2024-10-07T12:51:25-05:00 2023-12-31 550526247 KOZICKI HUGHES TICKERHOOF PLLC 32 TWENTIETH STREET SUITE 300 WHEELING WV 26003 990 2023-01-01 300002072 WV-OH SUPPLEMENTAL HEALTH PLAN WV-O 3045250331 3150 US ROUTE 60 ONA WV 25545 JESSICA MORRISON ADMINISTRATOR 3043999010 2024-10-07 1 NANCY HUGHES CPA P01447261 3042322280 2023 2024-10-15 13:58:12Z CHRIS SAMPLES 800 INDIANA AVENUE CHARLESTON WV 25302 2213976 0 X NA X 2001 WV PROVIDING SUPPLEMENTAL HEALTH PREMIUMS AND WEEKLY DISABILITY BENEFITS TO ELIGIBLE MEMBERS 12 12 32 0 0 0 0 0 1860410 2099826 693 114150 0 0 1861103 2213976 0 0 1634921 1900249 0 0 0 0 0 50029 60688 1684950 1960937 176153 253039 3837961 4407207 10440 13000 3827521 4394207 TO PROVIDE SUPPLEMENTAL HEALTH PREMIUMS & WEEKLY DISABILITY BENEFITS TO ELIGIBLE MEMBERS OF PARTICIPATING INTERNATIONAL BROTHERHOOD OF ELECTRICAL WORKERS (IBEW) UNIONS 0 0 1854373 THE PROVISION OF SUPPLEMENTAL HEALTH INSURANCE PREMIUMS FOR ELIGIBLE MEMBERS OF THE PARTICIPATING LOCAL IBEW UNIONS 45876 THE PROVISION OF SUPPLEMENTAL DISABILITY BENEFITS TO ELIGIBLE MEMBERS OF PARTICIPATING IBEW LOCAL UNIONS 1900249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1 2 0 1 32 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 X AMERICAN BENEFIT CORPORATION 3045250331 3150 US ROUTE 60 ONA WV 25545 X GLENN DOUG GIFFIN TRUSTEE 1.00 X 0 0 0 TOM SCHIFFER TRUSTEE 1.00 X 0 0 0 CHRIS SAMPLES TRUSTEE - CHAIRMAN 1.00 X X 0 0 0 BRUCE LAWSON TRUSTEE - SECRETARY 1.00 X X 0 0 0 JOHN YOUNG TRUSTEE 1.00 X 0 0 0 JAMES BANE TRUSTEE 1.00 X 0 0 0 LORNE MILLS TRUSTEE 1.00 X 0 0 0 JASON BLUE TRUSTEE 1.00 X 0 0 0 MICHAEL HAUGHT TRUSTEE 1.00 X 0 0 0 CODY PALMER TRUSTEE 1.00 X 0 0 0 WILLIAM HAMILTON TRUSTEE 1.00 X 0 0 0 JEREMY RYAN TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 0 EMPLOYER CONTRIBUTIONS 525100 2099826 2099826 2099826 114150 114150 2213976 2099826 0 114150 1900249 22213 7135 11743 1500 9582 8515 1960937 166182 329566 9586 8502 197896 317870 141172 0 3275326 3690802 47799 60467 3837961 4407207 10440 13000 10440 13000 X 0 0 0 0 3827521 4394207 3827521 4394207 3837961 4407207 253039 313647 0 X X 0 1 X 0 0 0 2518123 313647 -9500 304147 2213976 0 2213976 1951437 -9500 -9500 1960937 0 1960937 Part XI, Line 2d - Other Adjustments: INVESTMENT EXPENSES SHOWN NET OF REVENUE -9,500. Part XII, Line 2d - Other Adjustments: INVSETMENT EXPENSES SHOWN NET OF REVENUE -9,500. Form 990, Part VI, Section A, line 3 THE TRUSTEES FOR THE FUND ENGAGED AMERICAN BENEFIT CORPORATION TO PROVIDE ADMINISTRATIVE SERVICES FOR THE PLAN EFFECTIVE 1/1/2007. Form 990, Part VI, Section B, line 11b THE ORGANIZATION'S FORM 990 IS PREPARED ANNUALLY BY AN INDEPENDENT ACCOUNTING FIRM. THE FIRM SENDS A DRAFT TO THE ONE OR MORE MEMBERS OF THE GOVERNING BODY TO BE DISTRIBUTED TO THE REMAINING MEMBERS BEFORE THE FORM IS SIGNED BY AN AUTHORIZED MEMBER AND FILED WITH THE APPROPRIATE TAX AUTHORITIES. Form 990, Part VI, Section C, line 19 THIS 990 IS ALWAYS PUBLICALLY AVAILABLE THROUGH GUIDESTAR.COM; HOWEVER, THE PLAN'S GOVERNING DOCUMENTS AND AUDITED FINANCIAL STATEMENTS ARE ONLY AVAILABLE UPON REQUEST TO INTERESTED PARTIES. PART XII, LINE 2C EXPLANATION THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. SEE SCHEDULE R PART VII SUPPLEMENTAL INFORMATION SEE SCHEDULE R PART VII SUPPLEMENTAL INFORMATION 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE R, PART II, III & IV SCHEDULE R, PARTS II-IV. CONTRIBUTING EMPLOYERS AND ALL OTHER NECESSARY INFORMATION IS MAINTAINED WITHIN THE ORGANIZATION AND IS AVAILABLE UPON REQUEST FOR ANY INTERESTED PARTY.