2024-03-11T09:20:01-05:00 2023-05-31 470900880 CALIBRE CPA GROUP PLLC 230 WEST MONROE ST STE310 CHICAGO IL 60606 990 2022-06-01 363251688 ARCH IRONWORKERS LOCAL 63 WELFARE FUND ARCH 6304720627 625 ENTERPRISE DR OAK BROOK IL 605238813 PAUL WENDE TRUSTEE 6304720627 2024-03-11 1 PAUL WENDE 999009999 0 AARON PLATH P01360263 3126550037 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z PAUL WENDE 625 ENTERPRISE DR OAK BROOK IL 605238813 49584984 0 X N/A X 1983 IL TO PROVIDE MEDICAL, DENTAL, DISABILITY, AND DEATH BENEFITS. 6 3 67 0 0 0 0 0 21454043 23398633 7095338 529030 115 0 28549496 23927663 0 0 26982778 30522952 44626 47593 0 0 0 1755444 1718411 28782848 32288956 -233352 -8361293 104401164 98519717 24712470 27511965 79688694 71007752 X TO PROVIDE MEDICAL, DENTAL, VISION, DISABILITY, DEATH AND OTHER WELFARE BENEFITS 0 0 THE FUND PROVIDES MEDICAL, DENTAL, VISION, DISABILITY, AND DEATH BENEFITS TO ELIGIBLE PARTICIPANTS. THE FUND PROVIDES MEDICAL, DENTAL, VISION, DISABILITY, AND DEATH BENEFITS TO ELIGIBLE PARTICIPANTS. 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 3 0 1 67 1 1 1 0 0 0 0 0 0 0 X 6 3 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X CHRIS KRZYSKO AT BENEFITS MGMT GROUP 6304720627 625 ENTERPRISE DRIVE OAKBROOK IL 60523 MICHAEL SWANBERG TRUSTEE 3.00 X 0 0 0 PAUL WENDE CHAIRMAN 3.00 49.00 X 0 197229 133407 TIM BELL TRUSTEE 3.00 X 0 0 0 MARK LABUZ TRUSTEE 3.00 X 0 0 0 DAVE MURRAY TRUSTEE 3.00 46.00 X 0 174472 123396 FLETCHER HOLMES TRUSTEE 3.00 46.00 X 0 174277 123396 0 545978 380199 0 0 1 0 BCBS 300 E RANDOLPH CHICAGO IL 60601 CLAIMS PAYOR 961431 CERNER CORPORATION PO BOX 959156 ST LOUIS MO 63195 HEALTH CARE MANAGEMENT COMPANY 940433 BENEFITS MANAGEMENT GROUP 625 ENTERPRISE DR OAK BROOK IL 60523 THIRD PARTY ADMIN. 382737 UNION EYES 3460 S HALSTED ST CHICAGO IL 60608 VISION CLAIMS ADMINISTRATOR 282999 SAV-RX 224 NORTH PARK AVENUE FREEMONT NE 68025 PRESCRIPTION DRUG SERVICE PROVIDER 122128 5 EMPLOYER CONTRIBUTIONS 900099 21918724 21918724 EMPLOYEE CONTRIBUTIONS 900099 1387641 1387641 MEDICARE PART D SUBSIDY 900099 92268 92268 23398633 2791180 2791180 23395171 25657321 -2262150 -2262150 -2262150 23927663 23398633 0 529030 30522952 47593 366127 67662 33950 210164 972979 58600 5138 ACA FEES 3791 32288956 4539873 5341108 2222248 941723 2062247 2182921 246773 191085 1398780 236885 1239082 1161895 84963732 77474194 8607848 10737211 519361 489580 104401164 98519717 175131 130989 24537339 27380976 24712470 27511965 X 0 0 0 0 79688694 71007752 79688694 71007752 104401164 98519717 -8361293 -319649 0 X X 0 1 X 1 0 1398780 236885 1161895 1161895 FIRST LIGHT FOCUS FUND, LIMITED PARTNERSHIP 9080403 F STERLING BAY CAPITAL PARTNERS III, LP 1656808 F 10737211 EXTENDED ELIGIBILITY 14707000 CLAIMS INCURRED BUT NOT PAID 5103713 ACCUMULATED MRA ACCOUNT BALANCES 7570263 27380976 X 23305582 -319649 -319649 23625231 210164 92268 302432 23927663 29142010 0 29142010 210164 2936782 3146946 32288956 PART X, LINE 2: AS OF MAY 31, 2023, THERE WERE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIOD IN PROGRESS. AT MAY 31, 2023, THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS PRIOR TO THE FISCAL YEAR ENDED MAY 31, 2020. PART XI, LINE 4B - OTHER ADJUSTMENTS: MEDICARE PART D SUBSIDY 92,268. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFIT OBLIGATIONS 2,844,514. MEDICARE PART D SUBSIDY 92,268. 0 0 0 PAUL WENDE CHAIRMAN 0 195559 0 0 0 1670 0 106085 0 27322 0 330636 0 0 DAVE MURRAY TRUSTEE 0 172343 0 0 0 2129 0 96074 0 27322 0 297868 0 0 FLETCHER HOLMES TRUSTEE 0 172552 0 0 0 1725 0 96074 0 27322 0 297673 0 0 FORM 990, PART VI, SECTION A, LINE 3 LINE 3 EXPLANATION - BENEFITS MANAGEMENT GROUP, INC. IS THE THIRD PARTY ADMINISTRATOR HIRED TO ADMINISTER THE FUND'S DAY-TO-DAY OPERATIONS. FORM 990, PART VI, SECTION B, LINE 11B 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, SECTION B, LINE 12C THE TRUSTEES ARE GOVERNED BY THE TRUST DOCUMENT AND A WRITTEN POLICY AND HAVE A FIDUCIARY RESPONSIBILITY UNDER ERISA TO ADMINISTER 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, SECTION C, LINE 19 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. PART XII, LINE 2C THERE HAS BEEN NO CHANGE IN THE FUND'S PROCESS FROM THE PRIOR YEAR IN REGARDS TO THE OVERSIGHT PROCESS. 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