2014-06-23T14:44:09-05:00 2013-11-30 L M HENDERSON & COMPANY LLP 450 E 96TH ST STE 200 INDIANAPOLIS IN 46240 990 2012-12-01 350923209 INDIANA LABORERS WELFARE FUND INDI 8122382551 PO BOX 1587 TERRE HAUTE IN 47808 DAVID A FRYE 8122382551 2014-05-23 true MICHELLE L ZIMMERMAN 3175661000 2014-05-23 2012 2015-11-30 17:44:51Z FRANK DEGRAW PO BOX 1587 TERRE HAUTE IN 47808 452842315 false X NOT APPLICABLE X 1953 IN PROVIDE HEALTH & WELFARE BENEFITS TO MEMBERS 14 14 235 0 0 86007934 81713656 7123535 13220148 15940 21045 93147409 94954849 0 71339766 67299870 2001852 2116912 0 0 5348315 5502300 78689933 74919082 14457476 20035767 230023390 251648280 11538659 11052608 218484731 240595672 PROVIDE HEALTH & WELFARE BENEFITS TO MEMBERS false false PROVIDE UNDER COLLECTIVE BARGAINING FINANCIAL SUPPORT FOR PROGRAMS OF LIFE INSURANCE, HEALTH, ACCIDENT, AND OTHER RELATED BENEFITS TO APPROXIMATELY 9,213 PARTICIPANTS. false false false false false false false false false true false false true true true true false false false false false false false false false false false false false false false false false false false false false false false false true false false true 854 0 235 true false false false false false false X 14 14 false false false false false false false true true false false true true true true false true true true false IN X JANETTA ENGLAND 8122382551 413 SWAN STREET TERRE HAUTE IN 47807 X FRANK DEGRAW 0.00 X X 0 0 0 JACK BAKER 0.00 X 0 0 0 DOUGLAS S BANNING JR 0.00 X 0 0 0 TOM FLEENOR 0.00 X 0 0 0 BRIAN KRIEG 0.00 X 0 0 0 EDWARD T HAZLEDINE 0.00 X X 0 0 0 WILLIAM A HASSE III 0.00 X 0 0 0 MARK J STERN 0.00 X 0 0 0 WILLIAM K ROACH X 0 0 0 DAVID FRYE 0.00 X 0 0 0 FRANCIS GANTNER 0.00 X 0 0 0 JIM TERRY 0.00 X 0 0 0 MIKE MCCANN 0.00 X 0 0 0 JAMES W DANIELS X 0 0 0 false false false ANTHEM INC 220 VIRGINIA AVENUE INDIANAPOLIS IN 46204 MED CLAIMS PROC 3083260 MED-CARE MANAGEMENT PO BOX 20564 WEST PALM BEACH FL 334160564 MED CLAIM REVIE 306249 SMITH GRAHAM & CO 6900 CHASE TOWER 600 TRAVIS ST HOUSTON TX 77002 INVESTMENT MGR 270685 DELTA DENTAL PO BOX 30416 LANSING MI 489097916 DENT CLAIMS PRO 253814 IFM GLOBAL INFRASTRUCTURE 99 PARK AVENUE SUITE 1920 NEW YORK NY 10016 INVESTMENT FEES 165679 5 EMPLOYER CONTRIBUTIONS 525100 72343209 72343209 PARTICIPANT CONTRIBUTIONS 525100 8707308 8707308 ADMINISTRATIVE FEES 525100 638396 638396 INTEREST ON CONTRIBUTIONS 525100 24743 24743 81713656 9609089 9609089 361498525 357887466 3611059 3611059 3611059 MISCELLANEOUS INCOME 900099 21045 21045 21045 94954849 94954849 67299870 1323049 307219 307431 179213 68443 73600 336545 50338 144818 27800 72933 21860 ANTHEM ACCESS FEES 2979333 INVESTMENT EXPENSES 742613 OTHER ADMINISTRATIVE FEES 456307 MED CARE MANAGEMENT FEES 259816 267894 74919082 0 0 0 25210500 20536877 7621548 7299405 32025 37121 1779290 1253467 598756 525823 152511690 172272759 44048871 50976295 230023390 251648280 3981978 3936161 7556681 7116447 11538659 11052608 