2015-03-11T13:52:14-05:00 2014-04-30 362152389 BANSLEY AND KIENER LLP 8745 W HIGGINS RD STE 200 CHICAGO IL 606312704 990 2013-05-01 510245220 CHICAGO PAINTERS AND DECORATORS WELFARE FUND CHIC 6309603322 18861 90TH AVE - SUITE A MOKENA IL 60448 ANDREW PERCH TRUSTEE 6309603322 2015-03-03 1 PAUL A MERKEL P00420901 3122632700 2013 2016-02-25 16:41:14Z ANDREW PERCH 18861 90TH AVE - SUITE A MOKENA IL 60448 329941016 0 X N/A X 1953 IL TO PROVIDE HOSPITALIZATION, MEDICAL, AND OTHER RELATED BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 6 0 0 0 0 0 0 0 39246924 39627915 2726518 17388285 16729 12609 41990171 57028809 0 0 37223438 38308446 0 0 0 0 0 2059092 1919467 39282530 40227913 2707641 16800896 116913427 56845429 24166327 24937899 92747100 31907530 SEE BELOW 0 0 TO PROVIDE HOSPITALIZATION, MEDICAL AND OTHER RELATED BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0 0 X 6 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 X EDWARD OTSTOTT 6309603322 18861 90TH AVENUE SUITE A MOKENA IL 60448 MARTIN TEW TRUSTEE 2.00 45.00 X 0 0 0 DONALD STEADMAN TRUSTEE 2.00 45.00 X 0 0 0 TERRENCE FITZMAURICE TRUSTEE 2.00 45.00 X 0 217103 72621 ANDREW PERCH TRUSTEE 2.00 45.00 X 0 128638 61086 HUGO MANZO TRUSTEE 2.00 45.00 X 0 129139 61086 ANTHONY BOCHNIAK TRUSTEE 2.00 45.00 X 0 0 0 0 474880 194793 0 0 1 0 ARNOLD AND KADJAN 203 N LASALLE ST STE 1650 CHICAGO IL 60601 LEGAL AND COLLECTION 769476 BLUE CROSS BLUE SHIELD 300 E RANDOLPH CHICAGO IL 60601 HEALTH CARE PROVIDER 727431 ZENITH-AMERICAN 18861 90TH AVE STE A MOKENA IL 60448 THIRD PARTY ADMINISTRATOR 599509 AETNA HEALTH INSURANCE 7400 CAMPUS ROAD NEW ALBANY OH 43054 HEALTH CARE PROVIDER 428089 VSP PO BOX 742135 LOS ANGELES CA 90074 HEALTH CARE PROVIDER 117058 7 EMPLOYER CONTRIBUTIONS 900099 37022289 37022289 EMPLOYEE CONTRIBUTIONS 900099 2605626 2605626 39627915 1512137 1512137 288788355 272912207 15876148 15876148 15876148 MEDICARE REIMBURSEMENT 900099 12609 12609 12609 57028809 39640524 0 17388285 38308446 602509 298135 116977 105221 100065 106588 4000 12890 40976 COLLECTION FEES 525426 MISCELLANEOUS 6680 40227913 3522369 3697356 4009173 3982987 3481967 2430911 233257 226762 71280690 29968522 33915974 16164581 469997 374310 116913427 56845429 98227 142662 24068100 24795237 24166327 24937899 X 0 0 0 0 92747100 31907530 92747100 31907530 116913427 56845429 X 16800896 -10949689 -66690777 X X 0 1 X 1 0 0 COMMON TRUST FUNDS 16164581 F 16164581 EMPLOYER BONDS PAYABLE 187289 DUE TO BROKER FOR SECURITIES PURCHASED 275393 CLAIMS AND PREMIUMS PAYABLE 684000 CLAIMS INCURRED, NOT REPORTED 2745000 ACCRUED ELIGIBILITY 16677000 COBRA BENEFITS 2594000 DUE TO RELATED ORGANIZATIONS 1632555 24795237 45973899 -10949689 -10949689 56923588 105221 105221 57028809 40787692 0 40787692 105221 -665000 -559779 40227913 PART XII, LINE 4B - OTHER ADJUSTMENTS: DECREASE IN CHANGES IN BENEFIT OBLIGATIONS -665,000. 0 0 0 TERRENCE FITZMAURICE TRUSTEE 0 213598 0 0 0 3505 0 0 0 72621 0 289724 0 0 ANDREW PERCH TRUSTEE 0 128159 0 0 0 479 0 0 0 61086 0 189724 0 0 HUGO MANZO TRUSTEE 0 128159 0 0 0 980 0 0 0 61086 0 190225 0 0 CASH AND INVESTMENTS WERE TRANSFERRED TO NEW FUND 2013-12-31 66690777 FMV DETERMINED BY INVESTMENT CUSTODIAN. 901034518 CHGO PAINT & DECORAT RETIREE WELFARE FUND 18861 90TH AVE STE A MOKENA IL 60448 501(C)(9) 1 0 0 0 PART II, LINE 2E: PERSON(S) INVOLVED: ALL TRUSTEES OF THIS PLAN. PART II, LINE 2E: EXPLANATION OF INVOLVEMENT: EACH TRUSTEE OF THIS PLAN WILL ALSO BE A TRUSTEE OF CHICAGO PAINTERS AND DECORATORS RETIREE WELFARE FUND. