2015-12-23T09:22:05-06:00 2015-03-31 391531945 FREYBERG HINKLE ASHLAND POWERS & STOWELL 15420 W CAPITOL DR BROOKFIELD WI 530052621 990 2014-04-01 396048209 LOCAL UNIONS NO 19 AND 127 HEALTH AND WELFARE FUND LOCA 4145773700 11270 WEST PARK PLACE NO 950 MILWAUKEE WI 53224 BRETT LARGE SECRETARY/TREASURER 4145773700 2015-12-23 1 THOMAS M POWERS CPA P00241729 2627846210 2014 2016-03-07 17:11:31Z BRETT LARGE 11270 WEST PARK PLACE SUITE 950 MILWAUKEE WI 53224 15325232 0 X N/A X 1952 WI TO PROVIDE ACCIDENT, HEALTH, DENTAL, PRESCRIPTION DRUG, AND LOSS OF TIME BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS AND CERTAIN RETIREES. 6 6 17 0 0 0 0 0 7059651 6777963 62714 -143359 0 0 7122365 6634604 0 0 7015868 8328164 0 0 0 0 0 282315 362474 7298183 8690638 -175818 -2056034 4821341 2963199 3187194 3336282 1634147 -373083 TO PROVIDE ACCIDENT, HEALTH, DENTAL, PRESCRIPTION DRUG, AND LOSS OF TIME BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS AND CERTAIN RETIREES. 0 0 8328164 PROVIDED ACCIDENT, HEALTH, DENTAL, PRESCRIPTION DRUG, AND LOSS OF TIME BENEFITS TO APPROXIMATELY 585 MEMBERS. 8328164 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 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 126 0 1 17 1 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 0 0 0 X BENEFIT PLAN ADMINISTRATION 4145773700 11270 WEST PARK PLACE SUITE 950 MILWAUKEE WI 53224 WILLIAM NARETTA CHAIRMAN 0.10 X X 0 0 0 BRETT LARGE SECRETARY/TREASURER 0.10 40.00 X X 0 84202 67772 JIM BARTELT TRUSTEE 0.10 X 0 0 0 MARK BORCHARDT TRUSTEE 0.10 X 0 0 0 RICHARD VAN ROY TRUSTEE 0.10 X 0 0 0 FRANK RODRIGUEZ TRUSTEE 0.10 40.00 X 0 84373 74669 0 168575 142441 0 0 1 0 UNITED HEALTHCARE 115 W WAUSAU AVE WAUSAU WI 54401 CLAIMS PROCESSING 241773 LEE JOST & ASSOCIATES 11270 WEST PARK PLACE SUITE 950 MILWAUKEE WI 53224 CONSULTING 213050 2 EMPLOYER CONTRIBUTIONS-NET 900099 5994341 5994341 SELF-PAYMENT CONTRIBUTIONS-NET 900099 783622 783622 6777963 59199 59199 8488070 8690628 -202558 -202558 -202558 6634604 6777963 0 -143359 8328164 198838 7843 13150 5003 53789 7719 3549 5198 GOVERNMENTAL FEES AND A 53856 BANK SERVICE FEES 10713 WEBSITE EXPENSE 2000 EDUCATIONAL PROGRAM FEE 816 8690638 7537 114083 214313 302885 543768 371510 69706 72983 3986017 2101738 4821341 2963199 119423 86764 3067771 3249518 3187194 3336282 X 0 0 0 0 1634147 -373083 1634147 -373083 4821341 2963199 -2056034 48804 0 X X 0 1 X 1 0 0 CLAIMS PAYABLE 76000 MEMBER DOLLAR BANK 3173518 3249518 X 6678405 48804 48804 6629601 5003 5003 6634604 8765635 0 8765635 5003 -80000 -74997 8690638 PART X, LINE 2: U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO MARCH 31, 2012. PART XII, LINE 4B - OTHER ADJUSTMENTS: CURRENT YEAR DECREASE IN BENEFIT CLAIMS PAYABLE -80,000. 0 0 0 BRETT LARGE SECRETARY/TREASURER 0 84202 0 0 0 0 0 0 0 67772 0 151974 0 0 FRANK RODRIGUEZ TRUSTEE 0 84373 0 0 0 0 0 0 0 74669 0 159042 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PROVIDED TO PLAN MANAGEMENT TO REVIEW AND APPROVE. FORM 990, PART VI, SECTION B, LINE 12C THIS IS UPDATED ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE AVAILABLE UPON REQUEST AND ARE AVAILABLE FOR INSPECTION AT THE ORGANIZATION'S OFFICE. FORM 990, PART VII WILLIAM NARETTA - 1229 KISHWAUKEE STREET, ROCKFORD, IL 61104. BRETT LARGE - N27 W23155 ROUNDY DRIVE, PEWAUKEE, WI 53072. JIM BARTELT - 3011 PROGRESS DRIVE, APPLETON, WI 54911. MARK BORCHARDT - 616 SOUTH 89TH STREET, MILWAUKEE, WI 53214. RICHARD VAN ROY - 900 REGENT LANE, GREEN BAY, WI XXX-XX-XXXX. FRANK RODRIGUEZ - N7095 SWITZKE ROAD, WATERTOWN, WI 53094. FORM 990, PART XII, LINE 2C THE BOARD OF TRUSTEES ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FUND'S FINANCIAL STATEMENTS AND FOR THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, SCHEDULE R, PARTS II-IV IN ADDITION TO THE CONTRIBUTING EMPLOYERS REPORTED AS RELATED ORGANIZATIONS ON SCHEDULE R, PARTS II-IV, THE FUND MADE A REASONABLE EFFORT TO OBTAIN THE TAX CLASSIFICATION FROM ALL CONTRIBUTING EMPLOYERS, BUT EIGHT OF THE CONTRIBUTING EMPLOYERS HAVE NOT YET RESPONDED TO MULTIPLE REQUESTS. INT'L ASSOCIATION OF HEAT & FROST INSULATORS & ALLIED WORKERS LOCAL 19 N27W23155 ROUNDY DRIVE PEWAUKEE WI 53072 390137350 A LABOR UNION TO ORGANIZE THE EMPLOYEES IN THE PIPE INSULATING TRADE WI 501(C)(5) 0 BOARD OF TRUSTEES OF THE LOCAL UNIONS NO 19 AND 127 HEALTH & WELFARE FUND 11270 WEST PARK PLACE MILWAUKEE WI 53224 396048209 SPONSORING ORGANIZATION (JOINT BOARD OF TRUSTEES) WI 501(C)(9) 0 NATIONAL ASBESTOS WORKERS MEDICAL FUND HEAT AND FROST INSULATORS ST LOUIS WELFARE FUND ASBESTOS WORKERS LOCAL 34 HEALTH & WELFARE TRUST INT'L ASSOC OF HEAT & FROST INSULATORS LOCAL 17 PENSION FUND ASBESTOS LOCAL 133 WELFARE FUND ASBESTOS LOCAL 17 WELFARE FUND NATIONAL ASBESTOS WORKERS FUND ASBESTOS LOCAL 57 WELFARE FUND ADVANCED INDUSTRIAL SERVICES LLC ADVANCED SPECIALTY CONTRACTORS LLC FIRESTOP PLUS LLC ENVIRONMENTAL PLAN SERVICES INC DAY & ZIMMERMANN NPS INC NEW TECH OF WISCONSIN INC D & G INSULATION INC EXPRESS INSULATION INC BRAND ENERGY SERVIES LLC MIDWEST THERMAL SERVICES INC L & S INSULATION CO INC S & S PANEL SALES CORPORATION OF ILLINOIS TAYLOR INSULATION CO INC CENTRAL STATE MECHANICAL INSULATION LLC MAVO SYSTEMS INC ALL SYSTEMS INSULATION INC BARTELT INSULATION SUPPLY INC SPRINKMANN SONS CORPORATION ARM MECHANICAL INSULATION INC API INC CB&I STONE & WEBSTER CONSTRUCTION INC FIBRE FAB OF LA CROSSE INC MCDERMAID ROOFING & INSULATING CO TEBS INSULATION LUSE STEVENSON CO DIRTY DUCTS CLEANING ENVIRONMENTAL & INSULATION INC GAGNON INC INSULATION INDUSTRIES INC HOLIAN ASBESTOS OF WI INC HOLIAN INSULATION CO INC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0