2015-03-31T13:43:16-05:00 2014-08-31 470900880 CALIBRE CPA GROUP PLLC 566 W LAKE ST STE 300 CHICAGO IL 606611414 990 2013-09-01 237009055 WISCONSIN LABORERS' HEALTH FUND WISC 6088461742 4633 LIUNA WAY No 201 DEFOREST WI 535322514 john schmitt Trustee 6088461742 2015-03-31 1 COREY BILKEY P00499751 3126550037 2013 2016-03-07 17:11:31Z 4633 LIUNA WAY No 201 DEFOREST WI 535322514 171860208 0 X N/A X 1967 WI TO PROVIDE HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER THE PLAN. 14 14 113 0 0 0 0 0 70312115 75361287 8323364 9983941 0 0 78635479 85345228 0 0 60665765 67757473 27355 38285 0 0 0 4725939 5240596 65419059 73036354 13216420 12308874 215452701 247006482 32541367 37492853 182911334 209513629 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 0 113 1 0 0 0 0 0 0 X 14 14 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 DAVID BOHL Trustee 3.00 40.00 X 0 112264 21080 JOHN TOPP Trustee 3.00 40.00 X 0 138500 15235 KEVIN LEE Trustee 3.00 3.00 X 0 0 400 COREY MCGOVERN Former Trustee 3.00 50.00 X 0 87624 51078 TONY NEIRA Trustee 3.00 50.00 X 0 122287 64995 JEFF DEHNHOFF TRUSTEE 3.00 40.00 X 0 83561 55179 CLARK JENSEN TRUSTEE 3.00 40.00 X 0 75059 48529 TONY MARCELLE Trustee 3.00 40.00 X 0 76619 0 JOHN SCHMITT Trustee 3.00 40.00 X 0 138378 70627 DAVE SMESTAD Trustee 3.00 X 0 0 0 DAN BURKE Trustee 3.00 X 0 86431 50707 0 920723 377830 0 0 1 0 ANTHEM BLUE CROSS BLUE SHIELD PO BOX 34210 LOUISVILLE KY 40233 PPO SERVICE FEES 1547609 ZENITH AMERICAN SOLUTIONS 4633 LIUNA WAY SUITE 201 DEFOREST WI 53532 ADMIN 1467730 PREVIANT GOLDBERG UELMEN GRATZ MILLE PO BOX 12993 MILWAUKEE WI 53212 LEGAL SERVICES 333472 MANNING & NAPIER 655 METRO PLACE SOUTH DUBLIN OH 43017 INV MANAGER 229929 DELTA DENTAL INSURANCE 2801 HOOVER ROAD PO BOX 828 STEVENS POINT WI 54481 DENTAL CLAIMS ADMINISTRATOR 184054 8 EMPLOYER CONTRIBUTIONS 900099 67141961 67141961 SELF-PAY CONTRIBUTIONS 900099 7545747 7545747 SUBROGATION 900099 667953 667953 LIQUIDATED DAMAGES 900099 5626 5626 75361287 3514963 3514963 92983958 86514980 6468978 6468978 6468978 85345228 75361287 0 9983941 67757473 38285 1530598 338120 61495 876852 2089078 224204 78192 982 29021 aca fees and assessment 12054 73036354 445208 103659 12534957 14316592 9110183 10380683 6516 6516 113781602 126426705 79051887 95178104 522348 594223 215452701 247006482 4188713 3326753 28352654 34166100 32541367 37492853 X 0 0 0 0 182911334 209513629 182911334 209513629 215452701 247006482 X 12308874 14273318 20103 X X 0 1 X 1 0 0 COMMON COLLECTIVE TRUSTS 59264366 F POOLED SEPARATE ACCOUNTS 10680862 F LIMITED PARTNERSHIPS 25232876 F 95178104 EST FOR EXTENDED ELIG 29000000 EST FOR INCUR BUT NOT RPTD 4886100 EST FOR BANKED HOURS 280000 34166100 X 98741695 14273319 14273319 84468376 876852 876852 85345228 66977367 0 66977367 876852 5182135 6058987 73036354 Part X, Line 2: AS OF AUGUST 31, 2014, 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, 2014 THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO THE FISCAL YEAR ENDED AUGUST 31, 2011. Part XII, Line 4b - Other Adjustments: INCREASE IN INBR 1,059,600. INCREASE IN ACCUM ELIGIBILITY 5,000,000. DECREASE IN CLAIMS PAYABLE -907,465. INCREASE IN BANKED HOURS 30,000. 0 0 0 TONY NEIRA Trustee 0 122287 0 0 0 0 0 48771 0 16224 0 187282 0 0 JOHN SCHMITT Trustee 0 136143 0 0 0 2235 0 54403 0 16224 0 209005 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 XI, line 9: TRANSFER OF ASSETS FROM MERGED FUND 20,103. 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 A & A SITE AND SEPTIC INC AL LTDLANDSCAPING ABCO BUILDING CORP ACME FIREPROOFING & INS ACTION FENCE INC ADKINS CONSTRUCTION INC ADVANCE BOILER & TANK CO LLC ADVANCE CAST STONE CO ADVANCE MECHANICAL AHERN CO ALBERICI CONSTRUCTORS INC ALBRIGHTSON EXCAVATING INC ALFREDSON BROS CONST ALL FIVE CONCRETE CUTTING IN ALLIANCE CONCRETE SAWING ALLSTATE CONCRETE CUTTERS514 IN AMERI ENVIRONMENTAL INC AMERICAN DEMOLITION AMERICAN SEWER SERV AMES CONSTRUCTION INC AMON COMPANY ANDERSON INC ANDREWS HIGHWAY SERVICES INC ANTHONY INC API ARBOR GREEN INC ARD & CO LLC ARNDT INC ARNIE MACKEY CONST INC ARROW-CRETE CONSTRUCTION ARTEAGA CONSTRUCTION INC ASSOCIATED GENEAL 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