2011-01-10T07:53:12-08:00 2010-05-31 Levinson Simon Hein & Bilkey PC 566 West Lake Street Suite 300 Chicago IL 606611414 990 2009-06-01 237166771 OPERATING ENGINEERS LOCAL 139 HEALTH BENEFIT FUND OPER 2625499190 PO BOX 160 PEWAUKEE WI 53072 TERRY MCGOWAN 2011-01-07 Andrew Hein 3126550037 2009 2016-02-24 21:20:13Z 192703405 false false X N/A X 1970 WI TO PROVIDE HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER THE PLAN 10 10 0 0 0 101558718 93384246 8090088 7759020 0 109648806 101143266 0 82929363 85779750 0 0 0 5031932 5651442 87961295 91431192 21687511 9712074 186071406 213118907 21030746 25707455 165040660 187411452 TO PROVIDE HEALTH AND OTHER BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER THE PLAN false false THE PLAN PROVIDES MEDICAL, DENTAL, VISION, LIFE, AND ACCIDENTAL DEATH & DISMEMBERMENT BENEFITS TO ELIGIBLE MEMBERS AND THEIR DEPENDENTS. false false false false false false false false false false true true false false false false false false false false false false false false false false false false false false false false false false false false false false false false false true false false false true 3184 0 true 0 false false false false false false false false false false false false false 10 10 false true false false false false false true true false false false false true true true false false false false false false X CARDAY ASSOCIATES 2625499190 N27 W23233 ROUNDY DRIVE PEWAUKEE WI 530720130 X TOM WOLF 3.00 X 0 0 0 TIM PETERSON 3.00 X 0 0 0 TERRY MCGOWAN 3.00 X 0 0 0 RICHARD WANTA 3.00 X 0 0 0 JOHN TOPP 3.00 X 0 0 0 DENNIS LUCIANI 3.00 X 0 0 0 DAVID BOHL 3.00 X 0 0 0 DAN SPERBERG 3.00 X 0 0 0 CHARLES WARNER 3.00 X 0 0 0 CHARLES BOWEN 3.00 X 0 0 0 0 false false false UNITED HEALTH CARE 3100 AMS BLVD GREEN BAY WI 54307 PPO ACCESS FEES 1050639 THE SEGAL COMPANY 101 NORTH WACKER DRIVE CHICAGO IL 60606 PLAN CONSULTING 247322 CVS CAREMARK 2211 SANDERS ROAD NBT-5 NORTHBROOK IL 60062 RX ADMIN FEE 212837 COMPSYCH 455 N CITYFRONT PLAZA DR 13TH FL CHICAGO IL 60611 EMPLOYEE ASSIT PROG 263751 CARDAY ASSOCIATES INC N27 W23233 ROUNDY DR PEWAUKEE WI 53072 THIRD PARTY ADMIN 1965751 10 0 SUBROGATION RECOVERIES 900099 534928 534928 SELF-PAY CONTRIBUTIONS 900099 12338189 12338189 MEDICARE SUBSIDY 900099 1113436 1113436 EMPLOYER CONTRIBUTIONS 900099 79397693 79397693 93384246 7720296 7720296 0 0 0 91598863 91560139 38724 38724 38724 0 0 0 0 101143266 93384246 7759020 0 0 0 85779750 0 0 0 0 0 0 2066299 161540 23510 0 0 338414 2590478 0 133736 136731 0 94476 0 0 19793 0 0 67742 18723 0 91431192 0 0 0 2382577 2055243 0 0 9990609 9390713 0 0 0 0 22487 38603 1333432 988288 341258 345144 161661434 190610338 9093908 8397254 0 0 2579133 2281612 186071406 213118907 543368 343197 107651 176636 20379727 25187622 21030746 25707455 X 165040660 187411452 165040660 187411452 186071406 213118907 X false true true X false false 929149 844888 84261 404283 143400 260883 345144 CLAIMS PAYABLE 2195500 CLAIMS INCURRED BUT NOT REPORTED 8781800 ACCUM PART HEALTH SAV ACCOUNTS 14210322 25187622 101143266 91431192 9712074 12658718 4807895 17466613 27178687 113463570 12658718 12658718 100804852 338414 338414 101143266 86284883 86284883 338414 4807895 5146309 91431192 Part XIII, Line 4b Part XIII, Line 4b: Other revenue amounts included on 990 but not included in F/S INC IN EST CLAIMS PAYABLE $259700 INC IN EST CLAIMS INCURRED BUT NOT RPTD $1038700 INC IN PART. ACCUM HEALTH REIMB ACCOUNTS $3509495 Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances INC IN EST CLAIMS PAYABLE $259700 INC IN EST CLAIMS INCURRED BUT NOT RPTD $1038700 INC IN PART. ACCUM HEALTH REIMB ACCOUNTS $3509495 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 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 ACTIONS OF THE TRUSTEES ARE GOVERNED BY THE TRUST DOCUMENT AND ERISA. BOTH ESTABLISH STANDARDS OF CONDUCT FOR PLAN FIDUCIARIES. THE TRUSTEES ARE REQUIRED TO DISCLOSE ANY POSSIBLE CONFLICTS OF INTEREST TO THE ENTIRE BOARD. Form 990, Part VI, Line 11 Form 990, Part VI, Line 11: Form 990 Review Process THE BOARD OF TRUSTEES HAVE AUTHORIZED DESIGNATED TRUSTEES (THE CHAIRMAN AND/OR SECRETARY TREASURER) TO REVIEW THE FORM 990 PRIOR TO FILING. A COPY OF THE FILED RETURN IS MADE AVAILABLE TO ALL TRUSTEES TO REVIEW SUBSEQUENT TO FILING. Form 990, Part VI, Line 3 Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company IN ACCORDANCE WITH THE PLAN'S TRUST AGREEMENT, THE TRUSTEES HAVE CONTRACTED THE SERVICES OF A THRID PARTY ADMINISTRATOR, CARDAY ASSOCIATES. THE THIRD PARTY ADMINISTRATOR, UNDER THE DIRECTION OF THE TRUSTEES, ADMINISTERS THE OFFICES OF THE TRUST FUND. LMCT of Operating Engineers Local 139 PO Box 160 Pewaukee WI 53072 364656562 Labor/Management Cooperation Trust WI 501(c)(5) N/A Wis Oper Eng Skill Improvement & Apprent PO Box 160 Pewaukee WI 53072 391102559 Operating Engineers Training Fund WI 501(c)(3) 2 N/A false false false false false false false false false false false false false false false false false false