2014-08-11T10:19:35-05:00 2013-12-31 271235638 MOUNTJOY CHILTON MEDLEY LLP 462 S FOURTH ST SUITE 2600 LOUISVILLE KY 402023445 990 2013-01-01 237017526 KENTUCKY LABORERS DISTRICT COUNCIL HEALTH & WELFARE FUND KENT 5028398166 1996 BY-PASS SOUTH LAWRENCEBURG KY 40342 JAMES BLEVINS CHAIRMAN 5028398166 2014-08-05 1 REBECCA L PHILLIPS CPA P00024055 5027491900 2013 2015-11-30 17:44:51Z JAMES BLEVINS 1996 BY-PASS SOUTH LAWRENCEBURG KY 40342 28399052 0 X N/A X 1967 KY EMPLOYEE BENEFIT PLAN PROVIDING ACCIDENT, SICKNESS, DISABILITY, VISION, DENTAL AND DEATH AND ACCIDENTAL DEATH & DISMEMBERMENT BENEFITS FOR ACTIVE PARTICIPANTS AND ACCIDENT, SICKNESS, VISION, DENTAL AND DEATH BENEFITS FOR RETIRED PARTICIPANTS. 8 8 11 8 0 0 0 0 17913153 19841284 294293 435962 25688 12439 18233134 20289685 0 0 16150250 15484955 763377 766240 0 0 0 756875 873294 17670502 17124489 562632 3165196 22287649 26507845 249617 451679 22038032 26056166 EMPLOYEE BENEFIT PLAN PROVIDING ACCIDENT, SICKNESS, DISABILITY, VISION, DENTAL AND DEATH AND ACCIDENTAL DEATH & DISMEMBERMENT BENEFITS FOR ACTIVE PARTICIPANTS AND ACCIDENT, SICKNESS, VISION, DENTAL AND DEATH BENEFITS FOR RETIRED PARTICIPANTS. 0 0 EMPLOYEE BENEFIT PLAN PROVIDING ACCIDENT, SICKNESS, DISABILITY, VISION, DENTAL AND DEATH AND ACCIDENTAL DEATH & DISMEMBERMENT BENEFITS FOR ACTIVE PARTICIPANTS AND ACCIDENT, SICKNESS, VISION, DENTAL AND DEATH BENEFITS FOR RETIRED PARTICIPANTS. 0 0 0 0 0 0 0 0 0 1 0 0 0 0 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 1 0 0 1 1270 0 1 11 1 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X THE ORGANIZATION 5028398166 1996 BY-PASS SOUTH LAWRENCEBURG KY 40342 X JAMES BLEVINS CHAIRMAN 1.00 X X 0 0 0 DOUG HACKER SECRETARY/TREASURER 1.00 X X 0 0 0 PERRY BLADES TRUSTEE 1.00 X 0 0 0 MITCHELL ONEY TRUSTEE 1.00 X 0 0 0 CHRIS NELSON TRUSTEE 1.00 X 0 0 0 MARK EICHBERGER TRUSTEE 1.00 X 0 0 0 MARK ISAACS TRUSTEE 1.00 X 0 0 0 PAUL REYNOLDS TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 CIGNA PO BOX 644546 PITTSBURGH PA 15264 PPO AND CASE MANAGEMENT 366572 BENESYS 700 TOWER DR SUITE 300 TROY MI 48098 SOFTWARE PROVIDER AND CONSULTANT 106564 2 EMPLOYER CONTRIBUTIONS 900099 18160402 18160402 EMPLOYEE CONTRIBUTIONS 900099 1680882 1680882 19841284 293495 293495 8251834 8109353 14 142481 -14 142467 142467 CONTRIBUTION RECORDS F 900099 12343 12343 MISCELLANEOUS REVENUE 900099 96 96 12439 20289685 19853627 0 436058 15484955 462574 118760 113420 71486 21637 35920 51596 49400 151202 87535 37484 513 8666 11248 9594 PREFERRED PROVIDER DISC 366572 NON PPO DISCOUNT 21819 INTERNATIONAL FOUNDATIO 11555 MAINTENANCE & SERVICE C 4807 3746 17124489 1054538 1852520 1962689 1620649 9954 10968 205169 173968 27210 31201 19233258 22992507 22287649 26507845 249617 451679 249617 451679 X 22038032 26056166 0 0 0 0 22038032 26056166 22287649 26507845 3165196 852938 0 X X 0 1 X 1 0 28610 22242 6368 176559 151726 24833 31201 X 21142541 852938 14 852952 20289589 96 96 20289685 17124407 14 14 17124393 96 96 17124489 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS INTENDED TO QUALIFY PURSUANT TO SECTION 501(C)9 OF THE INTERNAL REVENUE CODE ("IRC"), AND ,ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE TRUST HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE ("IRS"), AND THE PLAN ADMINISTRATOR AND THE PLAN'S TAX COUNSEL BELIEVE THAT THE TRUST, AS AMENDED, CONTINUES TO QUALIFY AND TO OPPERATE IN ACCORDANCE WITH APPLICABLE PROVISIONS OF THE IRC. 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 IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2010. PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON ASSET DISPOSAL 14. PART XI, LINE 4B - OTHER ADJUSTMENTS: MISCELLANEOUS INCOME 96. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON ASSET DISPOSAL 14. PART XII, LINE 4B - OTHER ADJUSTMENTS: MISCELLANEOUS INCOME 96. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY THE FUND AUDITOR. IT IS REVIEWED BY THE FUND ATTORNEY, FUND CONSULTANT AND FUND ADMINISTRATOR PRIOR TO PRESENTATION TO THE BOARD OF TRUSTEES. THE BOARD OF TRUSTEES THEN REVIEW THE FORM 990 BEFORE APPROVAL AND SIGNING. AFTER APPROVAL AND EXECUTION BY BOARD OF TRUSTEES, THE FORM 990 IS FILED. (IN THIS CASE, IT IS E-FILED BY THE FUND AUDITOR) FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE OR EMPLOYEE OF THE FUND HAS THE DUTY TO DISCLOSE ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST. EACH TRUSTEE OR EMPLOYEE MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE TRUSTEES DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, THE BOARD OF TRUSTEES WILL DISCUSS AND VOTE TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE CHAIRPERSON OF THE BOARD OF TRUSTEES SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. THE BOARD OF TRUSTEES SHALL THEN DETERMINE WHETHER THE FUND CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OF TRUSTEES SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED TRUSTEES WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE FUND'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. FORM 990, PART VI, SECTION B, LINE 15 IN DETERMINING WAGE INCREASES FOR FUND EMPLOYEES, THE TRUSTEES REVIEW THE CURRENT AND PROJECTED FINANCIAL STATUS OF THE FUND, INCLUDING CURRENT AND PROJECTED ADMINISTRATIVE COSTS, AND TAKE INTO CONSIDERATION THE WAGES FOR SIMILAR POSITIONS IN OTHER TAFT-HARTLEY TRUST FUNDS, PROJECTED COST OF LIVING TRENDS, AND EMPLOYEES' WORK HISTORIES AND JOB PERFORMANCES. THE TRUSTEES HAVE ALSO IMPLEMENTED A POLICY WHEREIN THE ADMINISTRATOR WILL PERFORM ANNUAL JOB PERFORMANCE REVIEWS FOR EACH FUND EMPLOYEE. THE FUND TRUSTEES DO NOT RECEIVE COMPENSATION OF ANY KIND. THERE IS NO CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL OF THIS FUND. FORM 990, PART VI, SECTION C, LINE 19 THEY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. THE FUND'S ADMINISTRATOR AND ASSISTANT ADMINISTRATOR CONTINUE TO OVERSEE THE AUDIT PROCESS OF ITS FINANCIAL STATEMENTS. HOWEVER, THE FULL BOARD OF TRUSTEES FOR THE FUND ASSUMES RESPONSIBILITY FOR THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE BOARD OF TRUSTEES REVIEWS AND APPROVES ALL MONTHLY FINANCIAL STATEMENTS AT THEIR QUARTERLY MEETINGS AND REVIEWS THE ANNUAL FINANCIAL REPORT AT A QUARTERLY MEETING. 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