X 218484731 240595672 218484731 240595672 230023390 251648280 20035767 1823174 252000 X false true X true false 52103 52103 1477892 1037022 440870 249295 216445 32850 525823 LIMITED PARTNERSHIPS 24711575 GROUP ANNUITY INS. CONTRACT 12618039 COLLECTIVE FUND 12300182 ACCRUED INTEREST & DIVIDENDS 734718 MEDICARE PART D REIMBURSEMENT 575042 ACCRUED INTEREST ON CONTRIBUTIONS 20289 OTHER RECEIVABLES 16450 50976295 CLAIMS INCURRED BUT NOT REPORTED 6709970 DUE TO OTHER FUNDS 319447 MEDICAL CLAIMS PAYABLE 87030 7116447 X 95397014 1823174 1823174 93573840 742613 638396 1381009 94954849 73286073 73286073 742613 890396 1633009 74919082 LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X THE FUND IS TAX EXEMPT UNDER INTERNAL REVENUE CODE PARAGRAPH 501 (C)(9). THE EXEMPTION RULING WAS OBTAINED MAY 10, 1957. THE WELFARE FUND OBTAINED ITS LATEST DETERMINATION LETTER ON JANUARY 11, 1983 IN WHICH THE INTERNAL REVENUE SERVICE STATED THAT THE PLAN, AS THEN DESIGNED, WAS IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THE PLAN HAS BEEN RESTATED AND AMENDED SINCE RECEIVING THE DETERMINATION LETTER. HOWEVER, THE PLAN'S ADMINISTRATOR, LEGAL COUNSEL, AND CONSULTANT, BELIEVE THAT THE PLAN IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THEREFORE, THEY BELIEVE THAT THE PLAN WAS QUALIFIED AND THE RELATED TRUST WAS TAX-EXEMPT AS OF THE FINANCIAL STATEMENT DATE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE FUND, AND HAS CONCLUDED THAT AS OF NOVEMBER 30, 2013 AND NOVEMBER 30, 2012, THERE ARE 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 FUND IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE FUND ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO NOVEMBER 30, 2010. REVENUE AMOUNTS INCLUDED ON RETURN - OTHER SCHEDULE D, PAGE 4, PART XI, LINE 4B ADMINISTRATIVE FEES RECEIVED 638,396 EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER SCHEDULE D, PAGE 4, PART XII, LINE 4B ADMINISTRATIVE FEES RECEIVED 638,396 CHANGE IN BENEFIT OBLIGATION 252,000 ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B FORM 990 IS REVIEWED BY THE SECRETARY-TREASURER PRIOR TO SIGNING AND FILING THE RETURN. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C THE TRUST FUND CONFORMS WITH ERISA RULES AND REGULATIONS WITH REGARD TO DISCLOSURE AND REVIEW OF POTENTIAL CONFLICTS OF INTEREST. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A COMPENSATION FOR ALL EMPLOYEES IS REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B COMPENSATION FOR ALL EMPLOYEES IS REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE FUND PROVIDES A SUMMARY ANNUAL REPORT TO ALL PARTICIPANTS CONTAINING INSTRUCTIONS FOR OBTAINING A COPY OF THE FINANCIAL STATEMENTS AND FORM 5500. RECONCILIATION OF CHANGES - OTHER FORM 990, PART XI, LINE 9 ADMINISTRATIVE FEES RECEIVED -638,396 ADMINISTRATIVE FEES RECEIVED 638,396 CHANGE IN BENEFIT OBLIGATION 252,000 ACORN LANDSCAPING LLC N/A false false ADVANCED ENERGY SOLUTIONS LLC N/A false