2024-04-26T09:47:46-05:00 2023-06-30 470900880 Calibre CPA Group PLLC 230 West Monroe St Ste310 Chicago IL 60606 990 2022-07-01 362356062 SMART LOCAL 265 WELFARE FUND SHEE 6306687260 205 ALEXANDRA WAY CAROL STREAM IL 60188 John Daniel TRUSTEE 6306687260 2024-04-26 1 John Daniel 999009999 1 Andy Hein P00499757 3126550037 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JOHN DANIEL 205 ALEXANDRA WAY CAROL STREAM IL 60188 52204753 0 X N/A X 1962 IL PROVIDE HEALTH, DENTAL, PRESCRIPTION DRUG, VISION AND DEATH BENEFITS COVERING SUBSTANTIALLY ALL PARTICIPATING PERSONS UNDER THE SHEET METAL WORKERS LOCAL 265 UNION'S COLLECTIVE BARGAINING AGREEMENT. 10 5 96 0 0 0 167440 0 25916457 29742539 489135 -134607 510906 605005 27083938 30212937 0 0 32830711 28702036 1244658 1379091 0 0 0 3266319 4310631 37341688 34391758 -10257750 -4178821 43023590 41446905 14717888 15710715 28305702 25736190 X PROVIDE HEALTH, DENTAL, PRESCRIPTION DRUG, VISION AND DEATH BENEFITS COVERING SUBSTANTIALLY ALL PARTICIPATING PERSONS UNDER THE SHEET METAL WORKERS LOCAL 265 UNION'S COLLECTIVE BARGAINING AGREEMENT. 0 0 PROVIDED ARE HEALTH (HOSPITAL, MAJOR MEDICAL, AND LONG TERM DISABILITY), DENTAL, VISION, AND DEATH BENEFITS FOR ELIGIBLE PARTICIPANTS. PROVIDED ARE HEALTH (HOSPITAL, MAJOR MEDICAL, AND LONG TERM DISABILITY), DENTAL, VISION, AND DEATH BENEFITS FOR ELIGIBLE PARTICIPANTS. 0 0 0 0 0 0 0 0 0 1 1 0 1 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 1 617 0 1 96 1 0 0 0 0 0 0 0 0 X 10 5 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X KATIE EBY 6306687260 205 ALEXANDRA WAY CAROL STREAM IL 60188 PAT HUDGENS TRUSTEE 3.00 X 0 0 0 JOHN SHAW TRUSTEE 3.00 X 0 0 0 KEN WIESBROOK TRUSTEE 3.00 X 0 0 0 JOHN DANIEL TRUSTEE 3.00 40.00 X 0 227993 109481 KEVIN GALASS TRUSTEE 3.00 40.00 X 0 160104 95977 ANDY YONKUS TRUSTEE 3.00 X 0 0 0 TERRANCE VAN SOMEREN TRUSTEE 3.00 X 0 0 0 BRIAN DAHLMAN TRUSTEE 3.00 40.00 X 0 157460 95615 RON MIKA TRUSTEE 3.00 40.00 X 0 158683 95616 MATTHEW GUGALA TRUSTEE 3.00 40.00 X 0 171484 97834 KATIE EBY ADMINISTRATOR 40.00 X 172634 0 60689 BRIAN DOXIE CLAIMS MANAGER 40.00 X 105763 0 60624 278397 875724 615836 2 0 1 0 BLUE CROSS BLUE SHIELD 300 EAST RANDOLPH STREET CHICAGO IL 60601 PPO ACCESS FEES 835075 EXPRESS SCRIPTS 1 EXPRESS WAY ST LOUIS MO 63121 RX ADMIN FEES 250455 THE SEGAL COMPANY 101 NORTH WACKER STE 500 CHICAGO IL 60606 CONSULTING/ACTUARIAL FEES 202672 BAUM SIGMAN AUERBACH & NEUMAN 200 W ADAMS STREET STE 2200 CHICAGO IL 60606 LEGAL FEES 133846 4 EMPLOYER CONTRIBUTIONS 900099 27027775 27027775 EMPLOYEE CONTRIBUTIONS 900099 2714764 2714764 29742539 1050375 1050375 20806834 21991816 -1184982 -1184982 -1184982 REIMB FROM AFFILIATES 