2015-04-06T15:53:23-05:00 2014-08-31 510435869 Needles & Associates LLC 350 Interlocken Blvd STE 360 Broomfield CO 80021 990 2013-09-01 730790052 Oklahoma Operating Engineers Welfare Plan OKLA 4056822323 1300 S Meridian Street No 200 Oklahoma City OK 73108 Michael L Stark Jr CO Chairman 4056822323 2015-03-31 Kurt Needles P00850236 3034304225 2015-04-06 2013 2016-03-07 17:11:31Z Michael L Stark Jr 1300 S Meridian Street No 200 Oklahoma City OK 73108 10220118 0 X N/A X 1969 OK Provide health & welfare benefits to eligible participants. 4 0 6 0 0 0 0 0 6067230 7461150 270010 225540 77214 0 6414454 7686690 0 0 4521148 4876967 0 0 0 0 0 480551 562601 5001699 5439568 1412755 2247122 15204344 18964834 2770604 4289073 12433740 14675761 X Provide health & welfare benefits to eligible participants. 0 0 3904617 Health and welfare benefits paid. 421294 Insurance premiums paid on behalf of participants. 551056 Change in CIBNR and hour bank liabilities. Change in claims payable. 4876967 0 0 0 0 0 0 0 0 0 0 0 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 0 0 1 6 1 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X Board of Trustees 4056822323 1300 S Meridian STE 200 Oklahoma City OK 73108 X Mark Little Trustee 1.00 X 0 0 0 Sam Vanmeter Co Chairman 1.00 X 0 0 0 Michael L Stark Jr Chairman 1.00 X 0 0 0 Alan Ferris Trustee 1.00 X 0 0 0 0 0 0 0 0 0 0 Blue Cross Blue Shield 3401 NW 63rd St Oklahoma City OK 73116 Access Fee/Admin 189813 Zenith American Solutions Inc 1300 S Meridian STE 200 Oklahoma City OK 73108 Administrative 179149 2 Net Reciprocity 525100 4248979 4248979 Employer Contributions 525100 3087115 3087115 Employee Contributions 525100 125056 125056 7461150 225238 225238 2533730 2533428 302 302 302 7686690 7461452 0 225238 4876967 4876967 162831 162831 51647 51647 28056 28056 282254 282254 17618 17618 731 731 16879 16879 Misc. 2585 2585 5439568 4876967 562601 0 544019 3664201 3702300 993652 1216645 32712 10546491 13469158 15204344 18964834 214982 1182395 2555622 3106678 2770604 4289073 X 12433740 14675761 12433740 14675761 15204344 18964834 2247122 -5101 0 X 0 1 X 1 0 0 Estimated Hour Bank Liability 2196678 Claims Incurred but Not Reported 910000 3106678 X 7681589 -5101 -5101 7686690 0 7686690 4888509 -551059 -551059 5439568 0 5439568 Part X, Line 2: The Internal Revenue Service has determined that the Plan is exempt from federal income tax under Internal Revenue Code Section 501(c)(9). The Trust established to hold the Plan's assets obtained its original determination letter, in which the Internal Revenue Service stated that the trust, as then designed, was in compliance with the applicable requirements of the Internal Revenue Code. The trust has been amended since receiving the determination letter. However, the Plan's administrator and tax counsel believe that the trust is currently designed and being operated in compliance with the applicable requirements of the Internal Revenue Code. Management has evaluated the Plan's tax positions and concluded that the Plan has maintained its tax exempt status and had taken no uncertain tax positions that would require financial statement adjustment or disclosure for the years ended August 31, 2014 and 2013. With few exceptions, the Plan is no longer subject to income tax examinations by tax authorities for years preceding August 31, 2010. Part XII, Line 2d - Other Adjustments: Change in IBNR -284,000. Change in Hour Bank -267,059. Form 990, Part VI, Section B, line 11 The Form 990 was provided to the Board of Trustees for their review. Form 990, Part VI, Section B, line 12c Trustees review policies annually. Form 990, Part VI, Section C, line 18 All governing documents are available to the public upon request. Form 990, Part VI, Section C, line 19 Form 990 is available for public inspection upon request. Info not available for this section of Sch R N/A NA OK 73108 000000000 N/A OK 0 0 Info not available for this section of Sch R N/A NA OK 73108 000000000 N/A OK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0