MIDWEST TEAMSTERS HEALTH REIMBURSEMENT ARRANGEMENT TR FUND: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- MIDWEST TEAMSTERS HEALTH REIMBURSEMENT ARRANGEMENT TR FUND (EIN 20-2288018)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-09-15
- IRS object ID
- 201402609349301020
- Schema version
- 2013v3.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-09-15T16:14:00-05:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 320043599 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LEGACY PROFESSIONALS LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6800 FRANCE AVENUE SO SUITE 550 | AddressLine1 |
| City | EDINA | City |
| State | MN | State |
| ZIP Code | 55435 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 202288018 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDWEST TEAMSTERS HEALTH REIMBURSEMENT | BusinessNameLine1 |
| Business Name Line2 | ARRANGEMENT TRUST FUND | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MIDW | BusinessNameControlTxt |
| Phone | 6512561804 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O ZENITH AMER SOLUTIONS 2520 | AddressLine1 |
| Address Line2 | PILOT KNOB RD NO 325 | AddressLine2 |
| City | MENDOTA HEIGHTS | City |
| State | MN | State |
| ZIP Code | 55120 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DOUG RUBBELKE | PersonNm |
| Person Title | CHAIRMAN | PersonTitleTxt |
| Phone | 6512561804 | PhoneNum |
| Signature | 2014-09-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ERIC C BAERTSCH | PreparerPersonNm |
| PTIN | P00964071 | PTIN |
| Phone | 9528413950 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DOUG RUBBELKE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O ZENITH AMER SOLUTIONS 2520 | AddressLine1 |
| Address Line2 | PILOT KNOB RD | AddressLine2 |
| City | MENDOTA HEIGHTS | City |
| State | MN | State |
| ZIP Code | 55120 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $849,034 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Trust | Yes (X) | TypeOfOrganizationTrustInd |
| Formation | 2005 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | HEALTH REIMBURSEMENT ARRANGEMENT | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $868,994 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $790,977 | CYProgramServiceRevenueAmt |
| PY Investment Income | $70,256 | PYInvestmentIncomeAmt |
| CY Investment Income | $57,856 | CYInvestmentIncomeAmt |
| PY Other Revenue | $112 | PYOtherRevenueAmt |
| CY Other Revenue | $201 | CYOtherRevenueAmt |
| PY Total Revenue | $939,362 | PYTotalRevenueAmt |
| CY Total Revenue | $849,034 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $761,586 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $781,989 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $170,237 | PYOtherExpensesAmt |
| CY Other Expenses | $198,626 | CYOtherExpensesAmt |
| PY Total Expenses | $931,823 | PYTotalExpensesAmt |
| CY Total Expenses | $980,615 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,539 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$131,581 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,185,320 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,059,860 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,246 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $17,367 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,174,074 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $7,042,493 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THIS PLAN IS INTENDED TO PERMIT AN ELIGIBLE EMPLOYEE TO OBTAIN REIMBURSEMENT OF MEDICAL CARE EXPENSES ON A NONTAXABLE BASIS FROM THEIR HRA ACCOUNT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Desc | REIMBURSEMENT OF MEDICAL EXPENSES THAT QUALIFY UNDER SECTION 213 OF THE INTERNAL REVENUE CODE. | Desc |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ZENITH AMERICAN SOLUTIONS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6512561804 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2520 PILOT KNOB ROAD SUITE 325 | AddressLine1 |
| City | MENDOTA HEIGHTS | City |
| State | MN | State |
| ZIP Code | 55120 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|
| DOUG RUBBELKE | |||||
| CHAIRMAN | 0.50 | Yes (X) | $0 | $0 | $0 |
| MARTIN TREVOR LAWRENCE | |||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 |
| SUSAN MAUREN | |||||
| SECRETARY | 0.50 | Yes (X) | $0 | $0 | $0 |
| KEITH GLEASON | |||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 |
| DAVE MIFFLIN | |||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 |
| LISA STENGER | |||||
| TRUSTEE-PAST | 0.50 | Yes (X) | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ZENITH AMERICAN SOLUTIONS | BusinessNameLine1 |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2520 PILOT KNOB ROAD SUITE 325 | AddressLine1 |
| City | MENDOTA HEIGHTS | City |
| State | MN | State |
| ZIP Code | 55120 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | ADMINISTRATION & PAYROLL AUDITS | ServicesDesc |
| Compensation | $123,652 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | EMPLOYER CONTRIBUTIONS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $790,977 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $790,977 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $790,977 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $57,856 | TotalRevenueColumnAmt |
| Exclusion | $57,856 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LITIGATION SETTLEMENT | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $201 | TotalRevenueColumnAmt |
| Exclusion | $201 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $201 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $849,034 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $790,977 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $58,057 | ExclusionAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $781,989 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,352 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,644 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,250 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,116 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,300 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,101 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $813 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,050 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $980,615 | TotalAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$26,719 | BOYAmt |
| EOY | $66,077 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,148,632 | BOYAmt |
| EOY | $6,930,501 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,407 | BOYAmt |
| EOY | $63,282 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,185,320 | BOYAmt |
| EOY | $7,059,860 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,246 | BOYAmt |
| EOY | $17,367 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,246 | BOYAmt |
| EOY | $17,367 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,174,074 | BOYAmt |
| EOY | $7,042,493 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,174,074 | BOYAmt |
| EOY | $7,042,493 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,185,320 | BOYAmt |
| EOY | $7,059,860 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$131,581 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $849,034 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $849,034 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $849,034 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $980,615 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $980,615 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $980,615 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE PLAN FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, AND FORM 5500, ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLAN. THE PLANS RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UNTIL THE APPLICABLE STATUTE OF LIMITATIONS EXPIRE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | ALTHOUGH THE TRUSTEES RETAIN ULTIMATE RESPONSIBILITY, THE BOARD HAS DELEGATED THE DAY TO DAY ADMINISTRATIVE DUTIES TO ZENITH AMERICAN SOLUTIONS AS THE THIRD PARTY ADMINISTRATOR OF THE PLAN. |