900099 605005 605005 605005 30212937 30347544 0 -134607 X 28702036 756314 308689 215647 98441 119050 52192 101705 3638445 146899 118018 47694 24755 21960 29805 ACA FEES 10108 34391758 652996 622357 1628664 2103495 2464126 3035546 349527 112045 1748706 482884 1303660 1265822 30178083 26737312 5436875 4966684 1009659 2603644 43023590 41446905 86082 136976 14631806 15573739 14717888 15710715 X 0 0 0 0 28305702 25736190 28305702 25736190 43023590 41446905 -4178821 1609309 0 X X 0 1 X 1 0 1488638 254771 1233867 164560 149401 15159 95508 78712 16796 1265822 LIMITED PARTNERSHIPS 4966684 F 4966684 DUE FROM AFFILIATED FUNDS 239938 ACCRUED INTEREST 160606 PRESCRIPTION REBATES RECEIVABLE 1804096 RIGHT-OF-USE ASSETS 399004 2603644 CLAIMS PAYABLE 549000 EST LIAB FUT CLAIMS-FROM EXTNDED ELIG 12427500 EST LIAB FUT CLAIMS-INCURRED NOT REPORTE 2194000 ACCRUED PAYROLL TAXES AND WITHHOLDINGS 980 OPERATING LEASE LIABILITIES 402259 15573739 X 31115536 1609309 1609309 29506227 101705 605005 706710 30212937 32883948 0 32883948 101705 1406105 1507810 34391758 Part X, Line 2: The trust established under the Plan to hold the Plan's assets is qualified pursuant to Section 501(c)(9) of the Internal Revenue Code as a tax-exempt organization. The Plan has obtained a favorable tax determination letter from the Internal Revenue Service, and the Plan Sponsor believes that the Plan, as amended, continues to qualify and to operate in accordance with applicable provisions of the Internal Revenue Code. Accounting principles generally accepted in the United States of America require plan management to evaluate tax positions taken by the plan and recognize a tax liability (or asset) if the organization has taken an uncertain position that more likely than not would not be sustained upon examination by the taxing authorities. As of June 30, 2023, there were no uncertain 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 taxing jurisdictions; however, there are currently no audits for any tax periods in progress. Part XI, Line 4b - Other Adjustments: REIMB EXPENSES FROM AFFILIATED FUNDS 605,005. Part XII, Line 4b - Other Adjustments: REIMB. EXPENSES FROM AFFILIATED FUNDS 605,005. INC IN CLAIMS PAYABLE AND IBNR 881,000. INC IN LIABILITY FOR EXTENDED ELIGIBILITY -79,900. X 0 0 0 JOHN DANIEL TRUSTEE 0 203008 0 0 0 24985 0 81942 0 27539 0 337474 0 0 MATTHEW GUGALA TRUSTEE 0 151280 0 0 0 20204 0 70640 0 27194 0 269318 0 0 KEVIN GALASS TRUSTEE 0 143315 0 0 0 16789 0 68749 0 27228 0 256081 0 0 RON MIKA TRUSTEE 0 143315 0 0 0 15368 0 68431 0 27185 0 254299 0 0 BRIAN DAHLMAN TRUSTEE 0 143315 0 0 0 14145 0 68386 0 27229 0 253075 0 0 KATIE EBY ADMINISTRATOR 172634 0 0 0 0 0 38997 