2015-03-11T14:05:30-05:00 2014-04-30 320043599 LEGACY PROFESSIONALS LLP 6800 FRANCE AVENUE SO SUITE 550 EDINA MN 55435 990 2013-05-01 411384754 IBEW 292 HEALTH CARE PLAN IBEW 7634938830 6900 WEDGWOOD ROAD NO 425 MAPLE GROVE MN 55311 DAVID MANDERSON TRUSTEE 7634938830 2015-03-02 1 ERIC C BAERTSCH P00964071 9528413950 2013 2016-02-25 16:41:14Z DAVID MANDERSON 6900 WEDGWOOD ROAD NO 425 MAPLE GROVE MN 55311 106767905 0 X WWW.IBEW292BENEFITS.ORG X 1980 MN TO PROVIDE HEALTH AND WELFARE BENEFITS 6 2 158 0 0 0 0 0 41418639 43669513 2937479 1540748 0 23 44356118 45210284 0 0 40661400 41377134 747162 763278 0 0 0 1137460 1135161 42546022 43275573 1810096 1934711 103712979 109051060 559147 225306 103153832 108825754 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 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 9 0 1 158 1 0 0 0 0 0 0 0 0 X 6 2 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X JODY ROE-HARDIE 7634938830 6900 WEDGWOOD ROAD MAPLE GROVE MN 55311 JEFFREY HEIMERL TRUSTEE 2.00 48.00 X 0 95091 44022 RODGER KRETMAN TRUSTEE 2.00 48.00 X 0 98186 45135 ANDREW SNOPE TRUSTEE 2.00 48.00 X 0 95091 44022 TIMOTHY HOLMBERG TRUSTEE 2.00 X 0 0 0 FRED JAHNKE TRUSTEE 2.00 X 0 0 0 JEFFREY OHMAN TRUSTEE - PAST 2.00 40.00 X 0 60000 25264 DAVID MANDERSON TRUSTEE 2.00 40.00 X 0 100660 29020 0 449028 187463 0 0 0 0 BLUELINK TPACOMPREHENSIVE CARE SVCS PO BOX 64668 ST PAUL MN 55164 CLAIMS NETWRK ACCESS 847205 DELTA DENTAL PO BOX 9304 MINNEAPOLIS MN 55440 CLAIMS NETWRK ACCESS 163764 ANDERSON HELGEN DAVIS & NISSEN 333 SOUTH 7TH STREET STE 310 MINNEAPOLIS MN 55402 LEGAL COUNSEL 148985 CORVEL 3001 BROADWAY ST NE 600 MINNEAPOLIS MN 55413 HEALTH CARE RISK MANAGEMENT 108606 4 EMPLOYER CONTRIBS 900099 36715791 36715791 PARTICIPANT CONTRIBS 900099 6067275 6067275 ADMIN REIMBURSEMENTS 900099 581423 581423 STOP LOSS REIMBS 900099 305024 305024 43669513 2167561 2167561 60930808 61557621 -626813 -626813 -626813 OTHER INCOME 900099 23 23 23 45210284 43669513 0 1540771 41377134 519231 85032 110540 48475 222402 29540 88164 332131 205560 64727 88037 32746 9954 47961 EQUIPMENT MAINTENANCE 13939 43275573 100 100 1591640 4285882 3166714 2839234 333520 345994 252251 231897 9338 20354 98611667 81360041 20199455 103712979 109051060 100606 91341 458541 133965 559147 225306 X 0 0 0 0 103153832 108825754 103153832 108825754 103712979 109051060 1934711 3737211 0 X 0 1 X 1 0 135057 115303 19754 117194 116594 600 20354 GUARANTEED INVESTMENT CONTRACTS 20199455 F 20199455 DUE TO BROKER 109729 DUE TO LOCAL NO 292 SUB PLAN 24236 133965 X 48277908 3737211 3737211 44540697 88164 581423 669587 45210284 42605986 0 42605986 88164 581423 669587 43275573 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 581423. PART XII, LINE 4B - OTHER ADJUSTMENTS: COMMON ADMINISTRATIVE EXPENSES FOR 292 BENEFIT PLANS 581423. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS PROVIDED TO AND REVIEWED 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. ELEC WKRS LOCAL 292 PENSION PLAN 6900 WEDGWOOD ROAD SUITE 425 MAPLE GROVE MN 55311 416035616 TO PROVIDE PENSION BENEFITS MN 401(A) 0 ELEC WKRS LOCAL 292 DEFINED CONTRIBUTION & 401(K) PLAN 6900 WEDGWOOD ROAD SUITE 425 MAPLE GROVE MN 55311 411760754 TO PROVIDE ANNUITY AND 401(K) BENEFITS MN 401(A) 0 ELEC WKRS LOCAL 292 SUPP UNEMPLOYMENT PLAN 6900 WEDGWOOD ROAD SUITE 425 MAPLE GROVE MN 55311 411876011 TO PROVIDE SUPPLEMENTAL UNEMPLOYMENT BENEFITS MN 501(C)9 0 ELEC WKRS LOCAL 292 VACATIONHOLIDAY PLAN 6900 WEDGWOOD ROAD SUITE 425 MAPLE GROVE MN 55311 411701466 TO PROVIDE VACATION AND HOLIDAY BENEFITS MN 501(C)9 0 IBEW LOCAL 292 CONTRIBUTING EMPLOYER 0 MINNEAPOLIS ELEC IND APPRENTICESHIP CONTRIBUTING EMPLOYER 0 STATEWIDE LIMITED ENERGY APPRENTICESHIP CONTRIBUTING EMPLOYER 0 MPLS PUBLIC SCHOOLS-SPECIAL SCHOOL DIST #1 CONTRIBUTING EMPLOYER 0 CITY OF MINNEAPOLIS CONTRIBUTING EMPLOYER 0 MUNICIPAL BUILDING COMMISSION CONTRIBUTING EMPLOYER 0 UNIVERSITY OF MN CONTRIBUTING EMPLOYER 0 MINNEAPOLIS 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