2014-10-22T13:37:56-05:00 2013-12-31 522385296 LINDQUIST LLP 600 CITY PARKWAY WEST SUITE 300 ORANGE CA 92868 990 2013-01-01 366090694 BOILERMAKERS NATIONAL HEALTH & WELFARE FUND BOIL 9133426555 754 MINNESOTA AVENUE KANSAS CITY KS 66101 RONNIE L TRAXLER CHAIRMAN 9133426555 2014-10-22 1 RICHARD G THIERMANN P00974294 7142570100 2013 2015-11-30 17:44:51Z RONNIE L TRAXLER 754 MINNESOTA AVENUE KANSAS CITY KS 66101 980890817 0 X WWW.BNF-KC.COM X 1954 KS TO PROVIDE HEALTH AND WELFARE BENEFITS. 15 1 0 0 0 0 0 0 246710260 247424076 19930972 18616505 95534 145386 266736766 266185967 0 0 206783266 236593566 2369122 1470120 0 0 0 21956146 17049769 231108534 255113455 35628232 11072512 805024745 859040618 228367499 263239824 576657246 595800794 TO PROVIDE HEALTH AND WELFARE BENEFITS. 0 0 PROVIDED HEALTH AND WELFARE BENEFITS FOR PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 214 0 1 0 0 0 0 0 0 0 X 15 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 1 1 0 0 X TONYA PAVELAC-WALKER 9139067497 753 STATE AVENUE SUITE 106 KANSAS CITY KS 66101 RONNIE L TRAXLER CHAIRMAN 2.30 X X 0 0 0 JOHN T FULTZ SECRETARY 3.70 X X 0 0 0 KENNETH E WASILEWSKI VICE CHAIRMAN 2.10 X X 0 0 0 NELSON JORDAN TRUSTEE 0.50 X 0 0 0 MIKE DOLAN TRUSTEE 0.00 X 0 0 0 RANDY B ROBBINS TRUSTEE - PAST 0.80 X 0 0 0 VAN G STEPHENS TRUSTEE 0.80 X 0 0 0 JOHN CAMMUSO TRUSTEE 0.60 X 0 0 0 JOSEPH P REYNOLDS TRUSTEE 1.20 X 0 0 0 JAMES W BANFORD JR TRUSTEE - PAST 0.80 X 0 0 0 MARK VANDIVER TRUSTEE 0.50 X 0 0 0 J MICHAEL CARROLL TRUSTEE 1.40 X 0 0 0 CLAY HERFORD TRUSTEE 1.10 X 0 0 0 TYLER BROWN TRUSTEE 1.00 X 0 0 0 PATRICK GALLAGHER ASSISTANT SECRETARY 2.50 X X 0 0 0 JOHN CLARK TRUSTEE 0.50 X 0 0 0 MARK KEFELER TRUSTEE 0.30 X 0 0 0 SEE SCHEDULE O FOR COMPENSATION PAI BY RELATED ORGANIZATION 0.00 X 0 0 0 LORI JASPERSON H & W DIRECTOR 70.00 X 162570 0 46384 162570 0 46384 1 0 1 0 CGLIC-CHATTANOONA EASC (CIGNA) 900 COTTAGE GROVE ROAD HARTFORD CT 06152 ADMINISTRATIVE SERVICES 8104408 ZENITH AMERICAN SOLUTIONS 3501 FRONTAGE ROAD TAMPA FL 33607 MANAGEMENT SERVICES 1817998 FIRST EAGLE 1345 AVENUE OF THE AMERICAS NEW YORK NY 10105 INVESTMENT MANAGER 1012862 WILSON MCSHANE 3001 METRO DR STE 500 BLOOMINTON MN 55425 RECORD KEEPING 913200 CIGNA BEHAVIORAL HEALTH 11095 VIKING DRIVE SUITE 3505 EDEN PRAIRIE MN 55344 CLAIMS ADMINISTRATION 690238 14 EMPLOYER CONTRIBUTIONS 900099 196261735 196261735 MEMBER & RETIREE CONTRIBUTIONS 900099 49107422 49107422 PRESCRIPTION REBATE 900099 1943278 1943278 COBRA SUBSIDY 900099 77636 77636 MEDICARE PART D SUBSIDY 900099 34005 34005 247424076 13598643 13598643 719722712 714704850 5017862 5017862 5017862 DELINQ ER CONT INTEREST 900099 145386 145386 145386 266185967 247569462 0 18616505 236593566 767826 245043 395014 62237 1204375 590480 561798 3175776 10904599 203995 105197 66304 77922 35250 124073 255113455 54830 4027 62987034 88899655 15822212 16272817 70774 37080 854278 854278 0 0 432327943 444947673 293761952 308879366 805024745 859040618 5565083 901696 4429044 4387988 218373372 257950140 