2014-04-04T10:55:19-05:00 2013-06-30 364409576 BRONSWICK REICIN POLLACK LTD 2150 E LAKE COOK ROAD SUITE 430 BUFFALO GROVE IL 600891862 990 2012-07-01 366117757 MISC WHSMENS LOCAL 781 H & W FUND MISC 8472989999 747 CHURCH ROAD BUILDING D NO 1 ELMHURST IL 60126 PAUL J STRIPLING 8472989999 2014-04-04 1 JEFFREY D BRONSWICK P00440208 8478089800 2012 2015-11-30 17:44:51Z PAUL J STRIPLING 200 EAST HOWARD STREET 216 DES PLAINESS IL 60018 15860748 0 X N/A X 1960 IL TO PROVIDE HEALTH BENEFITS AND DEATH BENEFITS TO ELIGIBLE PARTICIPANTS AND COVERED DEPENDENTS. 4 4 0 0 0 0 0 0 5941963 6022025 620987 428859 -9025 0 6553925 6450884 0 0 5357362 6109040 1496 0 0 0 0 555466 642092 5914324 6751132 639601 -300248 18448048 17262732 1083827 616897 17364221 16645835 TO PROVIDE HEALTH BENEFITS AND DEATH BENEFITS TO ELIGIBLE PARTICIPANTS AND COVERED DEPENDENTS. 0 0 THE PLAN IS MAINTAINED PURSUANT TO A NUMBER OF COLLECTIVE BARGAINING AGREEMENTS AND PROVIDES FOR EMPLOYEE DEATH, DISABILITY, MEDICAL, HOSPITALIZATION, SURGICAL, PRESCRIPTION, DENTAL AND VISION BENEFITS. 0 0 0 0 0 0 0 0 0 1 0 0 0 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 0 0 1 3 0 1 0 0 0 0 0 0 0 X 4 4 1 0 0 0 1 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X PAUL J STRIPLING 8472989999 747 CHURCH ROAD BUILDING D NO 1 ELMHURST IL 60126 X S JAMES PERLOW - THRU 22813 1.00 X 0 0 0 EARL ABRAMSON 1.00 X 0 0 0 DAVID ABRAMSON - EFF 62613 1.00 X 0 0 0 PAUL J STRIPLING 6.00 X 0 0 0 TRACY L TREADWELL 2.00 X 0 0 0 0 0 0 0 0 0 0 BLUE CROSS BLUE SHIELD OF ILLINOIS 300 EAST RANDOLPH STREET CHICAGO IL 60601 PPO NETWORK PROVIDER 252719 GROUP ADMINISTRATORS LTD 915 NATIONAL PARKWAY SUITE F SCHAUMBURG IL 60173 THIRD PARTY ADMINISTRATOR 136833 BRONSWICK REICIN POLLACKLTD 2150 E LAKE COOK ROADSUITE 430 BUFFALO GROVE IL 60089 AUDITING 124606 3 EMPLOYER PREMIUM CONTRIBUTIONS 525100 5949372 5949372 EMPLOYEE COBRA CONTRIBUTIONS 525100 72653 72653 6022025 470053 470053 9368670 9409864 -41194 -41194 -41194 6450884 6022025 0 428859 6109040 90872 124603 53154 25677 10183 6239 8311 INSURANCE ADMINISTRATIO 125580 PROVISION FOR UNCOLLECT 100000 INSURANCE CONSULTANTS 61148 PRE-ADM SERVICES - UTIL 13679 22646 6751132 X 230241 562776 246198 345513 791149 399382 2067 8575 7902 7902 0 0 16642695 15642250 535698 304236 18448048 17262732 34340 13557 1049487 603340 1083827 616897 X 0 0 0 0 17364221 16645835 17364221 16645835 18448048 17262732 -300248 -418138 0 X X 0 1 X 1 0 7902 7902 0 0 DUE TO AFFILIATED ORGANIZATION 2397 CLAIMS PAYABLE AND CLAIMS IBNR 600943 603340 FORM 990, PAGE 3, PART IV, ITEM 12 - AUDITED FINANCIAL STATEMENTS THE FUND DID RECEIVE AN AUDITED FINANCIAL STATEMENT IN ACCORDANCE WITH GAAP. THE FUND'S AUDITED FINANCIAL STATEMENT IS NOT REQUIRED TO BE PREPARED IN ACCORDANCE WITH SFAS 117. THEREFORE, THE FUND ANSWERED "NO" TO THIS QUESTION AND IS NOT REQUIRED TO COMPLETE PARTS XI,XII AND XIII OF SCHEDULE D. NOTE THAT ON FORM 990,PAGE 12,PART XII, LINE 2B, THE FUND ANSWERED "YES" BECAUSE THE FUND'S FINANCIAL STATEMENTS WERE AUDITED BY AN INDEPENDENT ACCOUNTANT IN ACCORDANCE WITH GAAP. FORM 990, PART VI, SECTION A, LINE 2 MANAGEMENT TRUSTEE EARL ARBRAMSON AND MANAGEMENT TRUSTEE DAVID ABRAMSON HAVE A FAMILY AND BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 THE PARTICIPANTS OF THE FUND ARE CONSIDERED THE MEMBERS. THE HEALTH AND DEATH BENEFITS PROVIDED TO THE PARTICIPANTS AND THEIR ELIGIBLE DEPENDENTS ARE PAID FROM THE FUND'S INCOME AND/OR ASSETS. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES OTHER THAN THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE TWO LABOR TRUSTEES OF THE FUND REVIEWED THE FORM 990 IN DETAIL WITH THE PREPARER PRIOR TO ITS FILING. THE TWO MANAGEMENT TRUSTEES WERE PROVIDED COPIES OF THE FORM 990 PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C THE POLICY STATES THAT EACH TRUSTEE WILL BE REQUIRED TO STATE ANNUALLY THAT HE HAS REVIEWED THE POLICY AND DOES NOT HAVE ANY CONFLICTS OR , IF THERE IS A CONFLICT,THAT THE TRUSTEE IS REQUIRED TO INDICATE WHAT IT IS. FORM 990, PART VI, SECTION C, LINE 19 THE FUND'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST FROM THE FUND'S OFFICE. FORM 990, PAGE 11, PART X,COLUMN (A) - BEGINNING OF YEAR BALANCES CERTAIN RECLASSIFICATIONS HAVE BEEN MADE TO THE PRIOR YEAR AMOUNTS TO CONFORM TO THE CURRENT YEAR PRESENTATION.THERE WAS NO EFFECT TO THE NET ASSETS REPORTED AS OF JUNE 30, 2012 ON THE 2011 FORM 990 FILED. FORM 990, PAGE 12, PART XII,LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.