UNION CONSTRUCTION WORKERS HEALTH PLAN: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: UNION CONSTRUCTION WORKERS HEALTH PLAN (EIN 34-4442536)
Tax period: 2011-06-01 to 2012-05-31
Filed: 2013-04-12
IRS object ID: 201301029349300600
Schema version: 2011v1.5
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule D
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-04-12T05:42:14-07:00	Timestamp
Tax Period End Date	2012-05-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LublinSussman Group LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	3166 N Republic Blvd	AddressLine1
City	Toledo	City
State	OH	State
ZIP Code	436151507	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-06-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	344442536	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Union Construction Workers Health Plan	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	UNIO	NameControl
Phone	4192482401	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1600 Madison Avenue Suite 300	AddressLine1
City	Toledo	City
State	OH	State
ZIP Code	43624	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Brian Outland	Name
Title	Secretary	Title
Date Signed	2013-04-11	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Lee D Wunschel	Name
Phone	4198412848	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Gross Receipts	50076688	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
All Affiliates Included	false	AllAffiliatesIncluded
Organization501c	X	Organization501c
Web Site	N/A	WebSite
Activity Or Mission Description	The fund provides health benefits for eligible members of the construction trade unions covered by the fund.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	10	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	0	TotalNbrEmployees
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	19436274	ProgramServiceRevenuePriorYear
Program Service Revenue CY	22070522	ProgramServiceRevenueCY
Investment Income Prior Year	1047523	InvestmentIncomePriorYear
Investment Income Current Year	1428528	InvestmentIncomeCurrentYear
Other Revenue Prior Year	759259	OtherRevenuePriorYear
Other Revenue Current Year	4787	OtherRevenueCurrentYear
Total Revenue Prior Year	21243056	TotalRevenuePriorYear
Total Revenue Current Year	23503837	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	19495181	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	16254024	BenefitsPaidToMembersCY
Salaries Etc Current Year	0	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	1828934	OtherExpensePriorYear
Other Expenses Current Year	1556337	OtherExpensesCurrentYear
Total Expenses Prior Year	21324115	TotalExpensesPriorYear
Total Expenses Current Year	17810361	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-81059	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	5693476	RevenuesLessExpensesCY
Total Assets BOY	39176553	TotalAssetsBOY
Total Assets EOY	46153083	TotalAssetsEOY
Total Liabilities BOY	11383029	TotalLiabilitiesBOY
Total Liabilities EOY	12479324	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	27793524	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	33673759	NetAssetsOrFundBalancesEOY
Mission Description	The fund provides health benefits for eligible members of the construction trade unions covered by the fund.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	17810361	Expense
Description	The fund provides health benefits for eligible members of the construction trade unions covered by the fund.	Description
Total Program Service Expense	17810361	TotalProgramServiceExpense
Described In501 C3	false	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	false	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	803	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	0	NumberOfEmployees
Employment Tax Returns Filed	false	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Form990-T Filed	false	Form990-TFiled
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Form8886 T Filed	false	Form8886TFiled
Non Deductible Contributions	false	NonDeductibleContributions
Non Deductible Disclosure	false	NonDeductibleDisclosure
Excess Business Holdings	false	ExcessBusinessHoldings
Taxable Distributions	false	TaxableDistributions
Distribution To Donor	false	DistributionToDonor
Filed Lieu1041	false	FiledLieu1041
Licensed More Than One State	false	LicensedMoreThanOneState
Indoor Tanning Services	false	IndoorTanningServices
Form720 Filed	false	Form720Filed
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	10	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Policies Reference Chapters	false	PoliciesReferenceChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	false	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Written Policy Or Procedure	false	WrittenPolicyOrProcedure
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	Nicholas C Madden	NamePerson
Telephone Number	4192482401	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1600 Madison Ave	AddressLine1
City	Toledo	City
State	OH	State
ZIP Code	43624	ZIPCode

Field	Value	IRS element (for citing)
No Listed Persons Compensated	X	NoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (10 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
John Russell
Trustee	0.00	X	0	0	0
Donald Huss
Trustee	0.00	X	0	0	0
Michael Kujowa
Trustee	0.00	X	0	0	0
Brian Outland
Secretary	0.00	X	0	0	0
Joseph Blaze III
Trustee	0.00	X	0	0	0
Ken Gabel
Trustee	0.00	X	0	0	0
Brian Seeger
Trustee	0.00	X	0	0	0
Kevin Smith
Trustee	0.00	X	0	0	0
Greg Myers
Chairman	0.00	X	0	0	0
James Nicholson
Trustee	0.00	X	0	0	0

Field	Value	IRS element (for citing)
Number Individuals GT100 K	0	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
Univ of Southern California
University Gardens 203	Los Angeles	CA	90089	Health Care Provider	198679
The Toledo Hospital
P O Box 630253	Cincinnati	OH	45263	Health Care Provider	326616
Northwestern Ohio Administrators
1600 Madison Ave Suite 300	Toledo	OH	43624	Administrative Mgr	1205043
Mercy St Vincent
P O Box 636447	Cincinnati	OH	45263	Health Care Provider	190230
Aetna
151 Farmington Avenue	Hartford	CT	06156	Health Care Provider	278109