228367499 263239824 X 0 0 0 0 576657246 595800794 576657246 595800794 805024745 859040618 11072512 8071036 0 X X 0 1 X 1 0 854278 854278 0 0 LIMITED PARTNERSHIP/LIMITED LIABILITY COM 163644174 F 103-12 INVESTMENT ENTITY 145235192 F 308879366 BENEFIT OBLIGATIONS 168048000 CASH OVERDRAFT 864333 LIABILITY TO RETURN COLLATERAL FOR SECURITIES ON LOAN 89037807 257950140 X 271081227 8071036 8071036 263010191 3175776 3175776 266185967 236811679 0 236811679 3175776 15126000 18301776 255113455 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE THE TAX POSITIONS TAKEN BY THE PLAN AND TO RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN 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 PLAN IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL YEARS PRIOR TO 2010. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGES IN BENEFIT OBLIGATIONS 0 0 0 LORI JASPERSON H & W DIRECTOR 162570 0 0 0 0 0 45367 0 1017 0 208954 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 COPIES OF FORM 990 WERE PROVIDED TO THE GOVERNING BODY MEMBERS BY EMAIL PRIOR TO THE FORM 990 BEING FILED. NO REVIEW WAS OR WILL BE CONDUCTED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION DOES NOT REQUIRE ANNUAL DISCLOSURES FOR POTENTIAL CONFLICTS OF INTEREST. HOWEVER, THE ORGANIZATION'S TRUSTEES AND EMPLOYEES HAVE A DUTY TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST. ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE REVIEWED AND THE AFFECTED TRUSTEE OR EMPLOYEE MUST CEASE PARTICIPATION IN THE DECISION OR TRANSACTION UNTIL IT IS DETERMINED THAT THE AFFECTED TRUSTEE OR EMPLOYEE MAY CONTINUE TO PARTICIPATE IN THE DECISION OR TRANSACTION. POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE ALSO REVIEWED FOR COMPLIANCE WITH ERISA REQUIREMENTS. THE ORGANIZATION DOES REQUIRE FULL DISCLOSURE FOR POTENTIAL CONFLICTS OF INTEREST WHEN CONDUCTING SEARCHES FOR NEW VENDORS AND SERVICE PROVIDERS. FORM 990, PART VI, SECTION B, LINE 15A THE ORGANIZATION DOES NOT COMPENSATE TOP MANAGEMENT OFFICIALS. THE BOILERMAKER-BLACKSMITH NATIONAL PENSION TRUST (THE PENSION TRUST), PAYS ALL SALARIES AND OTHER COMPENSATION FOR THE EMPLOYEES OF THE PENSION TRUST, THE BOILERMAKERS NATIONAL ANNUITY TRUST (THE ANNUITY), AND THE BOILERMAKERS NATIONAL HEALTH AND WELFARE FUND (THE WELFARE FUND). THE PENSION TRUST AND THE ANNUITY TRUST ARE UNRELATED TO THE WELFARE FUND. A JOINT BOARD OF TRUSTEES HAS REVIEWED AND APPROVED AN ALLOCATION METHOD TO SHARE THE COMPENSATION-RELATED EXPENSES. THE WELFARE FUND REIMBURSES THE UNRELATED PENSION TRUST FOR ITS SHARE OF REPORTABLE SALARIES AND OTHER COMPENSATION. A JOINT COMMITTEE ON ADMINISTRATION (JCOA) COMPENSATION COMMITTEE REVIEWS ALL EMPLOYEES' CURRENT AND PAST SALARY AND RESPONSIBILITIES. BASED ON THIS INFORMATION, THE JCOA COMPENSATION COMMITTEE ADJUSTS COMPENSATION PACKAGES. THE DELIBERATIONS AND DECISIONS FOR COMPENSATION ARRANGEMENTS ARE DOCUMENTED IN THE MINUTES. THIS PROCESS WAS LAST USED IN JUNE 2013. THE ORGANIZATION DOES NOT HAVE KEY EMPLOYEES AND DOES NOT COMPENSATE ITS OFFICERS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT-OF-INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART V, LINE 2A: THE FULL BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND FOR THE SELECTION OF THEIR INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED. FORM 990, PART V, LINE 2A: THE BOILERMAKER-BLACKSMITH NATIONAL PENSION TRUST (PENSION TRUST), PAYS ALL SALARIES AND OTHER COMPENSATION FOR THE EMPLOYEES OF THE PENSION TRUST, BOILERMAKERS NATIONAL ANNUITY TRUST (ANNUITY), AND THE BOILERMAKERS NATIONAL HEALTH AND WELFARE FUND (THE WELFARE FUND). THE PENSION TRUST AND THE ANNUITY TRUST ARE UNRELATED TO THE WELFARE FUND. A JOINT BOARD ON ADMINISTRATION HAS REVIEWED AND APPROVED AN ALLOCATION METHOD TO SHARE THE COMPENSATION RELATED EXPENSES. THE WELFARE FUND REIMBURSES THE UNRELATED PENSION TRUST FOR ITS SHARE OF REPORTABLE SALARIES AND OTHER COMPENSATION. THE NUMBER OF THE ORGANIZATION'S EMPLOYEES ARE REPORTED ON THE W-3 OF THE PENSION TRUST. PART VII, SECTION A, LINE 1A: TRUSTEES ARE NOT COMPENSATED BY THE FUND. COMPENSATION PAID TO TRUSTEES EMPLOYED BY OTHER RELATED ORGANIZATIONS IS REPORTED ON THE FORM 990 FILED WITH THE INTERNAL REVENUE SERVICE BY THE RELATED TAX-EXEMPT ORGANIZATION. IF YOU WOULD LIKE ADDITIONAL INFORMATION, PLEASE CONTACT THE PLAN ADMINISTRATOR, THE BOILERMAKERS NATIONAL FUNDS. INTERNATIONAL BROTHERHOOD OF BOILERMAKERS IRON SHIP BUILDERS 753 STATE AVE NO 565 KANSAS CITY KS 66101 486031851 INTERNATIONAL LABOR ORGANIATION KS 501(C)(5) N/A N/A 0 INTERNATIONAL BROTHERHOOD OF BOILERMAKERS LOCAL LODGE 13 2300 NEW FALLS ROAD NEWPORTVILLE PA 19056 230724598 LABOR UNION PA 501(C)(5) N/A N/A 0 INTERNATIONAL BROTHERHOOD OF BOILERMAKERS LOCAL 105 PO BOX 858 PIKETON OH 45661 310220248 LABOR UNION OH 501(C)(5) N/A N/A 0 BOILERMAKERS LODGE 242 6404 NORTH PITTSBURG SPOKANE WA 99217 910268101 LABOR UNION WA 501(C)(5) N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE R, PART II SCHEDULE R, IDENTIFICATION OF RELATED ORGANIZATIONS: THE FILING ORGANIZATION IS A TAFT-HARTLEY MULTIEMPLOYER TRUST THAT PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. AS OF DECEMBER 31, 2013, THERE ARE APPROXIMATELY 534 EMPLOYERS THAT CONTRIBUTE TO THE TRUST. THE ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF THESE CONTRIBUTING EMPLOYERS, INCLUDING NAMES, ADDRESSES AND OTHER CONTACT INFORMATION. THE FEDERAL TAX CLASSIFICATION (DISREGARDED ENTITY, TAX EXEMPT ORGANIZATION, PARTNERSHIP, TAXABLE CORPORATION OR TRUST) FOR EACH CONTRIBUTING EMPLOYER IS NOT ON FILE WITH THE ADMINISTRATIVE OFFICE AND IT COULD NOT BE REASONABLY OBTAINED. AS A RESULT THE NAMES OF THE CONTRIBUTING EMPLOYERS ARE LISTED ON PART VII BELOW AND NOT ON PART IV BY FEDERAL TAX CLASSIFICATION. 1 WAY SERVICE INC A & B WELDING & CONSTR INC A P & F CONSTRUCTION A P I INC A R B INC ABATE IRWIN INC ABCO COMPOSITE SERVICES INC ACCO ENGINEERED SYSTEMS ACCURATE FABRICATORS INC ACM HEATING, INC. 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