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO OTHER COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS PREPARED BY AN INDEPENDENT CPA AND IS REVIEWED AND APPROVED BY THE FUND REPRESENTATIVE PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FORM 990 AND FORM 5500 (WHICH INCLUDES AUDITED ANNUAL FINANCIAL STATEMENTS) AND SUMMARY ANNUAL REPORT AVAILABLE FOR INSPECTION UPON REQUEST. FORM 990, PART XI, LINE 9: TRANSFER OF ASSETS TO CHICAGO PAINTERS AND DECORATORS RETIREE WELFARE FUND -66,690,777. FORM 990, PART XI, LINE 2C THE ORGANIZATION'S BOARD OF TRUSTEES ASSUMES THE RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS. THERE HAS BEEN NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. FORM 990, PART XI, LINE 9 THE CHICAGO PAINTERS AND DECORATORS WELFARE FUND (EIN 51-0245220) TRANSFERRED $66,690,777 OF ITS NET ASSETS OF THE FUND'S POST-RETIREMENT REIMBURSEMENT PROGRAM INTO A NEW PLAN NAMED CHICAGO PAINTERS AND DECORATORS RETIREE WELFARE FUND (EIN 90-1034518) EFFECTIVE DECEMBER 31, 2013. CHICAGO PAINTERS AND DECORATORS DEFERRED SAVINGS PLAN 18861 90TH AVE STE A MOKENA IL 60448 366162468 SAVINGS FUND IL 501(C)(9) 0 PAINTERS DISTRICT COUNCIL NO 14 1456 WEST ADAMS STREET CHICAGO IL 60607 361593286 UNION IL 501(C)(5) 0 BOARD OF TRUSTEES OF CHICAGO PAINTERS WELFARE FUND 18861 90TH AVE STE A MOKENA IL 60448 510245220 PLAN SPONSOR AND ADMINISTRATOR IL 0 CHICAGO PAINTERS AND DECORATORS RETIREE WELFARE FUND 18861 90TH AVE STE A MOKENA IL 60448 901034518 RETIREE WELFARE FUND IL 501(C)(9) 0 CHICAGO AREA DRYWALL JOINT APPRENTICE TRAINING TRUST 18861 90TH AVE STE A MOKENA IL 60448 362836849 TRAINING FUND IL 501(C)(5) 0 CHICAGO AREA PAINTING JOINT APPRENTICE TRAINING TRUST 1101 TAFT AVE BERKLEY IL 60163 362337329 TRAINING FUND IL 501(C)(5) 0 CHICAGO PAINTERS AND DECORATORS INDUSTRY ADVANCEMENT FUND 8700 W BRYN MAWR STE 7405 CHICAGO IL 60631 363606364 INDUSTRY ADVANCEMENT FUND IL 501(C)(6) 0 CHICAGO PAINTERS AND TAPERS COOPERATION AND EDUCATION TRUST FUND 18861 90TH AVE MOKENA IL 60448 363778556 FOSTERING COOPERATION BETWEEN EMPLOYEES AND EMPLOYERS IL 501(C)(6) 0 PAINTERS LOCAL 147 300 S ASHLAND CHICAGO IL 60607 360843820 UNION IL 501(C)(5) 0 400 CONDO ASSOCIATION THE 69 WWASHINGTON MGMT CO A & P PAINTING CO A GRAMER PTG & DEC SERVICE AC BROWN CONSTR CO INC ACCURATE BRANDING CORP ACE METAL REFINISHERS ACTION PAINTING CO INC ADVANTAGE SIGN INSTALLATION AIRTITE INTERIORS INC ALCA INC ALF INTERIORS INC ALL AMERICAN PTG & DEC INC ALL TECH DECORATING COMPANY ALLIANCE DRYWALL & ACOUSTICAL ALLPORT CONSTRUCTION CORP ALUMITEC LTD AM-COAT PAINTING INC ANDERSON MORAN CONSTRUCTION ANNING-JOHNSON COMPANY APRIL BUILDING SERVICES INC APRIL DECORATING INC ARC ELECTRO REFINISHER INC ARCHITEC MILWRK & FURNITURE SV ARNO DECORATING INC ARNOLD & KADJAN ART STUDIOS INC ASCHER BROS INCNON-COLLECTIVE ASCHER BROTHERS CO INC ASHLAUR CONSTRUCTION INC ASI SIGNAGE INNOVATIONS ASPEN COMMERCIAL PAINTING INC ATLANTIC PAINTING CO INC ATLANTIC PLANT SERVICES INC AVALOTIS PAINTING COMPANY INC B 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DECORATING CO TOP NOTCH PAINTING INC TOUCAN SIGNS TPL SIGN SERVICE TRIANGLE DECORATING CO TRICOR CARPENTRY TRIPAR DRYWALL INC TURNER INDUSTRIAL MAINTENANCE ULTIMATE SIGNS INC UPTOWN PAINTING & DECOR INC VAN BRUGGEN SIGNS VERNATE CONSTRUCTION INC VISION INTERIOR VISION PTG & DEC SVCS INC W K MEYER CONSTRUCTION CORP WALL-TECH INC WALLFORMS INCORPORATED WESTSIDE REALTY WILLIAM HUBER CABINET WORKS WILLIAMS POWER CORPORATION WOODBRIDGE CONST & CARPENTRY WOODS CONSTRUCTION INC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 CHICAGO PAINTERS AND DECORATORS RETIREE WELFARE FUND R 66690777 ACTUARIALLY DETERMINED FORM 990, SCHEDULE R PART IV: THE ORGANIZATION IS A MULTI-EMPLOYER COLLECTIVELY BARGAINED EMPLOYEE BENEFIT PLAN THAT IS SUBJECT TO THE PROVISIONS OF THE EMPLOYER RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA). AS REQUIRED, ONLY THE NAMES OF THE CONTRIBUTING EMPLOYERS OF THE ORGANIZATIONS ARE LISTED IN PART IV OF SCHEDULE R.