2016-08-05T14:39:31-05:00 2014-12-31 510435869 Needles & Associates LLC 350 Interlocken Blvd STE 360 Broomfield CO 80021 990 2014-01-01 526279969 Mid-South Carpenters Regional Council Health and Welfare Fund MID- 6158590131 PO Box 1449 Goodlettsville TN 37070 Mike Boner Trustee 6158590131 2015-08-04 1 Kurt D Needles P00850236 3034304225 2016-08-05 2014 2016-12-15 16:53:06Z X Mike Boner PO Box 1449 Goodlettsville TN 37070 22123953 0 X N/A X 1985 TN Provide health and welfare benefits to eligible participants. 13 0 0 0 0 0 0 0 18110956 19987761 -7894 94439 22919 0 18125981 20082200 0 0 19911923 11484562 0 0 0 0 0 1710900 1816027 21622823 13300589 -3496842 6781611 8934608 12392124 11387887 7989950 -2453279 4402174 Provide health and welfare benefits to eligible participants. 0 0 Provide health and welfare benefits to eligible participants. 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 2 0 1 0 0 0 0 0 0 0 0 0 X 13 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 0 0 0 X Board of Trustees 6158590131 2001 Caldwell Drive Goodlettsville TN 37072 X Mike Boner Trustee 1.00 X 0 0 0 David Park Trustee 1.00 X 0 0 0 Larry Kerley Trustee 1.00 X 0 0 0 Russ Lambert Trustee 1.00 X 0 0 0 Ray Trawick Trustee 1.00 X 0 0 0 Tim Brown Trustee 1.00 X 0 0 0 Timothy Burns Trustee 1.00 X 0 0 0 Lloyd Hicks Trustee 1.00 X 0 0 0 Joseph Helton Trustee 1.00 X 0 0 0 Michael Pfieffer Trustee 1.00 X 0 0 0 Clyde Tyree Trustee 1.00 X 0 0 0 Larry Parks Trustee 1.00 X 0 0 0 Mark Brodd Trustee 1.00 X 0 0 0 0 0 0 0 0 0 0 Blue Cross Blue Shield of Tennessee 1 Cameron Hill Circle Chattanooga TN 37402 Administrative 942181 Southern Benefit Administrators 2001 Caldwell Drive Goodlettsville TN 37072 Administrative 437995 2 Employer Contributions 525100 18090054 18090054 Reciprocity In 525100 1883693 1883693 Employee Contributions 525100 771664 771664 Reciprocity Out 525100 -757650 -757650 19987761 102948 102948 2033244 2041753 -8509 -8509 -8509 20082200 19987761 0 94439 X 11484562 436800 16072 40176 17846 969381 28023 4285 7466 Transitional Reinsuranc 283211 Misc. 12767 13300589 X 1238184 3040190 2284140 1936482 1875136 2018014 38856 3498292 5397438 8934608 12392124 233839 364816 11154048 7625134 11387887 7989950 X -2453279 4402174 -2453279 4402174 8934608 12392124 6781611 73842 0 X 0 1 X 1 0 0 Hour Bank Liability 5860090 Claims Payable - IBNR 1765044 7625134 X 20156042 73842 73842 20082200 0 20082200 16829503 0 16829503 -3528914 -3528914 13300589 Part X, Line 2: The trust established to hold the Fund's net assets received an exemption letter from the Internal Revenue Service dated April 5, 1988, stating that the trust is tax-exempt under the provisions of Section 501(c)(9) of the Internal Revenue Code (IRC). In addition, the Fund and the trust are required to operate in conformity with the IRC to maintain the tax-exempt status of the trust. Management believes that the Fund, as amended, is being operated in compliance with the applicable requirements of the IRC and, therefore, believes that the related trust remains tax-exempt. Accounting principles generally accepted in the United States of America require management to evaluate tax positions taken by the Fund and recognize a tax liability (or asset) if it has taken an uncertain position that more likely than not would not be sustained upon examination by the Internal Revenue Service. The Fund is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. Management believes it is no longer subject to income tax examinations for years prior to December 31, 2010. Part XII, Line 4b - Other Adjustments: Change in Hour Bank Liability Change in Claims Payable Form 990, Part VI, Section B, line 11 Form 990 was provided to the Trustees for their review prior to filing. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy during board of trustee meetings. Form 990, Part VI, Section C, line 18 The Form 990 is available for public inspection upon pubic request. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents available upon public request. Benefits paid The hour bank and CIBNR liabilities were adjusted subsequent to when the 2014 Form 990 was originally filed, which impacted benefits paid. This amended form reflects the changes. Other liabilities and fund balance The hour bank and CIBNR liabilities were adjusted subsequent to when the 2014 Form 990 was originally filed. This amended form reflects the changes. Info not available for Sch R Part III & IV N/A NA TN 37214 000000000 N/A TN 0 0 Info not available for Sch R Part III & IV N/A NA TN 37072 000000000 N/A TN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0