LOCAL UNION 422 WELFARE FUND: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization: LOCAL UNION 422 WELFARE FUND (EIN 36-2307077)
Tax period: 2009-06-01 to 2010-05-31
Filed: 2011-01-07
IRS object ID: 201100129349301145
Schema version: 2009v1.3
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	2011-01-07T14:03:26-08:00	Timestamp
Tax Period End Date	2010-05-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Levinson Simon Hein & Bilkey PC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	566 West Lake Street Suite 300	AddressLine1
City	Chicago	City
State	IL	State
ZIP Code	606611414	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2009-06-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	362307077	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	LOCAL UNION 422 WELFARE FUND	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	LOCA	NameControl
Phone	8157250278	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2114 S I-80 FRONTAGE ROAD	AddressLine1
City	JOLIET	City
State	IL	State
ZIP Code	60436	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	THOMAS NIXON	Name
Title	Trustee	Title
Date Signed	2011-01-07	DateSigned

Preparer Preparer

Field	Value	IRS element (for citing)
Name	HOWARD SIMON	Name
Phone	3126550037	Phone

Field	Value	IRS element (for citing)
Tax Year	2009	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Gross Receipts	36139100	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
All Affiliates Included	false	AllAffiliatesIncluded
Organization501c	X	Organization501c
Web Site	N/A	WebSite
Type Of Organization Trust	X	TypeOfOrganizationTrust
Year Formation	1949	YearFormation
State Legal Domicile	IL	StateLegalDomicile
Activity Or Mission Description	TO PROVIDE HEALTH AND DEATH BENEFITS	ActivityOrMissionDescription
Nbr Voting Members Governing Body	6	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	6	NbrIndependentVotingMembers
Total Nbr Employees	11	TotalNbrEmployees
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	11535424	ProgramServiceRevenuePriorYear
Program Service Revenue CY	9443797	ProgramServiceRevenueCY
Investment Income Prior Year	684674	InvestmentIncomePriorYear
Investment Income Current Year	720585	InvestmentIncomeCurrentYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	12220098	TotalRevenuePriorYear
Total Revenue Current Year	10164382	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	10475818	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	10965771	BenefitsPaidToMembersCY
Salaries Etc Prior Year	1500	SalariesEtcPriorYear
Salaries Etc Current Year	2703	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	583529	OtherExpensePriorYear
Other Expenses Current Year	630809	OtherExpensesCurrentYear
Total Expenses Prior Year	11060847	TotalExpensesPriorYear
Total Expenses Current Year	11599283	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	1159251	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-1434901	RevenuesLessExpensesCY
Total Assets BOY	13853565	TotalAssetsBOY
Total Assets EOY	12985967	TotalAssetsEOY
Total Liabilities BOY	1470946	TotalLiabilitiesBOY
Total Liabilities EOY	1145043	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	12382619	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	11840924	NetAssetsOrFundBalancesEOY
Mission Description	TO PROVIDE HEALTH AND DEATH BENEFITS	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Description	THE PLAN PROVIDES HEALTH CARE BENEFITS (HOSPITAL, SURGICAL, MAJOR MEDICAL, DENTAL, VISION, DISABILITY AND LIFE INSURANCE) TO COVERED EMPLOYEES WHO WORK THE QUALIFYING PERIOD PER PLAN REQUIREMENTS TO ALL ELIGIBLE MEMBERS AT YEAR END.	Description
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
Balance Sheet Amounts Reported	true	BalanceSheetAmountsReported
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
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	408	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	11	NumberOfEmployees
Employment Tax Returns Filed	true	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
Nbr Voting Governing Body Members	6	NbrVotingGoverningBodyMembers
Number Independent Voting Members	6	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	true	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	false	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Policies Reference Chapters	false	PoliciesReferenceChapters
Form990 Provided To Governing Body	false	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	false	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	TOM NIXON	NamePerson
Telephone Number	8157250278	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	2114 S I-80 FRONTAGE RD JOLIET IL	AddressLine1
City	JOLIET	City
State	IL	State
ZIP Code	60436	ZIPCode

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

Form990 Part VII Section A Form990PartVIISectionA (6 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
THOMAS NIXON
Trustee	3.00	X	0	0	0
RICK CRONHOLM
Secretary	3.00	X	0	0	0
MICHAEL BROWN
Trustee	3.00	X	0	0	0
JOSEPH STRONG
Trustee	3.00	X	0	0	0
BART SINGLETARY
Trustee	3.00	X	0	0	0
BW SELF
Trustee	3.00	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 (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
THE SEGAL COMPANY
101 NORTH WACKER DRIVE SUITE 500	CHICAGO	IL	60606	ACTUARIAL CONSULTING	100318
OBA MIDWEST
333 PIERCE ROAD STE 410	ITASCA	IL	60143	THIRD-PARTY ADMIN.	175556
BLUE CROSS BLUE SHIELD
300 EAST RANDOLPH STREET	CHICAGO	IL	60601	CLAIMS PAYOR	384523

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	3	NumberOfContractorsGT100K
Total Contributions	0	TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE SUBSIDY PART D	900099	133397	133397
EMPLOYERS' CONTRIBUTION	900099	8768041	8768041
EMPLOYEES' CONTRIBUTION	900099	542359	542359

Field	Value	IRS element (for citing)
Total Program Service Revenue	9443797	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	486664	TotalRevenueColumn
Exclusion	$486,664	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	26208639	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	25974718	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	233921	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	233921	TotalRevenueColumn
Exclusion	$233,921	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

Field	Value	IRS element (for citing)
Total Other Revenue	0	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	10164382	TotalRevenueColumn
Related Or Exempt Function Income	9443797	RelatedOrExemptFunctionIncome
Exclusion	$720,585	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	10965771	Total

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	2703	Total

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	215344	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	144068	Total

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	28590	Total

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	46475	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	54749	Total

Advertising Advertising

Field	Value	IRS element (for citing)
Total	0	Total

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	60036	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	13398	Total

Travel Travel

Field	Value	IRS element (for citing)
Total	15108	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	0	Total

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	1135	Total

Insurance Insurance

Field	Value	IRS element (for citing)
Total	5012	Total

Other Expenses OtherExpenses

Field	Value	IRS element (for citing)
Description	REIMBURSED EXPENSES - UNION	Description
Total	46894	Total

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	0	Total

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	11599283	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	50170	BOY
EOY	1221161	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	307730	BOY
EOY	1037263	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	1257881	BOY
EOY	1494744	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	6136	BOY
EOY	33396	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	43355	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	42015	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	2475	BOY
EOY	1340	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	10586616	BOY
EOY	7637801	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	1565833	BOY
EOY	1485754	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	76724	BOY
EOY	74508	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	13853565	BOY
EOY	12985967	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	54746	BOY
EOY	66443	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	1416200	BOY
EOY	1078600	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	1470946	BOY
EOY	1145043	EOY

Field	Value	IRS element (for citing)
Do Not Follow SFAS117	X	DoNotFollowSFAS117

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

Field	Value	IRS element (for citing)
BOY	12382619	BOY
EOY	11840924	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	12382619	BOY
EOY	11840924	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	13853565	BOY
EOY	12985967	EOY

Field	Value	IRS element (for citing)
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

Equipment Equipment

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	43355	InvestmentCostOrOtherBasis
Depreciation	42015	Depreciation
Book Value	1340	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	1340	TotalOfBookValueLandBuildings
Total Of Book Value Securities	1485754	TotalOfBookValueSecurities

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	CLAIMS PAYABLE & IBNR	Description
Amount	$1,078,600	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	1078600	TotalOfAmounts
Total Revenue	10164382	TotalRevenue
Total Expenses	11599283	TotalExpenses
Excess Or Deficit For Year	-1434901	ExcessOrDeficitForYear
Net Unrealized GL On Investments	893206	NetUnrealizedGLOnInvestments
Other	-$337,600	OtherAmount
Total Adjustments	555606	TotalAdjustments
Excess Or Deficit Per FS	-879295	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	10877716	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	893206	NetUnrealizedGainsInvestments
Revenue Not Rptd F990	893206	RevenueNotRptdF990
Revenue Subtotal	9984510	RevenueSubtotal
Other Revenues Not Included	179872	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	179872	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	10164382	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	11757011	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	11757011	ExpensesSubtotal
Other Expenses Not Included	-157728	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	-157728	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	11599283	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Part XII, Line 4b	Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S	INVESTMENT MANAGEMENT FEES $46475 MEDICARE PART D SUBSIDY $133397
Part XI, Line 8	Part XI, Line 8: Other Changes in Net Assets or Fund Balances	CHANGE IN BENEFIT OBLIGATIONS $ -337600

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Form 990, Part VI, Line 19	Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	A SUMMARY ANNUAL REPORT IS DISTRIBUTED TO ALL PARTICIPANTS. PARTICIPANTS ARE ABLE TO REQUEST THE AUDITOR'S REPORT AND OTHER FINANCIAL INFORMATION FROM THE PLAN ADMINISTRATOR AND/OR THE U.S. DEPARTMENT OF LABOR. ALSO, FORM 5500 IS OPEN TO THE PUBLIC INSPECTION THROUGH THE U.S. DEPARTMENT OF LABOR.
Form 990, Part VI, Line 12c	Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	THE TRUSTEES ARE GOVERNED BY THE TRUST DOCUMENT AND HAVE A FIDUCIARY RESPONSIBILITY UNDER ERISA TO ADMINSTER THE PLAN IN THE BEST INTEREST OF THE MEMBERSHIP. THE U.S. DEPARTMENT OF LABOR REQUIRES ALL LABOR TRUSTEES TO REPORT ON FORM LM-30 POTENTIAL SITUATIONS WHERE THERE MAY BE CONFLICTS OF INTEREST. THIS INFORMATION IS OPEN TO THE PUBLIC.
Form 990, Part VI, Line 11	Form 990, Part VI, Line 11: Form 990 Review Process	THE TRUSTEES AUTHORIZE THE FUND'S THIRD-PARTY ADMINISTRATOR AND A DESIGNATED TRUSTEE TO REVIEW THE FORM 990 BEFORE IT IS FILED.
Form 990, Part VI, Line 3	Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company	OBA MIDWEST OF ITASCA IS THE THIRD PARTY ADMINISTRATOR HIRED TO ADMINISTER THE FUND'S DAY-TO-DAY OPERATIONS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	PLUMBERS & PIPEFITTERS LOCAL 422 PENSION	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	2114 I-80 S FRONTAGE ROAD	AddressLine1
City	JOLIET	City
State	IL	State
ZIP Code	60436	ZIPCode

Field	Value	IRS element (for citing)
EIN	362942793	EIN
Primary Activities	PENSION FUND	PrimaryActivities
Legal Domicile State	IL	LegalDomicileState
Exempt Code Section	401 (A)	ExemptCodeSection

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1

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