| FORM 990, PART VI, SECTION B, LINE 11 | FORM 990 IS PROVIDED TO AND REVIEWED BY THE ENTIRE BOARD OF TRUSTEES PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE TRUSTEES EVALUATE ANY POSSIBLE CONFLICTS OF INTEREST ANNUALLY WITH THE PLAN'S ATTORNEY. IN ADDITION, PERIODIC REVIEWS OF COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ARE CONDUCTED BY THE BOARD OF TRUSTEES TO ENSURE THE PLAN OPERATES IN A MANNER CONSISTENT WITH NONPROFIT PURPOSES AND DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS LAWFUL STATUS AND FIDUCIARY OBLIGATIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO PARTICIPANTS AND NOT TO THE PUBLIC. THESE DOCUMENTS CAN BE OBTAINED BY REQUEST AT THE PLAN ADMINISTRATOR'S OFFICE IN MENDOTA HEIGHTS, MN. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|
| TEAMSTERS LOCAL 320 | |
| CONTRIBUTING EMPLOYER | 0 |
| TEAMSTERS LOCAL 346 | |
| CONTRIBUTING EMPLOYER | 0 |
| TEAMSTERS LOCAL 970 | |
| CONTRIBUTING EMPLOYER | 0 |
| TEAMSTERS LOCAL 792 | |
| CONTRIBUTING EMPLOYER | 0 |
| TEAMSTERS JOINT COUNCIL 32 | |
| CONTRIBUTING EMPLOYER | 0 |
| TEAMSTERS LOCAL 974 | |
| CONTRIBUTING EMPLOYER | 0 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|
| CHAMPAIGN ASPHALT CO LLC | ||
| CONTRIBUTING EMPLOYER | 0 | 0 |
| GEORGE JONES EXCAVATING LLC | ||
| CONTRIBUTING EMPLOYER | 0 | 0 |
| KS ENERGY SERVICE LLC | ||
| CONTRIBUTING EMPLOYER | 0 | 0 |
| INFRASOURCE CONST LLC | ||
| CONTRIBUTING EMPLOYER | 0 | 0 |
| R A BLACK & SON LLC | ||
| CONTRIBUTING EMPLOYER | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (96 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|
| AJ WALKER CONST COMPANY | |
| CONTRIBUTING EMPLOYER | 0 |
| AC PAVEMENT STRIPING CO | |
| CONTRIBUTING EMPLOYER | 0 |
| ADVANCED ASPHALT COMPANY | |
| CONTRIBUTING EMPLOYER | 0 |
| ASH MANAGEMENT SERVICES | |
| CONTRIBUTING EMPLOYER | 0 |
| ATLANTIC PLANT MAINTENANCE | |
| CONTRIBUTING EMPLOYER | 0 |
| BIG INCH FABRICATORS & CONST | |
| CONTRIBUTING EMPLOYER | 0 |
| BLANKENSHIP CONSTRUCTION CO | |
| CONTRIBUTING EMPLOYER | 0 |
| CARL MAURO JR TRUCKING | |
| CONTRIBUTING EMPLOYER | 0 |
| CENTRAL ILLINOIS CONT CORP | |
| CONTRIBUTING EMPLOYER | 0 |
| CENTRAL ILLINOIS TILE CO | |
| CONTRIBUTING EMPLOYER | 0 |
| CIVIL | |
| CONTRIBUTING EMPLOYER | 0 |
| CLEVENGER CONTRACTORS INC | |
| CONTRIBUTING EMPLOYER | 0 |
| CROSS CONSTRUCTION INC | |
| CONTRIBUTING EMPLOYER | 0 |
| DELAURENT CONST CO | |
| CONTRIBUTING EMPLOYER | 0 |
| DIAMOND CONSTRUCTION COMPANY | |
| CONTRIBUTING EMPLOYER | 0 |
| DOUBLE M TRUCKING | |
| CONTRIBUTING EMPLOYER | 0 |
| DUNN COMPANY | |
| CONTRIBUTING EMPLOYER | 0 |
| EJ CATTANI & SON INC | |
| CONTRIBUTING EMPLOYER | 0 |
| FEUTZ CONTRACTORS INC | |
| CONTRIBUTING EMPLOYER | 0 |
| FLUOR CONSTRUCTORS | |
| CONTRIBUTING EMPLOYER | 0 |
| FREESEN | |
| CONTRIBUTING EMPLOYER | 0 |
| FRIEDERICH CONST & TRUCKING | |
| CONTRIBUTING EMPLOYER | 0 |
| GM SIPES | |
| CONTRIBUTING EMPLOYER | 0 |
| GARICH & SONS INC | |
| CONTRIBUTING EMPLOYER | 0 |
| GL WARREN CONST INC | |
| CONTRIBUTING EMPLOYER | 0 |
| GARY RINKER TRUCKING INC | |
| CONTRIBUTING EMPLOYER | 0 |
| GENSINI EXCAVATING INC | |
| CONTRIBUTING EMPLOYER | 0 |
| GEORGEWITZ CONTRACTING CO | |
| CONTRIBUTING EMPLOYER | 0 |
| GRP MECHANICAL COMPANY INC | |
| CONTRIBUTING EMPLOYER | 0 |
| GUNTHER CONSTRUCTION CO | |
| CONTRIBUTING EMPLOYER | 0 |
| HARMON FARMS TRUCKING INC | |
| CONTRIBUTING EMPLOYER | 0 |
| HOERR CONSTRUCTION INC | |
| CONTRIBUTING EMPLOYER | 0 |
| HOWELL PRAVING INC | |
| CONTRIBUTING EMPLOYER | 0 |
| ILLINI EXCAVATION & RECLAMATION | |
| CONTRIBUTING EMPLOYER | 0 |
| ILLINOIS VALLEY PAVING | |
| CONTRIBUTING EMPLOYER | 0 |
| JC DILLION INC | |
| CONTRIBUTING EMPLOYER | 0 |
| JB CONTRACTING CORP | |
| CONTRIBUTING EMPLOYER | 0 |
| JOE HATZER & SON CONTRACTORS | |
| CONTRIBUTING EMPLOYER | 0 |
| JOHN POHAR & SONS INC | |
| CONTRIBUTING EMPLOYER | 0 |
| KINNEY CONTRACTORS INC | |
| CONTRIBUTING EMPLOYER | 0 |
| KLOECKNER CORPNAMASCO | |
| CONTRIBUTING EMPLOYER | 0 |
| L W CONTRACTORS INC | |
| CONTRIBUTING EMPLOYER | 0 |
| LAESCH ELECTRIC INC | |
| CONTRIBUTING EMPLOYER | 0 |
| LEN TROVERO CONST CORP | |
| CONTRIBUTING EMPLOYER | 0 |
| MACC OF ILL INC | |
| CONTRIBUTING EMPLOYER | 0 |
| MARTIN & COMPANY EXCAVATING | |
| CONTRIBUTING EMPLOYER | 0 |
| MCCARTHY IMPROVEMENT COMPANY | |
| CONTRIBUTING EMPLOYER | 0 |
| MCLEAN COUNTY ASPHALT | |
| CONTRIBUTING EMPLOYER | 0 |
| MIDWESTERN CONTRACTORS | |
| CONTRIBUTING EMPLOYER | 0 |
| MISCELLANEOUS SERVICES INC | |
| CONTRIBUTING EMPLOYER | 0 |
| MT CARMEL STABILIZATION GROUP | |
| CONTRIBUTING EMPLOYER | 0 |
| NEFINCH COMPANY | |
| CONTRIBUTING EMPLOYER | 0 |
| NE-CO ASPHALT COMPANY INC | |
| CONTRIBUTING EMPLOYER | 0 |
| OUTDOOR CONSTRUCTION INC | |
| CONTRIBUTING EMPLOYER | 0 |
| R A CULLINAN & SON | |
| CONTRIBUTING EMPLOYER | 0 |
| ROADSAFE TRAFFIC | |
| CONTRIBUTING EMPLOYER | 0 |
| ROADSAFE TRAFFIC SYSTEMS INC | |
| CONTRIBUTING EMPLOYER | 0 |
| ROGER JAMESON | |
| CONTRIBUTING EMPLOYER | 0 |
| ROWE CONST DIV OF UNITED CONTR | |
| CONTRIBUTING EMPLOYER | 0 |
| SAINT PAUL PIONEER PRESS | |
| CONTRIBUTING EMPLOYER | 0 |
| SCOTT NOVAK | |
| CONTRIBUTING EMPLOYER | 0 |
| SO IL ASPHALT COMPANY | |
| CONTRIBUTING EMPLOYER | 0 |
| STARKS EXCAVATING INC | |
| CONTRIBUTING EMPLOYER | 0 |
| STONE & WEBSTER CONST INC | |
| CONTRIBUTING EMPLOYER | 0 |
| STUTZ EXCAVATING INC | |
| CONTRIBUTING EMPLOYER | 0 |
| SUBLETTE TRUCKING CO INC | |
| CONTRIBUTING EMPLOYER | 0 |
| THIEMS CONSTUCTION | |
| CONTRIBUTING EMPLOYER | 0 |
| TYCE MAHANNAH EXCAVATING | |
| CONTRIBUTING EMPLOYER | 0 |
| URS ENERGY & CONSTRUCTION INC | |
| CONTRIBUTING EMPLOYER | 0 |
| VALLEY CONTRACTORS INC | |
| CONTRIBUTING EMPLOYER | 0 |
| WASHINGTON GROUPALBERICI | |
| CONTRIBUTING EMPLOYER | 0 |
| WILLIAM CHARLES CONST | |
| CONTRIBUTING EMPLOYER | 0 |
| WM AUPPERLY & SONS INC | |
| CONTRIBUTING EMPLOYER | 0 |
| BAXMEYER CONSTRUCTION INC | |
| CONTRIBUTING EMPLOYER | 0 |
| BECHTEL CONST COMPANY | |
| CONTRIBUTING EMPLOYER | 0 |
| BECO | |
| CONTRIBUTING EMPLOYER | 0 |
| BERCO CONSTRUCTION INC | |
| CONTRIBUTING EMPLOYER | 0 |
| COLLINS & HERMANN INC | |
| CONTRIBUTING EMPLOYER | 0 |
| COUNTY CONTRACTORS INC | |
| CONTRIBUTING EMPLOYER | 0 |
| DW MERTZKE EXCAVATING & TRUCK | |
| CONTRIBUTING EMPLOYER | 0 |
| ET SIMONDS CONSTRUCTION CO | |
| CONTRIBUTING EMPLOYER | 0 |
| FEKEN TRUCKING & EXCAVATING | |
| CONTRIBUTING EMPLOYER | 0 |
| FOLEY CONSTRUCTION COMPANY | |
| CONTRIBUTING EMPLOYER | 0 |
| FRED WEBER INC | |
| CONTRIBUTING EMPLOYER | 0 |
| GEO DYNAMICS INC | |
| CONTRIBUTING EMPLOYER | 0 |
| HAIER PLUMBING AND HEATING INC | |
| CONTRIBUTING EMPLOYER | 0 |
| ILLINOIS EXCAVATORS INC | |
| CONTRIBUTING EMPLOYER | 0 |
| IROQUOIS PAVING CORPORATION | |
| CONTRIBUTING EMPLOYER | 0 |
| KEELEY AND SONS INC | |
| CONTRIBUTING EMPLOYER | 0 |
| PETERSON TRUCKING | |
| CONTRIBUTING EMPLOYER | 0 |
| PRADO CONSTRUCTION | |
| CONTRIBUTING EMPLOYER | 0 |
| RAY LA FORE TRUCK SERVICE INC | |
| CONTRIBUTING EMPLOYER | 0 |
| RIDGE TRUCKING INC | |
| CONTRIBUTING EMPLOYER | 0 |
| VALLEY CONSTRUCTION COMPANY | |
| CONTRIBUTING EMPLOYER | 0 |
| VISSERING CONSTRUCTION COMPANY | |
| CONTRIBUTING EMPLOYER | 0 |
| WILLIAM M LONIE | |
| CONTRIBUTING EMPLOYER | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |