2014-11-11T09:29:06-06:00 2013-12-31 352123203 KSM BUSINESS SERVICES INC PO BOX 40857 INDIANAPOLIS IN 462400857 990 2013-01-01 350851694 ELECTRICAL WORKERS BENEFIT TRUST FUND ELEC 3179234577 1828 NORTH MERIDIAN STREET NO 103 INDIANAPOLIS IN 462021471 ROBERT CADWELL BENEFITS ADMINISTRATOR 3179234577 2014-10-28 1 PATRICK R BRAUER P01046592 3175802000 2014-10-28 2013 2015-11-30 17:44:51Z ROBERT CADWELL 1828 N MERIDIAN SUITE 103 INDIANAPOLIS IN 462021471 107209303 0 X N/A X 1949 IN THE FUND PROVIDES VARIOUS BENEFITS TO PARTICIPANTS AND ELIGIBLE DEPENDENTS 6 6 60 0 0 0 0 0 22100282 22013380 3531448 5902981 0 0 25631730 27916361 0 0 25557466 24939980 381626 417732 0 0 0 1177924 1404828 27117016 26762540 -1485286 1153821 107140495 114849602 138119382 115446345 -30978887 -596743 THE FUND PROVIDES MEDICAL AND WELFARE BENEFITS TO PARTICIPANTS AND ELIGIBLE DEPENDENTS. 0 0 THE FUND PROVIDES VARIOUS MEDICAL AND WELFARE BENEFITS TO PARTICIPANTS AND ELIGIBLE DEPENDENTS 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 736 0 1 60 1 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 0 0 IN X ROBERT CADWELL ELECTRICAL WORKERS 3179234577 1828 NORTH MERIDIAN STREET SUITE INDIANAPOLIS IN 462021471 X LARRY E VANTRIES TRUSTEE 1.00 X 0 0 0 JAMES TSAREFF TRUSTEE 1.00 X 0 0 0 BRIAN MILLER TRUSTEE 1.00 X 0 0 0 KEVIN SCHRADER TRUSTEE 1.00 X 0 0 0 SEAN SEYFERTH TRUSTEE 1.00 X 0 0 0 DAVID RAY TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 ANTHEM INSURANCE COMPANIES INC 220 VIRGINIA AVE INDIANAPOLIS IN 46204 MEDICAL NETWORK PROVIDER 904510 DBMS HEALTH SERVICES LLC 5975 CASTLE CREEK PKY N DR SUITE INDIANAPOLIS IN 46250 MEDICAL NETWORK PROVIDER 164253 PNC BANK 1900 E 9TH ST FLOOR 13 CLEVELAND OH 44114 CUSTODIAL AND INVESTMENT MANAGEMENT 104840 3 CONTRIBUTION INCOME 525920 22013380 22013380 22013380 2535558 2535558 82660365 79292942 3367423 3367423 3367423 27916361 22013380 0 5902981 24939980 293304 8136 74856 41436 37853 29257 63848 30789 12677 7641 8400 ANTHEM CONTRACT SERVICE 943824 PROFESSIONAL FEES 190082 COMPUTER EXPENSE 37588 OTHER EXPENSE 28813 14056 26762540 2421650 351339 2456196 2327443 134388 117343 14024 17045 102248625 112153775 107140495 114849602 34699 64275 22771 15911 138061912 115366159 138119382 115446345 X 0 0 0 0 -30978887 -596743 -30978887 -596743 107140495 114849602 X 1153821 29228323 X X 0 1 X 1 0 134388 117343 17045 17045 CLAIM RESERVES 11966000 POST RETIREMENT BENEFIT OBLIGATIONS 103400159 115366159 X 34074713 6275570 6275570 27799143 117218 117218 27916361 26388322 0 26388322 117218 257000 374218 26762540 PART X, LINE 2: PART IV, LINE 11F - THE FUND IS SUBJECT TO THE PROVISIONS OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA). THE FUND MAINTAINS A QUALIFIED TRUST UNDER SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE AND IS, THEREFORE, EXEMPT FROM FEDERAL INCOME TAX. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FUND AND TO RECOGNIZE A TAX LIABILITY IF THE FUND HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER TAXING AUTHORITIES. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE FUND AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN, OR EXPECTED TO BE TAKEN, THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE FUND IS SUBJECT TO ROUTINE AUDITS BY TAXING AND REGULATORY AUTHORITIES; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROCESS. THE PLAN ADMINISTRATOR BELIEVES THE FUND IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2010. PART XII, LINE 4B - OTHER ADJUSTMENTS: DECREASE IN BENEFIT OBLIGATION OTHER THAN POST RETIREMENT BENEFIT OBLIGATION FORM 990, PART VI, SECTION B, LINE 11 PREPARER PRESENTED COMPLETED FORM 990 IN DRAFT FORM TO THE TRUSTEES. THE TRUSTEES APPROVED THE FORM 990 BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES REFER TO ANNUAL FORMS WHEN CONSIDERING TRANSACTIONS FORM 990, PART VI, SECTION B, LINE 15A THE PROCESS OF DETERMINING THE COMPENSATION OF THE BENEFITS ADMNISTRATOR INCLUDES APPROVAL OF INDEPENDENT TRUSTEES, WHO CONSIDER COMPARABILITY OF WAGES WITH SIMILAR ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 ORGANIZATION'S FORMS ARE AT THE ORGANIZATION'S OFFICES UPON REQUEST. FORM 990, PART XI, LINE 9: POST RETIREMENT BENEFIT OBLIGATIONS 29,228,323. FORM 990, PART XII, LINE 2C: FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PARK XI, LINE 9, CHANGES IN NET ASSETS: POST RETIREMENT BENEFIT OBLIGATIONS - SOP92-6 22,952,753 UNREALIZED APPRECIATION/(DEPRECIATION) OF INVESTMENTS 6,275,570 TOTAL TO FORM 990, PART XI, LINE 9 29,228,323