UNION CONSTRUCTION WORKERS HEALTH PLAN: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: UNION CONSTRUCTION WORKERS HEALTH PLAN (EIN 34-4442536)
Tax period: 2012-06-01 to 2013-05-31
Filed: 2014-01-27
IRS object ID: 201400279349300215
Schema version: 2012v2.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-01-27T09:38:38-08:00	Timestamp
Tax Period End Date	2013-05-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LublinSussman Group LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	3166 N Republic Blvd	AddressLine1
City	Toledo	City
State	OH	State
ZIP Code	436151507	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-06-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	344442536	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Union Construction Workers Health Plan	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	UNIO	NameControl
Phone	4192482401	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1600 Madison Avenue Suite 300	AddressLine1
City	Toledo	City
State	OH	State
ZIP Code	43624	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Brian Outland	Name
Title	Secretary	Title
Date Signed	2014-01-15	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Lee D Wunschel	Name
PTIN	P00088726	PTIN
Phone	4198412848	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Gross Receipts	56559320	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
All Affiliates Included	false	AllAffiliatesIncluded
Organization501c	X	Organization501c
Web Site	N/A	WebSite
Activity Or Mission Description	The fund provides health benefits for eligible members of the construction trade unions covered by the fund.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	10	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	0	TotalNbrEmployees
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	22070522	ProgramServiceRevenuePriorYear
Program Service Revenue CY	19651985	ProgramServiceRevenueCY
Investment Income Prior Year	1428528	InvestmentIncomePriorYear
Investment Income Current Year	1461227	InvestmentIncomeCurrentYear
Other Revenue Prior Year	4787	OtherRevenuePriorYear
Other Revenue Current Year	12976	OtherRevenueCurrentYear
Total Revenue Prior Year	23503837	TotalRevenuePriorYear
Total Revenue Current Year	21126188	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	16254024	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	20725228	BenefitsPaidToMembersCY
Salaries Etc Current Year	0	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	1556337	OtherExpensePriorYear
Other Expenses Current Year	1814775	OtherExpensesCurrentYear
Total Expenses Prior Year	17810361	TotalExpensesPriorYear
Total Expenses Current Year	22540003	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	5693476	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-1413815	RevenuesLessExpensesCY
Total Assets BOY	46153083	TotalAssetsBOY
Total Assets EOY	46465060	TotalAssetsEOY
Total Liabilities BOY	12479324	TotalLiabilitiesBOY
Total Liabilities EOY	13088896	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	33673759	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	33376164	NetAssetsOrFundBalancesEOY
Mission Description	The fund provides health benefits for eligible members of the construction trade unions covered by the fund.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	22540004	Expense
Description	The fund provides health benefits for eligible members of the construction trade unions covered by the fund.	Description
Total Program Service Expense	22540004	TotalProgramServiceExpense
Described In501 C3	false	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	false	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	false	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	974	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	0	NumberOfEmployees
Employment Tax Returns Filed	false	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Form990-T Filed	false	Form990-TFiled
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Excess Business Holdings	false	ExcessBusinessHoldings
Taxable Distributions	false	TaxableDistributions
Distribution To Donor	false	DistributionToDonor
Filed Lieu1041	false	FiledLieu1041
Licensed More Than One State	false	LicensedMoreThanOneState
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	10	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	false	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	Nicholas C Madden	NamePerson
Telephone Number	4192482401	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1600 Madison Ave	AddressLine1
City	Toledo	City
State	OH	State
ZIP Code	43624	ZIPCode

Field	Value	IRS element (for citing)
No Listed Persons Compensated	X	NoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (10 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer
John Russell
Trustee	0.00	0.00	X	0	0	0
Donald Huss
Trustee	0.00	0.00	X	0	0	0
Michael Kujawa
Trustee	0.00	0.00	X	0	0	0
Brian Outland
Secretary	0.00	0.00	X	0	0	0	X
Joseph Blaze III
Trustee	0.00	0.00	X	0	0	0
Ken Gabel
Trustee	0.00	0.00	X	0	0	0
Brian Seeger
Trustee	0.00	0.00	X	0	0	0
Kevin Smith
Trustee	0.00	0.00	X	0	0	0
Greg Myers
Chairman	0.00	0.00	X	0	0	0	X
James Nicholson
Trustee	0.00	0.00	X	0	0	0

Field	Value	IRS element (for citing)
Number Individuals GT100 K	0	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
Vision Service Plan
PO Box 60000	San Francisco	CA	94160	Vision Insurance	160222
Shumaker Loop & Kendrick
1000 Jackson Street	Toledo	OH	43604	Attorney	132016
Northwestern Ohio Administrators
1600 Madison Ave Suite 300	Toledo	OH	43624	Administrative Mgr	1182445
Aetna
151 Farmington Avenue	Hartford	CT	06156	Health Care Provider	645194

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	4	NumberOfContractorsGT100K
Total Contributions	0	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	Contributions	Description
Total Revenue Column	19651985	TotalRevenueColumn
Related Or Exempt Function Income	19651985	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	19651985	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	1481977	TotalRevenueColumn
Exclusion	$1,481,977	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	35412382	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	35433132	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	-20750	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-20750	TotalRevenueColumn
Exclusion	-$20,750	ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescription	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Other Income
Liquidated Damages	12976	12976

Field	Value	IRS element (for citing)
Total Other Revenue	12976	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	21126188	TotalRevenueColumn
Related Or Exempt Function Income	19664961	RelatedOrExemptFunctionIncome
Exclusion	$1,461,227	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	0	Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	20725228	Total
Program Services	20725228	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	0	Total

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	0	Total

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	0	Total

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	0	Total

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	142395	Total
Program Services	142395	ProgramServices

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	46377	Total
Program Services	46377	ProgramServices

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	0	Total

Advertising Advertising

Field	Value	IRS element (for citing)
Total	0	Total

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	0	Total

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	0	Total

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	0	Total

Travel Travel

Field	Value	IRS element (for citing)
Total	0	Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	9738	Total
Program Services	9738	ProgramServices

Interest Interest

Field	Value	IRS element (for citing)
Total	0	Total

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	0	Total

Insurance Insurance

Field	Value	IRS element (for citing)
Total	16378	Total
Program Services	16378	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
Consulting	80130	80130
Custodial Trust Fees	108779	108779
Adjustments	156463	156463
Administrative Expenses	1182445	1182445

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	72070	Total
Program Services	72070	ProgramServices

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	22540003	Total
Program Services	22540003	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	1434793	BOY
EOY	1398353	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	2330556	BOY
EOY	1891554	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	3556782	BOY
EOY	2937823	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
EOY	0	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
EOY	0	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
EOY	0	EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
EOY	0	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	38539867	BOY
EOY	39997622	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	291085	BOY
EOY	239708	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	46153083	BOY
EOY	46465060	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	466543	BOY
EOY	375756	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	12012781	BOY
EOY	12713140	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	12479324	BOY
EOY	13088896	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	33673759	BOY
EOY	33376164	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	33673759	BOY
EOY	33376164	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	46153083	BOY
EOY	46465060	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	-1413815	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	1116220	ReconciliationUnrealizedInvest
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Separate	X	FinancialStatementSeparate

Field	Value	IRS element (for citing)
Audit Committee	true	AuditCommittee
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
Reserve for Extended Eligibility	$9,571,640
IBNR	$3,141,500

Field	Value	IRS element (for citing)
Total Of Amounts	12713140	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt	22133629	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	1116220	NetUnrealizedGainsInvestments
Revenue Not Rptd F990	1116220	RevenueNotRptdF990
Revenue Subtotal	21017409	RevenueSubtotal
Investment Expenses Not Included	108779	InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt	108779	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	21126188	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	21730865	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	21730865	ExpensesSubtotal
Investment Expenses Not Included2	108779	InvestmentExpensesNotIncluded2
Other Expenses Not Included	700359	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	809138	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	22540003	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Part XII, Line 4b	Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S	Change in Estimated Future Benefits $724152 Change-Estimated Unpaid Claims Incurred $-23793
Part X	Part X : FIN48 Footnote	The Plan has determined that there are no uncertain tax positions that require disclosure in these financial statements under the FASB Accounting Standards Codification topic, Income Taxes. The tax years 2008 through 2012 are subject to possible examination by the Internal Revenue Service.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Form 990, Part VI, Line 19	Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	ALL GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST TO NORTHWESTERN OHIO ADMINISTRATORS, INC., THE PLAN ADMINISTRATOR.
Form 990, Part VI, Line 12c	Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	THE PLAN ADMINISTRATOR AND ATTORNEY FOLLOW UP WITH EACH TRUSTEE TO ENSURE THAT EACH COMPLETES THE ANNUAL CONFLICT OF INTEREST DISCLOSURE.
Form 990, Part VI, Line 11b	Form 990, Part VI, Line 11b: Form 990 Review Process	EACH TRUSTEE IS PROVIDED WITH A COPY OF THE FORM 990 EITHER AT A BOARD MEETING OR VIA MAIL OR EMAIL FOR THEIR REVIEW AND APPROVAL PRIOR TO THE FILING OF THE FORM.