2011-10-28T08:20:13-05:00 2010-12-31 HARTOG KALLENBERGER & SWARTHOUT PLLC 1560 EAST 21ST STREET SUITE 300 TULSA OK 74114 990 2010-01-01 730776131 PIPE FITTERS LOCAL UNION 430 HEALTH AND WELFARE FUND PIPE 9188360430 2908 NORTH HARVARD TULSA OK 74115 BRAD FORD 9188360430 2011-10-26 1 LEE R SWARTHOUT 9187432581 2010 2016-03-07 17:11:31Z BRAD FORD 2908 NORTH HARVARD AVENUE TULSA OK 74115 9594640 0 X N/A X 1968 OK HEALTH AND WELFARE INSURANCE PLAN FOR PLUMBERS AND PIPEFITTERS LOCAL UNION 430. 8 8 0 0 0 0 0 0 6747150 5202953 455796 475658 0 0 7202946 5678611 0 0 6564262 5425243 0 0 0 0 0 800440 789206 7364702 6214449 -161756 -535838 15387844 15014778 1351359 1169594 14036485 13845184 TO PROVIDE HEALTH AND WELFARE BENEFITS FOR PLUMBERS AND PIPEFITTERS LOCAL UNION 430. 0 0 5373445 5202953 ADMINISTRATION OF EMPLOYERS' CONTRIBUTIONS PURSUANT TO A COLLECTIVELY BARGAINED PLAN; AND ADMINISTRATION OF BENEFIT PAYMENTS FOR CLAIMS OF THE SELF INSURED HEALTH & WELFARE FUND 5373445 0 0 0 0 0 0 0 0 1 1 1 0 1 0 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 0 1 0 0 0 0 0 0 0 0 0 X 8 8 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 OK X ADMINISTRATOR 9188360430 2908 N HARVARD TULSA OK 74115 RICHARD SHOEMAKER JR 2.50 X X 0 0 0 J BRAD FORD 2.50 X X 0 90912 0 SAMUEL STAMPER 2.50 X X 0 0 0 SCOTT SODER 2.50 X X 0 0 0 L MIKE DAVIDSON 2.50 X 0 80336 0 GEORGE ADAMS 2.50 X 0 0 0 TOM OWENS 2.50 X 0 0 0 R CHUCK JONES 2.50 X 0 77395 0 LYNN CLAXTON 2.50 X 0 0 0 MICHAEL SKINNER 2.50 X 0 0 0 0 248643 0 0 0 0 0 BLUE CROSS BLUE SHIELD 1001 E LOOKOUT DRIVE RICHARDSON TX 75082 IN-NETWORK CLAIMS PROCESSING 224970 ERISA ADMINISTRATORS LLC P O BOX 860007 PLANO TX 750860007 THIRD-PARTY ADMINISTRATOR 220885 2 EMPLOYER CONTRIBUTIONS 900001 4903414 4903414 EMPLOYEE CONTRIBUTIONS 900001 299539 299539 5202953 393017 393017 3998670 3916029 82641 82641 82641 5678611 5202953 0 475658 5425243 25644 48098 39393 22740 7719 6151 214 2860 12845 ACCESS & ADMINISTRATION 569985 ACTUARY 47910 BANK CHARGES 3387 STORAGE EXPENSE 1109 DUES 935 216 6214449 58685 101284 3164844 3208805 825898 643914 11935 1446 55733 55622 2970 111 9231178 8934310 2092334 2124908 15387844 15014778 1347576 1168435 3783 1159 1351359 1169594 X 0 0 0 0 14036485 13845184 14036485 13845184 15387844 15014778 X -535838 344537 X X 0 1 0 X 0 55733 55622 111 0 111 FEDERAL NAT'L MORTG ASSOCIATION 929972 F FEDERAL HOME LOAN MORTG CORP 1194936 F 2124908 CAPITALIZED LEASE OBLIGATION 1159 1159 5678611 6214449 -535838 344537 -274000 70537 -465301 6023148 344537 344537 5678611 0 5678611 6488449 0 6488449 -274000 -274000 6214449 PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN CLAIMS INCURRED BUT NOT REPORTED -274,000. THE -$274,000 ADJUSTMENT IN PART XI LINE 8 AND PART XIII LINE 4B IS THE DECREASE IN CLAIMS THAT WERE INCURRED BUT NOT REPORTED. FORM 990, PART VI, SECTION A, LINE 3 THE ENTITY CONTRACTS WITH A THIRD-PARTY ADMINISTRATOR TO ADJUDICATE AND PAY ALL HEALTHCARE CLAIMS. FORM 990, PART VI, SECTION A, LINE 6 THIS ENTITY IS A COLLECTIVELY BARGAINED HEALTH AND WELFARE FUND ORGANIZED FOR THE BENEFIT OF THE PLUMBERS AND PIPEFITTERS LOCAL UNION 430 MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OF THE PLUMBERS AND PIPE FITTERS LOCAL UNION 430 ELECT HALF OF THE TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED BY THE BOARD OF TRUSTEES AT THEIR MEETINGS. FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE, PRINCIPAL OFFICER, AND MEMBERS OF COMMITTEES ARE REQUIRED TO ANNUALLY SIGN A DISCLOSURE STATEMENT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE FOR THE PUBLIC TO VIEW UPON REQUEST. DESCRIBE ANY CHANGES TO AUDIT COMMITTEE OVERSIGHT AND SELECTION PROCESS: 990, PART XI, LINE 2C: THERE HAVE BEEN NO SIGNIFICANT CHANGES TO THE AUDIT OVERSIGHT COMMITTEE'S OVERSIGHT OR SELECTION PROCESSES. PLUMBERS AND PIPE FITTERS LOCAL UNION 430 2908 NORTH HARVARD TULSA OK 74115 731530462 LABOR UNION OK 501(C)5 0 OKLAHOMA STATE PIPE TRADES ANNUITY FUND 2908 NORTH HARVARD TULSA OK 74115 731153085 TO PROVIDE RETIREMENT BENEFITS FOR UNION MEMEBERS OK 501(A) 0 TULSA PIPE TRADES TRAINING SCHOOL 2908 NORTH HARVARD TULSA OK 74115 730705632 TO PROVIDE PIPE TRADES TRAINING FOR APPRENTICES OK 501(C)3 170(B)(1)(A)(II) 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0