2014-10-09T10:37:35-05:00 2012-12-31 510435869 Needles & Associates LLC 350 Interlocken Blvd STE 220 Broomfield CO 80021 990 2012-01-01 526279969 Mid-South Carpenters Regional Council He MID- 4056822323 PO Box 1449 Goodlettsville TN 37070 Mike Boner 4056822323 2014-10-06 Kurt Needles P00850236 3034304225 2014-10-08 2012 2016-03-07 17:11:31Z Amended: Financials changed after originally filed X Mike Boner PO Box 1449 Goodlettsville TN 37070 26995966 0 X N/A X 1985 TN Provide medical benefits for participants. 15 0 0 0 0 0 0 0 18072182 18798369 307667 281431 317683 41777 18697532 19121577 0 0 18739002 21313381 93035 523 0 0 0 1797796 1667672 20629833 22981576 -1932301 -3859999 13336400 10499448 10819767 11820162 2516633 -1320714 Provide health and welfare benefits to eligible participants. 0 0 20048444 Benefits paid to eligible participants and dependents. 387427 Insurance premium paid for participants and their dependents. 877510 Change in IBNR and hour bank liability. 21313381 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 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 15 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X Board of Trustees 4056822323 2001 Caldwell Drive Goodlettsville TN 37072 X Mike Boner 1.00 X 0 0 0 David Park 1.00 X 0 0 0 Larry Kerley 1.00 X 0 0 0 Victor White 1.00 X 0 0 0 Michael B Pfieffer 1.00 X 0 0 0 Clyde Tyree 1.00 X 0 0 0 Howard Graves 1.00 X 0 0 0 Larry Parks 1.00 X 0 0 0 Tim Brown 1.00 X 0 0 0 Donald Finley 1.00 X 0 0 0 Henry Hagood 1.00 X 0 0 0 Mark Brodd 1.00 X 0 0 0 0 0 0 0 0 0 0 Blue Cross Blue Shield of Tennessee 1 Cameron Hill Circle Chattanooga TN 37402 Administrative 1049056 Southern Benefit Administrators 2001 Caldwell Drive Goodlettsville TN 37072 Admin & Consulting 448120 2 Employer Contributions 525100 17987135 17987135 Reciprocity In 525100 1659610 1659610 Employee Contributions 525100 811275 811275 COBRA Subsidt Reimb. 525100 2535 2535 Reciprocity Out 525100 -1662186 -1662186 18798369 160034 160034 7995786 7874389 121397 121397 121397 Late Penalties 525100 31487 31487 Subrogation Refunds 525100 10290 10290 41777 19121577 18961543 0 160034 21313381 21313381 523 523 428120 428120 32464 32464 51662 51662 28619 28619 1076770 1076770 33400 33400 2264 2264 1687 1687 2207 2207 3716 3716 7542 7542 Other expenses-Mngmnt-9 -779 -779 22981576 21313381 1668195 0 1093600 881541 2671645 573951 2024304 1947622 20267 20267 3716 0 7543135 7096334 13336400 10499448 130327 253212 10689440 11566950 10819767 11820162 X 2516633 -1320714 2516633 -1320714 13336400 10499448 -3859999 22652 0 X 0 1 X 1 0 20267 20267 0 0 Hour Bank Liability 9301179 Claims Payable - IBNR 2265771 11566950 X 19133939 22652 22652 19111287 10290 10290 19121577 22093776 0 22093776 887800 887800 22981576 Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: The Trust established under the Fund to hold the Funds net assets is qualified pursuant to Section 501(c)(9) of the Internal Revenue Code, and accordingly, the trust's net investment income is exempt from income taxes. The Fund obtained a favorable tax determination letter dated April 5, 1988, from the Internal Revenue Service and the Fund believes that the trust, as amended, continues to qualify and to operate as designed. Management has evaluated the Funds tax positions and concluded that the Fund has maintained its tax exempt status and had taken no uncertain tax positions that required adjustments to the financial statements. Therefore, they believe that the Fund was qualified and the related trust was tax-exempt as of the financial statement date. Part XI, Line 4b - Other Adjustments: Subrogation Refunds, netted with benefits paid in the financials Part XII, Line 4b - Other Adjustments: Change in Hour Bank Liability Change in Claims Payable Subrogation Refunds, netted with benefits paid in the financials Form 990, Part VI, Section B, line 11 Form 990 was provided to the Trustees for their review prior to filing. Form 990, Part VI, Section C, line 18 The Form 990 is available for public inspection upon pubic request. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents available upon public request. Info not available for Sch R Part III & IV N/A NA TN 37214 000000000 N/A TN 0 0 Info not available for Sch R Part III & IV N/A NA TN 37072 000000000 N/A TN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0