2014-04-14T10:16:13-05:00 2013-08-31 470900880 CALIBRE CPA GROUP PLLC 566 W LAKE ST STE 300 CHICAGO IL 606611414 990 2012-09-01 237009055 WISCONSIN LABORERS' HEALTH FUND WISC 6088461742 4633 LIUNA WAY No 201 DEFOREST WI 535322514 john schmitt 6088461742 2014-04-14 1 COREY BILKEY P00499751 3126550037 2012 2015-11-30 17:44:51Z 4633 LIUNA WAY No 201 DEFOREST WI 535322514 159252088 0 X N/A X 1967 WI TO PROVIDE HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER THE PLAN. 14 14 113 0 0 0 0 0 65896786 70312115 10863495 8323364 0 0 76760281 78635479 0 0 54631770 60665765 33607 27355 0 0 0 4741938 4725939 59407315 65419059 17352966 13216420 190741068 215452701 28991486 32541367 161749582 182911334 X TO PROVIDE HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER THE PLAN. 0 0 THE PLAN PROVIDES HOSPITAL, MEDICAL, SURGICAL, DENTAL, VISION, LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT, DISABILITY, AND SKILLED NURSING CARE BENEFITS TO ALL ELIGIBLE PARTICIPANTS. THE PLAN PROVIDES HOSPITAL,MEDICAL, SURGICAL, DENTAL, VISION, LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT, DISABILITY, AND SKILLED NURSING CARE BENEFITS TO ALL ELIGIBLE PARTICIPANTS. 0 0 0 0 0 0 0 0 0 0 1 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 0 0 113 1 0 0 0 0 0 0 X 14 14 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 1 0 0 0 X ZENITH AMERICAN SOLUTIONS 6088461742 4633 LIUNA WAY SUITE 201 DEFOREST WI 535322514 MARY WILCOX 3.00 X 0 0 0 WILLIAM KENNEDY 3.00 X 0 0 0 PATRICK BASTIEN 3.00 X 0 0 0 THOMAS PTACIN 3.00 X 0 0 0 BRIAN HORNUNG 3.00 X 0 0 0 DAVID BOHL 3.00 40.00 X 0 108241 21079 JOHN TOPP 3.00 40.00 X 0 139000 8100 KEVIN LEE 3.00 15.00 X 0 11929 16875 COREY MCGOVERN 3.00 50.00 X 0 87411 49728 TONY NEIRA 3.00 50.00 X 0 115702 64423 JEFF DEHNHOFF 3.00 40.00 X 0 78548 51955 CLARK JENSEN 3.00 40.00 X 0 68098 44572 TONY MARCELLE 3.00 40.00 X 0 76247 0 JOHN SCHMITT 3.00 40.00 X 0 135975 67277 DAVE SMESTAD 3.00 X 0 0 0 0 821151 324009 0 0 1 0 ZENITH AMERICAN SOLUTIONS 4633 LIUNA WAY SUITE 201 DEFOREST WI 53532 ADMIN 1470049 ANTHEM BLUE CROSS BLUE SHIELD PO BOX 34210 LOUISVILLE KY 40233 PPO SERVICE FEES 1378441 PREVIANT GOLDBERG UELMEN GRATZ MILLE PO BOX 12993 MILWAUKEE WI 53212 LEGAL SERVICES 359655 MANNING & NAPIER 655 METRO PLACE SOUTH DUBLIN OH 43017 INV MANAGER 184829 DELTA DENTAL INSURANCE 2801 HOOVER ROAD PO BOX 828 STEVENS POINT WI 54481 CLAIMS ADMINISTRATOR 175061 8 EMPLOYER CONTRIBUTIONS 900099 62104636 62104636 SELF-PAY CONTRIBUTIONS 900099 7457457 7457457 SUBROGATION 900099 743989 743989 LIQUIDATED DAMAGES 900099 6033 6033 70312115 3253522 3253522 85686451 80616609 5069842 5069842 5069842 78635479 70312115 0 8323364 60665765 27355 1458623 390778 58709 721551 1758514 233644 75803 997 27320 65419059 -327585 445208 10688711 12534957 7454929 9110183 6299 6516 106263888 113781602 66119134 79051887 535692 522348 190741068 215452701 3304786 4188713 25686700 28352654 28991486 32541367 X 0 0 0 0 161749582 182911334 161749582 182911334 190741068 215452701 X 13216420 4735076 3210256 X X 0 1 X 1 0 0 COMMON COLLECTIVE TRUSTS 47564487 F POOLED SEPARATE ACCOUNTS 9822152 F LIMITED PARTNERSHIPS 21665248 F 79051887 EST FOR EXTENDED ELIG 24000000 EST FOR INCUR BUT NOT RPTD 3826500 EST FOR BANKED HOURS 250000 DUE TO MILW PAINTERS HEALTH FUND 276154 28352654 X 82649005 4735077 4735077 77913928 721551 721551 78635479 61454426 0 61454426 721551 3243082 3964633 65419059 Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: AS OF AUGUST 31, 2013, THERE WERE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIOD IN PROGRESS. AT MAY 31, 2013 THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO THE FISCAL YEAR ENDED AUGUST 31, 2010. Part XII, Line 4b - Other Adjustments: DECREASE IN INBR -1,360,200. INCREASE IN ACCUM ELIGIBILITY 3,500,000. INCREASE IN CLAIMS PAYABLE 853,282. INCREASE IN BANKED HOURS 250,000. 0 0 0 TONY NEIRA 0 115702 0 0 0 0 0 49885 0 14538 0 180125 0 0 JOHN SCHMITT 0 132607 0 0 0 3368 0 51053 0 16224 0 203252 0 0 Form 990, Part VI, Section A, line 3 Line 3 explanation - ZENITH AMERICAN SOLUTIONS IS THE THIRD PARTY ADMINISTRATOR HIRED TO ADMINISTER THE FUND'S DAY-TO-DAY OPERATIONS. Form 990, Part VI, Section B, line 11 THE TRUSTEES AUTHORIZE THE FUND'S THIRD PARTY ADMINISTRATOR AND A DESIGNATED TRUSTEE TO REVIEW THE FORM 990 BEFORE IT IS FILED. Form 990, Part VI, Section B, line 12c THE TRUSTEES ARE GOVERNED BY THE TRUST DOCUMENT AND HAVE A FIDUCIARY RESPONSIBILITY UNDER ERISA TO ADMINISTER THE PLAN IN THE BEST INTEREST OF THE MEMBERSHIP. THE US DEPARTMENT OF LABOR REQUIRES ALL LABOR TRUSTEES TO REPORT ON FORM LM-30 POTENTIAL SITUATIONS WHERE THERE MAY BE CONFLICTS OF INTEREST. THIS INFORMATION IS OPEN TO THE PUBLIC. Form 990, Part VI, Section C, line 19 A SUMMARY ANNUAL REPORT IS DISTRIBUTED TO ALL PARTICIPANTS. PARTICIPANTS ARE ABLE TO REQUEST THE AUDITOR'S REPORT AND OTHER FINANCIAL INFORMATION FROM THE PLAN ADMINISTRATOR AND/OR DEPARTMENT OF LABOR. ALSO, THE FORM 5500 IS OPEN TO PUBLIC INSPECTION. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: TRANSFER OF ASSETS FROM MERGED FUND 3,210,256. Form 990, Part XII, line 2c: The process has not changed from the prior year. WISCONSIN LABORERS PENSION FUND 4633 LIUNA WAY SUITE 201 DEFOREST WI 53532 396198530 TO PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTS WI 401 A 0 WISCONSIN LABORERS APPR & TRAINING FUND 4633 LIUNA WAY 100 DEFOREST WI 53532 391161160 TO PROVIDE TRAINING AND IMPROVE THE SKILLS OF MEMBERS WI 501C 3 0 LABORERS UNION LOCAL #464 1438 n stoughton rd madison WI 53714 390189279 improve condition of workers WI 501c5 0 LABORERS UNION LOCAL 113 6310 w appleton ave milwaukee WI 53210 390367985 improve condition of workers WI 501c5 0 LABORERS UNION LOCAL 140 2771 george st lacrosse WI 54603 390367733 improve condition of workers WI 501c5 0 LABORERS UNION LOCAL 330 886 w airport rd menasha WI 54952 201169193 improve condition of workers WI 501c5 0 LABORERS UNION-LOCAL 268 2233 birch st eau claire WI 54703 562460681 improve condition of workers WI 501c5 0 WIS LABORERS DISTRICT COUNC 4633 LIUNA WAY 100 DEFOREST WI 53532 391142477 improve condition of workers WI 501C5 0 WISCONSIN LABORERS LECET 4633 LIUNA WAY 100 DEFOREST WI 53532 391705116 improved labor mgmt cooperation WI 501c5 0 agc of wisconsin 4814 e broadway madison WI 53716 390712400 improved labor mgmt cooperation WI 501c6 0 allied construction employers assn 17100 w bluemound rd brookfield WI 53005 390189310 improved labor mgmt cooperation WI 501c6 0 A - 1 EXCAVATING INC A & A SITE AND SEPTIC INC AL LTDLANDSCAPING ABCO BUILDING CORP ACME FIREPROOFING & INS INC ACTION FENCE INC ADAIR CONSTRUCTION ADKINS CONSTRUCTION INC ADVANCE BOILER & TANK CO LLC ADVANCE CAST STONE COMPANY ADVANCE MECHANICAL AHERN CO J F AJM CONTRACTORS INC ALASKA CONTINENTAL PIPELINE ALBRIGHTSON EXCAVATING INC ALFREDSON BROS CONST ALL-FIVE CONCRETE CUTTING IN ALLIANCE CONCRETE SAWING ALPINE DEMOLITION SERVICES LL AMERI ENVIRONMENTAL INC AMERICAN DEMOLITION CORP AMERICAN SEWER SERV AMES CONSTRUCTION INC AMON COMPANY ANDERSON INC RAY ANDREWS HIGHWAY SERVICES INC ANTHONY INC J P API APPALACHIAN PIPELINE CONTRACT ARBOR GREEN INC ARNDT INC HAROLD E ARNIE 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