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	9	NumberOfContractorsGT100K
Total Contributions	0	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	Contributions	Description
Total Revenue Column	22070522	TotalRevenueColumn
Related Or Exempt Function Income	22070522	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	22070522	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	1417881	TotalRevenueColumn
Exclusion	$1,417,881	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	26583498	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	26572851	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	10647	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	10647	TotalRevenueColumn
Exclusion	$10,647	ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	Liquidated Damages	Description
Total Revenue Column	4787	TotalRevenueColumn
Related Or Exempt Function Income	4787	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	4787	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	23503837	TotalRevenueColumn
Related Or Exempt Function Income	22075309	RelatedOrExemptFunctionIncome
Exclusion	$1,428,528	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	0	Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	16254024	Total
Program Services	16254024	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	0	Total

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	0	Total

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	0	Total

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	0	Total

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	123798	Total
Program Services	123798	ProgramServices

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	34818	Total
Program Services	34818	ProgramServices

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	3750	Total
Program Services	3750	ProgramServices

Advertising Advertising

Field	Value	IRS element (for citing)
Total	0	Total

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	0	Total

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	0	Total

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	0	Total

Travel Travel

Field	Value	IRS element (for citing)
Total	0	Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	3165	Total
Program Services	3165	ProgramServices

Interest Interest

Field	Value	IRS element (for citing)
Total	0	Total

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	0	Total

Insurance Insurance

Field	Value	IRS element (for citing)
Total	8199	Total
Program Services	8199	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
Printing and Publications	27211	27211
Consulting	70908	70908
Custodian Trust Fees	95072	95072
Administative Expenses	1183030	1183030

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	6386	Total
Program Services	6386	ProgramServices

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	17810361	Total
Program Services	17810361	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	2109525	BOY
EOY	1434793	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	2030892	BOY
EOY	2330556	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	3531842	BOY
EOY	3556782	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
EOY	0	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
EOY	0	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	12488	BOY
EOY	0	EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
EOY	0	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	31203026	BOY
EOY	38539867	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	288780	BOY
EOY	291085	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	39176553	BOY
EOY	46153083	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	422713	BOY
EOY	466543	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	10960316	BOY
EOY	12012781	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	11383029	BOY
EOY	12479324	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	27793524	BOY
EOY	33673759	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	27793524	BOY
EOY	33673759	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	39176553	BOY
EOY	46153083	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	5693476	ReconcilationRevenueExpenses
Reconcilation Other Changes	186759	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
Federal Grant Audit Required	false	FederalGrantAuditRequired
Federal Grant Audit Performed	false	FederalGrantAuditPerformed

Schedule D IRS990ScheduleD

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
Reserve for Extended Eligibility	$8,847,488
Incurred But Not Reported Claims	$3,165,293

Field	Value	IRS element (for citing)
Total Of Amounts	12012781	TotalOfAmounts
Total Revenue	23503837	TotalRevenue
Total Expenses	17810361	TotalExpenses
Excess Or Deficit For Year	5693476	ExcessOrDeficitForYear
Net Unrealized GL On Investments	186759	NetUnrealizedGLOnInvestments
Other	$1,052,465	OtherAmount
Total Adjustments	1239224	TotalAdjustments
Excess Or Deficit Per FS	6932700	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	23595524	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	186759	NetUnrealizedGainsInvestments
Revenue Not Rptd F990	186759	RevenueNotRptdF990
Revenue Subtotal	23408765	RevenueSubtotal
Investment Expenses Not Included	95072	InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt	95072	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	23503837	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	16662824	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	16662824	ExpensesSubtotal
Investment Expenses Not Included2	95072	InvestmentExpensesNotIncluded2
Other Expenses Not Included	1052465	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	1147537	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	17810361	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Part X	Part X : FIN48 Footnote	The Plan has determined that there are no uncertain tax positions that require disclosure in these financial statements under the FASB Accounting Standards Codification topic, Income Taxes. The tax years 2008 through 2011 are subject to possible examination by the Internal Revenue Service.
Part XIII, Line 4b	Part XIII, Line 4b: Other revenue amounts included on 990 but not included in F/S	Change in Estimated Future Benefits $29447 Change-Estimated Unpaid Claims Incurred $1023018

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Form 990, Part VI, Line 19	Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	All governing documents, policies and financial statements are available upon request to Northwestern Ohio Administrators, Inc., the plan administrator.
Form 990, Part VI, Line 12c	Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	The plan administrator and attorney follow up with each trustee to ensure that each completes the annual conflict of interest disclosure.
Form 990, Part VI, Line 11	Form 990, Part VI, Line 11: Form 990 Review Process	Each trustee is provided with a copy of the Form 990 either at a board meeting or via mail or email for their review and approval prior to the filing of the form.

Schedule R IRS990ScheduleR

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	See attached list	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1600 Madison Avenue Ste 300	AddressLine1
City	Toledo	City
State	OH	State
ZIP Code	43604	ZIPCode

Field	Value	IRS element (for citing)
EIN	341337680	EIN
Legal Domicile State	OH	LegalDomicileState
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Type Of Entity	C corp	TypeOfEntity

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	false	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	false	SharingOfPaidEmployees
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg