL BLASKI TRUSTEE 1.00 X 0 0 0 DOUG ZIEGLER TRUSTEE 1.00 34.00 X 0 135558 26922 0 448421 72201 0 0 1 0 CIGNA PO BOX 644546 PITTSBURGH PA 15264 MEDICAL PPO PROVIDER 251409 FRINGE BENEFIT SERVICES INC 7010 N BROADWAY SUITE 106 DENVER CO 80221 THIRD PARTY ADMINISTRATOR 210624 2 EMPLOYER CONTRIBUTIONS 900099 7256566 7256566 STOP LOSS POLICY REIMBURSEMENTS 900099 271039 271039 PRESCRIPTION REBATES 900099 64078 64078 PARTICIPANT CONTRIB 900099 10168 10168 7601851 388946 388946 3083261 3098028 -14767 -14767 -14767 MISCELLANEOUS REVENUE 900099 4451 4451 4451 7980481 7601851 0 378630 6424189 196633 133986 48799 23152 105530 14621 14072 5176 FEES MANDATED BY ACA 131255 MISCELLANEOUS 5247 7102660 108104 326745 794038 988303 716053 1150124 3318 2940 9547792 9644057 806010 810389 11975315 12922558 16839 68516 16839 68516 X 0 0 0 0 11958476 12854042 11958476 12854042 11975315 12922558 877821 17745 0 X 0 1 X 1 0 0 CLOSED END INVESTMENT COMPANY 574211 F COMMINGLED MORTGAGE FUND 236178 F 810389 X 7975074 17745 17745 7957329 23152 23152 7980481 7079508 0 7079508 23152 23152 7102660 PART X, LINE 2: THE PLAN FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM TAX, AND FORM 5500, ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLAN. THE PLAN'S RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UNTIL THE APPLICABLE STATUTE OF LIMITATION EXPIRES. 0 0 0 KINSEY ROBINSON TRUSTEE 0 201761 0 0 0 111102 0 21185 0 24094 0 358142 0 0 DOUG ZIEGLER TRUSTEE 0 135206 0 0 0 352 0 14197 0 12725 0 162480 0 0 FORM 990, PART VI, SECTION A, LINE 3 WHILE THE BOARD OF TRUSTEES RETAINS THE ULTIMATE RESPONSIBILITY, THEY HAVE DELEGATED THE DAY TO DAY MANAGEMENT DUTIES TO FRINGE BENEFITS SERVICES, INC. AS THIRD PARTY ADMINISTRATOR OF THE FUND. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 IS PROVIDED TO AND REVIEWED BY THE ORGANIZATION'S ENTIRE GOVERNING BODY BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C FUND PERSONNEL HAVE THE CONTINUING RESPONSIBILITY TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES. IN ANY DETERMINATION BY THE TRUSTEES OF A CONFLICT OF INTEREST, THE PERSON WITH THE CONFLICT OF INTEREST SHALL BE EXCLUDED FROM THE DISCUSSION AND DETERMINATION OF SUCH CONFLICT. DISCLOSURE OF A CONFLICT OF INTEREST SHOULD BE MADE TO THE ADMINISTRATIVE MANAGER, WHO SHALL BRING THE MATTER TO THE ATTENTION OF THE TRUSTEES OR A DULY CONSTITUTED COMMITTEE THEREOF. DISCLOSURE INVOLVING TRUSTEES SHOULD BE MADE TO THE CHAIRMAN OF THE BOARD OF TRUSTEES, WHO SHALL BRING THESE MATTERS TO THE TRUSTEES OR A DULY CONSTITUTED COMMITTEE THEREOF. THE TRUSTEES OR A DULY CONSTITUTED COMMITTEE THEREOF SHALL DETERMINE WHETHER A CONFLICT EXISTS AND, IN THE CASE OF AN EXISTING CONFLICT, WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR AND REASONABLE TO THE FUND. THE DECISION OF THE TRUSTEES OR A DULY CONSTITUTED COMMITTEE THEREOF ON THESE MATTERS WILL REST IN THEIR SOLE DISCRETION, AND THEIR CONCERN SHALL BE THE WELFARE OF THE PLAN AND THE ADVANCEMENT OF ITS PURPOSE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. 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