2016-02-22T12:23:07-06:00 2015-04-30 320043599 LEGACY PROFESSIONALS LLP 6800 FRANCE AVENUE SO SUITE 550 EDINA MN 55435 990 2014-05-01 411384754 IBEW 292 HEALTH CARE PLAN IBEW 7634938830 6900 WEDGWOOD ROAD N NO 425 MAPLE GROVE MN 55311 FRED JAHNKE TRUSTEE 7634938830 2016-02-22 1 ERIC C BAERTSCH P00964071 9528413950 2014 2016-08-17 19:52:53Z FRED JAHNKE 6900 WEDGWOOD ROAD N NO 425 MAPLE GROVE MN 55311 79109507 0 X WWW.IBEW292BENEFITS.ORG X 1980 MN TO PROVIDE HEALTH AND WELFARE BENEFITS 6 2 188 0 0 0 0 0 43669513 49591776 1540748 2831702 23 0 45210284 52423478 0 0 41377134 47067053 763278 829553 0 0 0 1135161 1596296 43275573 49492902 1934711 2930576 109051060 115774508 225306 411370 108825754 115363138 TO PROVIDE HEALTH CARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR BENEFICIARIES 0 0 PAYMENT OF ACCIDENTAL, HOSPITAL, SURGICAL, VISION, LIFE, DENTAL, AND LOSS OF TIME BENEFITS FOR ELIGIBLE PARTICIPANTS AND DEPENDENTS AS PROVIDED BY THE SUMMARY PLAN DESCRIPTION. 0 0 0 0 0 0 0 0 0 1 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 9 0 1 188 1 0 0 0 0 0 0 0 0 X 6 2 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X JODY ROE-HARDIE 7634938830 6900 WEDGWOOD ROAD NO SUITE 425 MAPLE GROVE MN 55311 JEFFREY HEIMERL TRUSTEE-PAST 2.00 48.00 X 0 51669 21849 RODGER KRETMAN TRUSTEE-PAST 2.00 48.00 X 0 56631 27793 ANDREW SNOPE TRUSTEE 2.00 48.00 X 0 51709 25062 TIMOTHY HOLMBERG TRUSTEE 2.00 X 0 0 0 FRED JAHNKE TRUSTEE 2.00 X 0 0 0 PETER LINDHAL TRUSTEE 2.00 48.00 X 0 86876 40552 DAVID MANDERSON TRUSTEE 2.00 40.00 X 0 121197 29733 DANIEL FERGUSON TRUSTEE 2.00 48.00 X 0 98552 47083 0 466634 192072 0 0 1 0 BLUELINK TPACOMPREHENSIVE CARE SVCS PO BOX 64668 ST PAUL MN 55164 CLAIMS NETWRK ACCESS 1009067 DELTA DENTAL PO BOX 9304 MINNEAPOLIS MN 55440 CLAIMS NETWRK ACCESS 186540 2 EMPLOYER CONTRIBS 900099 40274096 40274096 PARTICIPANT CONTRIBS 900099 6256185 6256185 STOP LOSS REIMBS 900099 2409941 2409941 ADMIN REIMBURSEMENTS 900099 651554 651554 49591776 2391877 2391877 27125854 26686029 439825 439825 439825 52423478 49591776 0 2831702 47067053 552239 79857 122842 74615 106665 25384 98006 313088 152545 71990 82385 57364 8987 51074 FEES MANDATED BY ACA 619373 EQUIPMENT MAINTENANCE 9435 49492902 100 100 4285882 3934090 2839234 3985612 345994 235559 141633 130266 20354 11367 81360041 81456364 20199455 26151416 109051060 115774508 91341 251067 133965 160303 225306 411370 X 0 0 0 0 108825754 115363138 108825754 115363138 109051060 115774508 2930576 3606808 0 X 0 1 X 1 0 108845 97478 11367 32788 32788 0 11367 GUARANTEED INVESTMENT CONTRACTS 26151416 F 26151416 DUE TO BROKER 109419 DUE TO LOCAL NO 292 SUB PLAN 50884 160303 X 55280726 3606808 3606808 51673918 98006 651554 749560 52423478 48743342 0 48743342 98006 651554 749560 49492902 PART X, LINE 2: THE PLAN FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, AND FORM 5500, ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLAN, WITH THE INTERNAL REVENUE SERVICE. THE PLAN'S RETURNS ARE SUBJECT TO EXAMINATION UNTIL THE APPLICABLE STATUTE OF LIMITATIONS EXPIRES. PART XI, LINE 4B - OTHER ADJUSTMENTS: COMMON ADMINISTRATIVE EXPENSES FOR 292 BENEFIT PLANS 651554. PART XII, LINE 4B - OTHER ADJUSTMENTS: COMMON ADMINISTRATIVE EXPENSES FOR 292 BENEFIT PLANS 651554. 0 0 0 DAVID MANDERSON TRUSTEE 0 121197 0 0 0 0 0 14040 0 15693 0 150930 0 0 FORM 990, PART VI, SECTION A, LINE 7A THREE TRUSTEES ARE APPOINTED BY THE UNION, AND THREE TRUSTEES ARE APPOINTED BY THE CONTRACTORS ASSOCIATION. THE ASSOCIATION AND THE UNION MAY ALSO APPOINT UP TO ONE ALTERNATE TRUSTEE, WHO WILL BE QUALIFIED TO ACT ONLY IN THE ABSENCE OF A TRUSTEE. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS PROVIDED TO, REVIEWED AND APPROVED BY THE ENTIRE BOARD OF TRUSTEES PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE TRUSTEES REVIEW THE PLAN'S CONFLICT OF INTEREST POLICY ANNUALLY WITH THE PLAN ATTORNEY AND ARE REQUIRED TO SIGN AN ANNUAL CERTIFICATION OF COMPLIANCE WITH THE POLICY. IN ADDITION, TO ENSURE THE PLAN OPERATES IN A MANNER CONSISTENT WITH ITS PURPOSES AND DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS LAWFUL STATUS AND FIDUCIARY OBLIGATIONS, PERIODIC REVIEWS OF COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ARE CONDUCTED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO PARTICIPANTS UPON REQUEST. THESE DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. 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