false ALL ACCESS LLC N/A false false ATLANTIC PLANT SERVICES LLC N/A false false BADGETT CONSTRUCTORS LLC N/A false false CECO CONCRETE CONSTR LLC N/A false false CONSTRUCTION SERVICES CO LLC N/A false false COUNTRYSIDE ENTERPRISES LLC N/A false false D&K CONSTRUCTION SERVICES LLC N/A false false DALLMAN CONTRACTORS LLC N/A false false DOUBLE D CONST LLC N/A false false ELLAS CONSTRUCTION LLC N/A false false FULKERSON C A LLC N/A false false GIBSON LEWIS LLC N/A false false GIBSON LEWIS OF INDIANAPOLIS LLC N/A false false H&G UNDERGROUND UTILITIES LLC N/A false false HOME ACRES BUILDING SUPPLY N/A false false INDEPENDENT LIMESTONE CO LLC N/A false false KLENCK TIM DEMOLITION LLC N/A false false MORGAN JAY E N/A false false NEEMA LLC N/A false false PASCHEN FH NIELSEN SN & ASSOC LLC N/A false false PLIBRICO CO LLC DBA SALES & SERV N/A false false PRECISION PIPELINE LLC N/A false false RIVER CITY CONSTRUCTION LLC N/A false false ROBINS & MORTON GROUP N/A false false SHEEHAN PIPELINE CONST CO N/A false false T&T EXCAVATING & PAVING N/A false false TONN & BLANK N/A false false WABASH VALLEY ASPHALT CO LLC N/A false false WB KOESTER CONSTRUCTION LLC N/A false false WEDDLE BROS BLDG GROUP LLC N/A false false WEDDLE BROS HWY GROUP LLC N/A false false ACORN LANDSCAPING LLC N/A false false ADVANCED ENERGY SOLUTIONS LLC N/A false false ALL ACCESS LLC N/A false false ATLANTIC PLANT SERVICES LLC N/A false false BADGETT CONSTRUCTORS LLC N/A false false CECO CONCRETE CONSTR LLC N/A false false CONSTRUCTION SERVICES CO LLC N/A false false COUNTRYSIDE ENTERPRISES LLC N/A false false D&K CONSTRUCTION SERVICES LLC N/A false false DALLMAN CONTRACTORS LLC N/A false false DOUBLE D CONST LLC N/A false false ELLAS CONSTRUCTION LLC N/A false false FULKERSON C A LLC N/A false false GIBSON LEWIS LLC N/A false false GIBSON LEWIS OF INDIANAPOLIS LLC N/A false false H&G UNDERGROUND UTILITIES LLC N/A false false HOME ACRES BUILDING SUPPLY N/A false false INDEPENDENT LIMESTONE CO LLC N/A false false KLENCK TIM DEMOLITION LLC N/A false false MORGAN JAY E N/A false false NEEMA LLC N/A false false PASCHEN FH NIELSEN SN & ASSOC LLC N/A false false PLIBRICO CO LLC DBA SALES & SERV N/A false false PRECISION PIPELINE LLC N/A false false RIVER CITY CONSTRUCTION LLC N/A false false ROBINS & MORTON GROUP N/A false false SHEEHAN PIPELINE CONST CO N/A false false T&T EXCAVATING & PAVING N/A false false TONN & BLANK N/A false false WABASH VALLEY ASPHALT CO LLC N/A false false WB KOESTER CONSTRUCTION LLC N/A false false WEDDLE BROS BLDG GROUP LLC N/A false false WEDDLE BROS HWY GROUP LLC N/A false false ACORN LANDSCAPING LLC N/A false false ADVANCED ENERGY SOLUTIONS LLC N/A false false ALL ACCESS LLC N/A false false ATLANTIC PLANT SERVICES LLC 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PAVING N/A false false TONN & BLANK N/A false false WABASH VALLEY ASPHALT CO LLC N/A false false WB KOESTER CONSTRUCTION LLC N/A false false WEDDLE BROS BLDG GROUP LLC N/A false false WEDDLE BROS HWY GROUP LLC N/A false false ACORN LANDSCAPING LLC N/A false false ADVANCED ENERGY SOLUTIONS LLC N/A false false ALL ACCESS LLC N/A false false ATLANTIC PLANT SERVICES LLC N/A false false BADGETT CONSTRUCTORS LLC N/A false false CECO CONCRETE CONSTR LLC N/A false false CONSTRUCTION SERVICES CO LLC N/A false false COUNTRYSIDE ENTERPRISES LLC N/A false false D&K CONSTRUCTION SERVICES LLC N/A false false DALLMAN CONTRACTORS LLC N/A false false DOUBLE D CONST LLC N/A false false ELLAS CONSTRUCTION LLC N/A false false FULKERSON C A LLC N/A false false GIBSON LEWIS LLC N/A false false GIBSON LEWIS OF INDIANAPOLIS LLC N/A false false H&G UNDERGROUND UTILITIES LLC N/A false false HOME ACRES BUILDING SUPPLY N/A false false INDEPENDENT LIMESTONE CO LLC N/A false false KLENCK TIM DEMOLITION LLC N/A false false MORGAN JAY E N/A false false NEEMA LLC N/A false false PASCHEN FH NIELSEN SN & ASSOC LLC N/A false false PLIBRICO CO LLC DBA SALES & SERV N/A false false PRECISION PIPELINE LLC N/A false false RIVER CITY CONSTRUCTION LLC N/A false false ROBINS & MORTON GROUP N/A false false SHEEHAN PIPELINE CONST CO N/A false false T&T EXCAVATING & PAVING N/A false false TONN & BLANK N/A false false WABASH VALLEY ASPHALT CO LLC N/A false false WB KOESTER CONSTRUCTION LLC N/A false false WEDDLE BROS BLDG GROUP LLC N/A false false WEDDLE BROS HWY GROUP LLC N/A false false ACORN LANDSCAPING LLC N/A false false ADVANCED ENERGY SOLUTIONS LLC N/A false false ALL ACCESS LLC N/A false false ATLANTIC PLANT SERVICES LLC N/A false false BADGETT CONSTRUCTORS LLC N/A false false CECO CONCRETE CONSTR LLC N/A false false CONSTRUCTION SERVICES CO LLC N/A false false COUNTRYSIDE ENTERPRISES LLC N/A false false D&K CONSTRUCTION SERVICES LLC N/A false false DALLMAN CONTRACTORS LLC N/A false false DOUBLE D CONST LLC N/A false false ELLAS CONSTRUCTION LLC N/A false false FULKERSON C A LLC N/A false false GIBSON LEWIS LLC N/A false false GIBSON LEWIS OF INDIANAPOLIS LLC N/A false false H&G UNDERGROUND UTILITIES LLC N/A false false HOME ACRES BUILDING SUPPLY N/A false false INDEPENDENT LIMESTONE CO LLC N/A false false KLENCK TIM DEMOLITION LLC N/A false false MORGAN JAY E N/A false false NEEMA LLC N/A false false PASCHEN FH NIELSEN SN & ASSOC LLC N/A false false PLIBRICO CO LLC DBA SALES & SERV N/A false false PRECISION PIPELINE LLC N/A false false RIVER CITY CONSTRUCTION LLC N/A false false ROBINS & MORTON GROUP N/A false false SHEEHAN PIPELINE CONST CO N/A false false T&T EXCAVATING & PAVING N/A false false TONN & BLANK N/A false false WABASH VALLEY ASPHALT CO LLC N/A false false WB KOESTER CONSTRUCTION LLC N/A false false WEDDLE BROS BLDG GROUP LLC N/A false false WEDDLE BROS HWY GROUP LLC N/A false false ACORN LANDSCAPING LLC N/A false false ADVANCED ENERGY SOLUTIONS LLC N/A false false ALL ACCESS LLC N/A false false ATLANTIC PLANT SERVICES LLC N/A false false BADGETT CONSTRUCTORS LLC N/A false false CECO CONCRETE CONSTR LLC N/A false false CONSTRUCTION SERVICES CO LLC N/A false false COUNTRYSIDE ENTERPRISES LLC N/A false false D&K CONSTRUCTION SERVICES LLC N/A false false DALLMAN CONTRACTORS LLC N/A false false DOUBLE D CONST LLC N/A false false ELLAS CONSTRUCTION LLC N/A false false FULKERSON C A LLC N/A false false GIBSON LEWIS LLC N/A false false GIBSON LEWIS OF INDIANAPOLIS LLC N/A false false H&G UNDERGROUND UTILITIES LLC N/A false false HOME ACRES BUILDING SUPPLY N/A false false INDEPENDENT LIMESTONE CO LLC N/A false false KLENCK TIM DEMOLITION LLC N/A false false MORGAN JAY E N/A false false NEEMA LLC N/A false false PASCHEN FH NIELSEN SN & ASSOC LLC N/A false false PLIBRICO CO LLC DBA SALES & SERV N/A false false PRECISION PIPELINE LLC N/A false false RIVER CITY CONSTRUCTION LLC N/A false false ROBINS & MORTON GROUP N/A false false SHEEHAN PIPELINE CONST CO N/A false false T&T EXCAVATING & PAVING N/A false false TONN & BLANK N/A false false WABASH VALLEY ASPHALT CO LLC N/A false false WB KOESTER CONSTRUCTION LLC N/A false false WEDDLE BROS BLDG GROUP LLC N/A false false WEDDLE BROS HWY GROUP LLC N/A false false ACORN LANDSCAPING LLC N/A false false ADVANCED ENERGY SOLUTIONS LLC N/A false false ALL ACCESS LLC N/A false false ATLANTIC PLANT SERVICES LLC N/A false false BADGETT CONSTRUCTORS LLC N/A false false CECO CONCRETE CONSTR LLC N/A false false CONSTRUCTION SERVICES CO LLC N/A false false COUNTRYSIDE ENTERPRISES LLC N/A false false D&K CONSTRUCTION SERVICES LLC N/A false false DALLMAN CONTRACTORS LLC N/A false false DOUBLE D CONST LLC N/A false false ELLAS CONSTRUCTION LLC N/A false false FULKERSON C A LLC N/A false false GIBSON LEWIS LLC N/A false false GIBSON LEWIS OF INDIANAPOLIS LLC N/A false false H&G UNDERGROUND UTILITIES LLC N/A false false HOME ACRES BUILDING SUPPLY N/A false false INDEPENDENT LIMESTONE CO LLC N/A false false KLENCK TIM DEMOLITION LLC N/A false false MORGAN JAY E N/A false false NEEMA LLC N/A false false PASCHEN FH NIELSEN SN & ASSOC LLC N/A false false PLIBRICO CO LLC DBA SALES & SERV N/A false false PRECISION PIPELINE LLC N/A false false RIVER CITY CONSTRUCTION LLC N/A false false ROBINS & MORTON GROUP N/A false false SHEEHAN PIPELINE CONST CO N/A false false T&T EXCAVATING & PAVING N/A false false TONN & BLANK N/A false false WABASH VALLEY ASPHALT CO LLC N/A false false WB KOESTER CONSTRUCTION LLC N/A false false WEDDLE BROS BLDG GROUP LLC N/A false false WEDDLE BROS HWY GROUP LLC N/A false false ACORN LANDSCAPING LLC N/A false false ADVANCED ENERGY SOLUTIONS LLC N/A false false ALL ACCESS LLC N/A false false ATLANTIC PLANT SERVICES LLC N/A false false BADGETT CONSTRUCTORS LLC N/A false false CECO CONCRETE CONSTR LLC N/A false false CONSTRUCTION SERVICES CO LLC N/A false false COUNTRYSIDE ENTERPRISES LLC N/A false false D&K CONSTRUCTION SERVICES LLC N/A false false DALLMAN CONTRACTORS 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