0 21692 0 233323 0 0 0 BRIAN DOXIE CLAIMS MANAGER 105763 0 0 0 0 0 38932 0 21692 0 166387 0 0 0 Form 990, Part VI, Section B, line 11b THE TRUSTEES HAVE AUTHORIZED THE FUND'S CHAIRMAN AND/OR SECRETARY TO REVIEW THE FORM 990 BEFORE IT IS FILED. Form 990, Part VI, Section B, line 12c PERSONS COVERED BY THE CONFLICT OF INTEREST POLICY WILL ANNUALLY DISCLOSE OR UPDATE TO THE BOARD OF TRUSTEES THEIR INTERESTS THAT COULD GIVE RISE TO CONFLICTS OF INTEREST. FOR EACH INTEREST DISCLOSED TO THE BOARD OF TRUSTEES, THE TRUSTEES WILL DETERMINE WHETHER TO: (A) TAKE NO ACTION; (B) ASSURE FULL DISCLOSURE TO THE BOARD OF TRUSTEES AND OTHER INDIVIDUALS COVERED BY THIS POLICY; (C) ASK THE PERSON TO REFUSE FROM PARTICIPATION IN RELATED DISCUSSIONS OR DECISIONS WITHIN THE FUNDS; OR (D) ASK THE PERSON TO RESIGN FROM HIS OR HER POSITION IN THE FUND, OR IF THE PERSON REFUSES TO RESIGN, BECOME SUBJECT TO POSSIBLE REMOVAL IN ACCORDANCE WITH THE FUND'S REMOVAL PROCEDURES. THE ADMINISTRATIVE MANAGER WILL MONITOR PROPOSED OR ONGOING TRANSACTIONS FOR CONFLICTS OF INTEREST AND DISCLOSE THEM TO THE BOARD OF TRUSTEES IN ORDER TO DEAL WITH POTENTIAL OR ACTUAL CONFLICTS, WHETHER DISCOVERED BEFORE OR AFTER THE TRANSACTION HAS OCCURRED. 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 US DEPARTMENT OF LABOR. ALSO, FORM 5500 IS OPEN TO PUBLIC INSPECTION THROUGH THE US DEPARTMENT OF LABOR. Form 990, Part IX, line 11g CONSULTING & ACTUARIAL FEES 176,532. CLAIMS PAYMENT FEES 1,080,538. PREFERRED PROVIDER FEES 724,805. WELLNESS CENTER FEES 1,656,570. Form 990, Part XII, Line 2c THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. SMART LOCAL 265 PENSION 205 ALEXANDRA WAY CAROL STREAM IL 60188 366168611 PENSION FUND IL 401(A) 0 SMART LOCAL 265 SUPPLEMENTAL RETIREMENT PLAN 205 ALEXANDRA WAY CAROL STREAM IL 60188 363911499 ANNUITY FUND IL 401(A) 0 SMART LOCAL 265 LMCC 2703 VAN BUREN STREET BELLWOOD IL 60104 364146794 LABOR MANAGEMENT COOPERATION COMMITTEE IL 501(c)(5) 0 SMART LOCAL 265 EDUCATION 205 ALEXANDRA WAY CAROL STREAM IL 60188 366148078 TRAINING FUND IL 501(c)(5) 0 SMART LOCAL 265 205 ALEXANDRA WAY CAROL STREAM IL 60188 362368182 LABOR UNION IL 501(c)(5) 0 A P I INC A-1 ROOFING CO ADMIRAL MECHANICAL SERVICES ADVANCE MECHANICAL SYSTEMS IN AIR COMFORT CORP AIR DESIGN SYSTEMS INC AIR DUCT MFG & SUPPLY INC AIR FLOW CO INC AIR QUALITY INC AIR RITE HEATING & COOLING AIRTECH HEATING & AC CORP ALBERT J WAGNER & SONLLC ALL AMERICAN ROOFING COINC ALL TECH MECHANICAL SERVICES I ALLIED POWER LLC ALLSTATE METAL FAB ALTHOFF INDUSTRIES INC AMBER MECHANICAL CONTRACTORS I AMCO INC AMERICAN AIR MECH SERV INC AMS MECHANICAL 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