CONSTRUCTION INDUSTRY WELFARE FUND: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization: CONSTRUCTION INDUSTRY WELFARE FUND (EIN 36-2265130)
Tax period: 2009-11-01 to 2010-10-31
Filed: 2011-06-06
IRS object ID: 201121579349300457
Schema version: 2009v1.7
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

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-06-06T08:19:41-07:00	Timestamp
Tax Period End Date	2010-10-31	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	2009-11-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	362265130	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CONSTRUCTION INDUSTRY WELFARE FUND OF	BusinessNameLine1
Business Name Line2	ROCKFORD ILLINOIS	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	CONS	NameControl
Phone	8153974267	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1322 EAST STATE STREET	AddressLine1
City	ROCKFORD	City
State	IL	State
ZIP Code	61104	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	SAMUEL J GIARDONO	Name
Title	Trustee	Title
Date Signed	2011-06-06	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)
Address Change	X	AddressChange
Gross Receipts	21822991	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	1954	YearFormation
State Legal Domicile	IL	StateLegalDomicile
Activity Or Mission Description	To provide health, dental, vision and life insurance benefit to eligible members and their dependents.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	8	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	7	NbrIndependentVotingMembers
Total Nbr Employees	37	TotalNbrEmployees
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	14012520	ProgramServiceRevenuePriorYear
Program Service Revenue CY	13938596	ProgramServiceRevenueCY
Investment Income Prior Year	817254	InvestmentIncomePriorYear
Investment Income Current Year	738608	InvestmentIncomeCurrentYear
Other Revenue Prior Year	262544	OtherRevenuePriorYear
Other Revenue Current Year	358777	OtherRevenueCurrentYear
Total Revenue Prior Year	15092318	TotalRevenuePriorYear
Total Revenue Current Year	15035981	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	12979959	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	16995906	BenefitsPaidToMembersCY
Salaries Etc Prior Year	22735	SalariesEtcPriorYear
Salaries Etc Current Year	26419	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	2119950	OtherExpensePriorYear
Other Expenses Current Year	1484496	OtherExpensesCurrentYear
Total Expenses Prior Year	15122644	TotalExpensesPriorYear
Total Expenses Current Year	18506821	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-30326	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-3470840	RevenuesLessExpensesCY
Total Assets BOY	20320639	TotalAssetsBOY
Total Assets EOY	18409137	TotalAssetsEOY
Total Liabilities BOY	10605014	TotalLiabilitiesBOY
Total Liabilities EOY	12338043	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	9715625	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	6071094	NetAssetsOrFundBalancesEOY
Mission Description	To provide health, dental, vision and life insurance benefit to eligible members and their dependents.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Description	TO PROVIDE MEDICAL, DENTAL, VISION AND PRESCRIPTION DRUG BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR BENEFICIARIES.	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	false	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	5	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	37	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	8	NbrVotingGoverningBodyMembers
Number Independent Voting Members	7	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	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	SHELLI MCPEEK	NamePerson
Telephone Number	8153974267	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1322 EAST STATE STREET	AddressLine1
City	ROCKFORD	City
State	IL	State
ZIP Code	61104	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (8 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
TODD STEFFEN
Trustee	3.00	X	0	0	0
SAMUEL J GIARDONO
Trustee	3.00	X	7210	0	0
LYNN ULRICH
Trustee	3.00	X	0	0	0
GLEN TURPOFF
Trustee	3.00	X	0	0	0
DAVE FLUERY
Trustee	3.00	X	0	0	0
DAN JANSEN
Trustee	3.00	X	0	0	0
CARL SCANDROLI
Trustee	3.00	X	0	0	0
ART STURMS
Trustee	3.00	X	0	0	0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	7210	TotalReportableCompFromOrg
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 (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
MARC PEKAY
30 NORTH LASALLE SUITE 2426	CHICAGO	IL	60602	ATTORNEY	210413
GROUP ADMINISRATORS LTD
1322 EAST STATE STREET SUITE 300	ROCKFORD	IL	61104	ADMINISTRATOR	209591
BLUE CROSS BLUE SHIELD
300 E RANDOLPH ST	CHICAGO	IL	60601	INSURANCE ADMIN	447575
BENEFIT PLANNING SERVICES
929 SOUTH ALPINE ROAD SUITE 408	ROCKFORD	IL	61108	ADMINISTRATOR	781306

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	4	NumberOfContractorsGT100K
Total Contributions	0	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS	900099	12924496	12924496
EMPLOYEE CONTRIBUTIONS	900099	1014100	1014100

