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Mid-South Iron Workers Welfare Fund: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
Mid-South Iron Workers Welfare Fund (EIN 73-6104291)
Tax period
2012-12-01 to 2013-11-30
Filed
2014-07-15
IRS object ID
201401969349301215
Schema version
2012v2.1
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-07-15T12:38:16-05:00Timestamp
Tax Period End Date2013-11-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN510435869EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Needles & Associates LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1350 Interlocken Blvd STE 220AddressLine1
CityBroomfieldCity
StateCOState
ZIP Code80021ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-12-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN736104291EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Mid-South Iron Workers Welfare PlanBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMID-NameControl
Phone4056822323Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11300 South Meridian StreetAddressLine1
CityOklahoma CityCity
StateOKState
ZIP Code73108ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameWalter AshfordName
TitleTrusteeTitle
Phone4056822323Phone
Date Signed2014-06-26DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameKurt NeedlesName
PTINP00850236PTIN
Phone3034304225Phone
Date Prepared2014-07-15DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonWalter AshfordNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11300 South Meridian StreetAddressLine1
CityOklahoma CityCity
StateOKState
ZIP Code73108ZIPCode
FieldValueIRS element (for citing)
Gross Receipts2620359GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1964YearFormation
State Legal DomicileOKStateLegalDomicile
Activity Or Mission DescriptionTo provide health benefits to participants and their dependents.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI2508652TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year2949407ProgramServiceRevenuePriorYear
Program Service Revenue CY2508652ProgramServiceRevenueCY
Investment Income Prior Year57611InvestmentIncomePriorYear
Investment Income Current Year52280InvestmentIncomeCurrentYear
Other Revenue Prior Year39089OtherRevenuePriorYear
Other Revenue Current Year59427OtherRevenueCurrentYear
Total Revenue Prior Year3046107TotalRevenuePriorYear
Total Revenue Current Year2620359TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year3259404BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY2484071BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year385242OtherExpensePriorYear
Other Expenses Current Year351059OtherExpensesCurrentYear
Total Expenses Prior Year3644646TotalExpensesPriorYear
Total Expenses Current Year2835130TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-598539RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-214771RevenuesLessExpensesCY
Total Assets BOY4305389TotalAssetsBOY
Total Assets EOY3614468TotalAssetsEOY
Total Liabilities BOY1737998TotalLiabilitiesBOY
Total Liabilities EOY1337205TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2567391NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2277263NetAssetsOrFundBalancesEOY
Mission DescriptionTo provide health benefits to participants and their dependents.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense2626435Expense
DescriptionBenefits paid.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense283677Expense
DescriptionInsurance premiums.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense-426041Expense
DescriptionChange in hour bank liability and claims incurred but not reported.Description
FieldValueIRS element (for citing)
Total Program Service Expense2484071TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Board of TrusteesBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4056822323TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11300 South Meridian StreetAddressLine1
CityOklahoma CityCity
StateOKState
ZIP Code73108ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (5 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
Michael Richards
Co Chairman1.00X000
Tom Lambert
Chairman1.00X000
Ivan B Williams
Trustee1.00X000
Walter Ashford
Trustee1.00X000
Kenneth Beatty
Trustee1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Zenith American Solutions
1300 S Meridian StreetOklahoma CityOK73108Administrative123530
Blue Cross Blue Shield
225 North Michigan AveChicagoIL60601PPO/Access Fees113589
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenue
Employers' Contributions52510022993502299350
Reciprocity In525100169127169127
Retiree Contributions525100100650100650
COBRA Contributions5251003137031370
Reciprocity Out525100-91845-91845
FieldValueIRS element (for citing)
Total Program Service Revenue2508652TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column52280TotalRevenueColumn
Exclusion$52,280ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Sav-RX Rebates5251003371533715
Stop Loss Recoveries5251002571225712
FieldValueIRS element (for citing)
Total Other Revenue59427TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column2620359TotalRevenueColumn
Related Or Exempt Function Income59427RelatedOrExemptFunctionIncome
Unrelated Business Revenue2508652UnrelatedBusinessRevenue
Exclusion$52,280ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total2484071Total
Program Services2484071ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total123530Total
Management And General123530ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total22735Total
Management And General22735ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total24910Total
Management And General24910ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total165535Total
Management And General165535ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total12939Total
Management And General12939ManagementAndGeneral

