2016-04-14T12:48:29-05:00 2015-05-31 320043599 LEGACY PROFESSIONALS LLP 6800 FRANCE AVENUE SO SUITE 550 EDINA MN 55435 990 2014-06-01 237015120 INTERNATIONAL OPERATING ENGINEERS UNION 49 HEALTH AND WELFARE FUND INTE 9528540795 3001 METRO DRIVE NO 500 BLOOMINGTON MN 55425 GLEN JOHNSON CHAIRMAN 9528540795 2016-03-17 1 ERIC C BAERTSCH P00964071 9528413950 2014 2016-08-17 19:52:53Z GLEN JOHNSON 3001 METRO DRIVE NO 500 BLOOMINGTON MN 55425 182760364 0 X N/A X 1968 MN HEALTH AND WELFARE FUND 8 0 112 0 0 0 0 0 134698107 153350980 6373183 4536815 0 0 141071290 157887795 0 0 121365126 138490103 153468 193910 0 0 0 4114201 4556070 125632795 143240083 15438495 14647712 223469719 240647325 4631856 4606812 218837863 236040513 PAYMENT OF HEALTH CARE BENEFITS FOR ELIGIBLE PARTICIPANTS AND DEPENDENTS AS PROVIDED BY THE PLAN DOCUMENT. 0 0 THE PLAN PROVIDES HEALTH CARE, PRESCRIPTION DRUGS, LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT, DENTAL, DISABILITY AND VISION BENEFITS FOR ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS OR BENEFICIARIES. 0 0 0 0 0 0 0 0 0 1 0 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 2975 0 1 112 1 0 0 0 0 0 0 0 0 X 8 0 0 1 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X WILSON-MCSHANE CORPORATION 9528540795 3001 METRO DRIVE SUITE 500 BLOOMINGTON MN 55425 STEVE HALL TRUSTEE 2.00 X 0 0 0 KYLE JONES TRUSTEE 2.00 50.00 X 0 113428 41178 TIMOTHY GILLEN TRUSTEE 2.00 X 0 0 0 CLAYTON JOHNSON TRUSTEE 2.00 50.00 X 0 113428 41178 MARTHA HENRICKSON ALTERNATE TRUSTEE 1.00 X 0 0 0 STEVE PIPER TRUSTEE 2.00 50.00 X 0 95107 41087 BRENT PYKKONEN ALTERNATE TRUSTEE 1.00 50.00 X 0 95107 41087 MARK HUBBARD TRUSTEE 1.00 X 0 0 0 GLEN JOHNSON CHAIRMAN 2.00 50.00 X 0 131749 42204 WILLIAM PATT SECRETARY 2.00 X 0 0 0 MARTHA LAFAVE FUND COORDINATOR 40.00 X 106237 0 42933 106237 548819 249667 1 0 1 0 BLUELINK TPA 1200 YANKEE DOODLE ROAD EAGAN MN 55122 PPO ACCESS FEE 2662890 WILSON-MCSHANE CORPORATION 3001 METRO DRIVE SUITE 500 BLOOMINGTON MN 55425 THIRD PARTY ADMINISTRATOR 2221765 MEDICAL ADVOCATE PROGRAM 12425 28TH STREET NORTH ST PETERSBURG FL 33716 MEDICAL CONSULTING 831106 STAIRWAY PARTNERS LLC 2215 YORK ROAD OAK BROOK IL 60523 INVESTMENT SERVICES 524870 DELTA DENTAL 500 WASHINGTON AVENUE SOUTH SUITE MINNEAPOLIS MN 55415 PPO ACCESS FEE 228887 5 EMPLOYER CONTRIB 900099 119447915 119447915 PARTIC/RETIREE CONTRIB 900099 10907443 10907443 NON-BARGAINING CONTRIB 900099 9294477 9294477 HRA CONTRIB 900099 9117772 9117772 RECIPROCITY CONTRIB 900099 3407634 3407634 1175739 1175739 153350980 4375274 4375274 25034110 24872569 161541 161541 161541 157887795 153350980 0 4536815 138490103 126027 39445 18455 9983 2136551 224535 29500 558546 301999 101398 4526 60978 12489 41510 FEES MANDATED BY ACA 1057983 DUES & SUBSCRIPTIONS 26055 143240083 -1344872 6366388 20690166 20898963 11980556 15357162 23087 37554 47373 32177 25462 15196 190964954 194302785 1130366 3669277 223469719 240647325 973421 1114713 3294021 3156555 364414 335544 4631856 4606812 X 0 0 0 0 218837863 236040513 218837863 236040513 223469719 240647325 14647712 2554938 0 X 0 1 X 1 0 47373 32177 15196 15196 DEPOSITS HELD FOR OTHER FUNDS 335544 335544 X 159884187 2554938 2554938 157329249 558546 558546 157887795 142681537 0 142681537 558546 558546 143240083 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. THE PLAN'S RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UNTIL THE APPLICABLE STATUTE OF LIMITATIONS EXPIRES. 0 0 0 KYLE JONES TRUSTEE 0 113428 0 0 0 0 0 28991 0 12187 0 154606 0 0 CLAYTON JOHNSON TRUSTEE 0 113428 0 0 0 0 0 28991 0 12187 0 154606 0 0 GLEN JOHNSON CHAIRMAN 0 131749 0 0 0 0 0 30017 0 12187 0 173953 0 0 FORM 990, PART VI, SECTION A, LINE 3 ALTHOUGH THE BOARD OF TRUSTEES RETAINS THE ULTIMATE RESPONSIBILITY, THE BOARD HAS DELEGATED THE DAY TO DAY ADMINISTRATIVE DUTIES TO WILSON-MCSHANE CORPORATION AS THE THIRD PARTY ADMINISTRATOR OF THE FUND. FORM 990, PART VI, SECTION A, LINE 7A THE FUND SHALL BE ADMINISTERED BY AN EQUAL NUMBER OF TRUSTEES, HALF OF WHOM SHALL BE APPOINTED BY INTERNATIONAL UNION OF OPERATING ENGINEERS LOCAL NO. 49 AND SHALL ACT AS UNION TRUSTEES, AND HALF OF WHOM SHALL BE APPOINTED BY ASSOCIATED GENERAL CONTRACTORS OF MINNESOTA, INC. MINNEAPOLIS AND SAINT PAUL BUILDERS DIVISION AND HIGHWAY AND HEAVY DIVISION AND SHALL ACT AS EMPLOYER TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS PROVIDED TO, REVIEWED, AND APPROVED BY THE ENTIRE BOARD OF TRUSTEES BEFORE THE FORM 990 IS FILED. FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE IS REQUIRED TO ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT EACH TRUSTEE: HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, AND HAS AGREED TO COMPLY 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 ALLOW THE TRUSTEES TO FULFILL THEIR FIDUCIARY OBLIGATIONS, PERIODIC REVIEWS OF COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ARE CONDUCTED BY THE TRUSTEES AND THE PLAN'S ATTORNEY. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO PARTICIPANTS AT THE FUND OFFICE. 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