Field	Value	IRS element (for citing)
Total Program Service Revenue	13938596	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	739335	TotalRevenueColumn
Exclusion	$739,335	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	6786283	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	6787010	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	-727	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-727	TotalRevenueColumn
Exclusion	-$727	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 (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PROCESSING FEE INCOME	900099	19106	19106
COLLECTION FEE INCOME	900099	22000	22000
COBRA SUBSIDY	900099	312063	312063

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	5608	TotalRevenueColumn
Related Or Exempt Function Income	5608	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	358777	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	15035981	TotalRevenueColumn
Related Or Exempt Function Income	14297373	RelatedOrExemptFunctionIncome
Exclusion	$738,608	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	16995906	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	9857	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	16562	Total

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	578661	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	183416	Total

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	96179	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	0	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	569333	Total

Advertising Advertising

Field	Value	IRS element (for citing)
Total	0	Total

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	29619	Total

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	5522	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	9052	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	234	Total

Insurance Insurance

Field	Value	IRS element (for citing)
Total	12480	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	18506821	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	734117	BOY
EOY	1889435	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	7523450	BOY
EOY	6299371	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	1544706	BOY
EOY	1522319	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	18305	BOY
EOY	19170	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	92840	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	91456	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	1618	BOY
EOY	1384	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	10294617	BOY
EOY	8459767	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	203826	BOY
EOY	217691	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	20320639	BOY
EOY	18409137	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	492032	BOY
EOY	304518	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	10112982	BOY
EOY	12033525	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	10605014	BOY
EOY	12338043	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	9715625	BOY
EOY	6071094	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	9715625	BOY
EOY	6071094	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	20320639	BOY
EOY	18409137	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)
Other Cost Or Other Basis	92840	OtherCostOrOtherBasis
Depreciation	91456	Depreciation
Book Value	1384	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	1384	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescription	AmountAmount
PARTICIPANTS' ACC. ELIGIBILITY CREDITS	$9,423,000
LESS: STOP LOSS RECEIVABLE	-$159,083
CLAIMS INCURRED BUT NOT REPORTED	$1,657,000
CLAIMS & PREMIUMS PAYABLE (NET)	$266,650
ACCRUED PAYROLL TAXES & WITHHOLDING	$5,958
ACC. BALANCE IN PART. HEALTH REIMB ACCTS	$840,000

Field	Value	IRS element (for citing)
Total Of Amounts	12033525	TotalOfAmounts
Total Revenue	15035981	TotalRevenue
Total Expenses	18506821	TotalExpenses
Excess Or Deficit For Year	-3470840	ExcessOrDeficitForYear
Net Unrealized GL On Investments	-173691	NetUnrealizedGLOnInvestments
Total Adjustments	-173691	TotalAdjustments
Excess Or Deficit Per FS	-3644531	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	14862290	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	-173691	NetUnrealizedGainsInvestments
Revenue Not Rptd F990	-173691	RevenueNotRptdF990
Revenue Subtotal	15035981	RevenueSubtotal
Total Revenue Per Form990	15035981	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	18506821	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	18506821	ExpensesSubtotal
Total Expenses Per Form990	18506821	TotalExpensesPerForm990

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 ACCOUNTANT'S REPORT AND OTHER FINANCIAL INFORMATION FROM THE PLAN ADMINISTRATOR AND/OR THE US DEPARTMENT OF LABOR. ALSO, FORM 5500 IS OPEN TO PUBLIC INSPECTION THROUGH THE US 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 A WRITTEN CONFLICT OF INTEREST POLICY AND THE TRUST DOCUMENT AND HAVE A FIDUCIARY RESPONSIBILTY UNDER ERISA TO ADMINISTER THE PLAN IN THE BEST INTEREST OF THE MEMBERSHIP.FOR THE YEAR ENDED OCTOBER 31, 2010, THE TRUSTEES HAVE SIGNED OFF ON ANY CONFLICTS OF INTEREST OR HAVE INDICATED THAT THEY WERE NOT INVOLVED IN ANY CONFLICTS OF INTEREST DURING THE FISCAL YEAR.THE US 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 BOARD AUTHORIZES THE CHAIRMAN SECRETARY ALONG WITH LEGAL COUNSEL AND THIRD PARTY ADMINISTRATOR TO REVIEW THE FILING
Form 990, Part VI, Line 3	Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company	BENEFIT PLANNING SERVICES, INC. IS THE THIRD PARTY ADMINISTRATOR HIRED TO ADMINISTER THE FUND'S DAY-TO-DAY OPERATIONS. THEY WERE TERMINATED AND REPLACED WITH GROUP ADMINISTRATORS, LTD. EFFECTIVE SEPTEMBER 1, 2009.