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionClaims ReviewDescription
Total1410Total
Management And General1410ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2835130Total
Program Services2484071ProgramServices
Management And General351059ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY409014BOY
EOY349936EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY978596BOY
EOY951285EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY367368BOY
EOY351721EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
EOY0EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2550411BOY
EOY1961526EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY4305389BOY
EOY3614468EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY116676BOY
EOY141924EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1621322BOY
EOY1195281EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1737998BOY
EOY1337205EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2567391BOY
EOY2277263EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2567391BOY
EOY2277263EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4305389BOY
EOY3614468EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-214771ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-75357ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Hour Bank Liability$735,281
Claims Incurred but Not Reported$460,000
FieldValueIRS element (for citing)
Total Of Amounts1195281TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt2545474TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-75357NetUnrealizedGainsInvestments
Revenue Not Rptd F990-75357RevenueNotRptdF990
Revenue Subtotal2620831RevenueSubtotal
Other Revenues Not Included-472OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-472RevenueNotRptdOnFinStmt
Total Revenue Per Form9902620359TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt3261643TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal3261643ExpensesSubtotal
Other Expenses Not Included-426513OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt-426513ExpensesNotRptdOnFinStmt
Total Expenses Per Form9902835130TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Uncertain Tax Positions Under FIN 48:Part X, Line 2:The Trust, established under the Plan to hold the Plan's assets, is qualified under Section 501(c)(9) of the Internal Revenue Code, and, accordingly, the Trust's net investment income is exempt from income taxes. The Plan has obtained a favorable tax determination letter. The Plan has been amended since receiving the determination letter. Management has evaluated the Plans tax positions and concluded that the Plan had maintained its tax exempt status and had taken no uncertain tax positions that required adjustments to the financial statements. With few exceptions, the Plan is no longer subject to income tax examinations by tax authorities for years preceding December 31, 2009.
Part XI, Line 4b - Other Adjustments:Subrogation recoveries netted with benefits paid on 990, income on FS.
Part XII, Line 4b - Other Adjustments:Increase in Hour Bank and Change in IBNR Subrogation recoveries netted with benefits paid on 990, income on FS.
Subrogation recoveries netted with benefits paid on 990, income on FS.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

Return ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Section B, line 11Form 990 was provided to the Trustees prior to filing.
Form 990, Part VI, Section B, line 12cDuring Board of Trustee meetings, Trustees discuss and enforce compliance with the conflict of interest policy.
Form 990, Part VI, Section C, line 18The Form 990 is available for public inspection upon request.
Form 990, Part VI, Section C, line 19Governing documents are available to the public upon request.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Oklahoma Iron Workers Direct Contribution PlanBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11300 S Meridian STE 200AddressLine1
CityOklahoma CityCity
StateOKState
ZIP Code73108ZIPCode
FieldValueIRS element (for citing)
EIN736278639EIN
Primary ActivitiesThe Plan provides pension benefits.PrimaryActivities
Legal Domicile StateOKLegalDomicileState
Exempt Code Section501c9ExemptCodeSection
Controlled Org0ControlledOrg

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Info not available for Sch R Part III & IVBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1N/AAddressLine1
CityNACity
StateOKState
ZIP Code73108ZIPCode
FieldValueIRS element (for citing)
EIN000000000EIN
Primary ActivityN/APrimaryActivity
Legal Domicile StateOKLegalDomicileState
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Info not available for Sch R Part III & IVBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1N/AAddressLine1
CityNACity
StateOKState
ZIP Code73108ZIPCode
FieldValueIRS element (for citing)
EIN000000000EIN
Primary ActivityN/APrimaryActivity
Legal Domicile StateOKLegalDomicileState
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg