2024-11-12T12:46:49-06:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2023-01-01 396069788 NORTH CENTRAL STATES REGIONAL COUNCIL OF CARPENTERS' HEALTH FUND NORT 7158353174 PO BOX 4002 EAU CLAIRE WI 54702 BURT JOHNSON CHAIRMAN 7158353174 2024-11-11 1 0 DOUGLAS BERTOSSI P00637990 6123764500 2024-11-11 2023 2024-10-15 13:58:12Z BURT JOHNSON PO BOX 4002 EAU CLAIRE WI 54702 120095480 0 X WWW.NCSCBF.COM X 1963 WI TO PROVIDE HEALTH AND WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 18 0 0 18 0 0 0 0 78066797 84977423 4312682 2626403 9712 82578 82389191 87686404 0 0 84253256 97534992 793699 0 0 0 0 2013266 3249917 87060221 100784909 -4671030 -13098505 139652826 135714913 746966 540385 138905860 135174528 TO PROVIDE HEALTH AND WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 0 0 PROVIDE SELF FUNDED BENEFITS FOR APPROXIMATELY 6,037 UNION MEMBERS AND THEIR DEPENDENTS. TO PAY FOR INSURANCE PREMIUMS FOR TRANSPLANT COVERAGE FOR MEMBERS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 3 0 0 0 0 0 0 0 0 0 0 X 18 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X NICOLE SUMMERS 7158353174 PO BOX 4002 EAU CLAIRE WI 54702 PATRICK NILSEN LABOR TRUSTEE 1.00 40.00 X 0 319928 86273 MIKE SHEA MANAGEMENT TRUSTEE 1.00 40.00 X 0 0 0 ROBERT SIEBEL MANAGEMENT TRUSTEE 1.00 40.00 X 0 0 0 BARRY SCHOLZ MANAGEMENT TRUSTEE 1.00 40.00 X 0 0 0 JAMES MARTIN MANAGEMENT TRUSTEE 1.00 40.00 X 0 0 0 SAM GABRILSKA MANAGEMENT TRUSTEE 1.00 40.00 X 0 0 0 ERIC BALLWEG MANAGEMENT TRUSTEE 1.00 40.00 X 0 0 0 DAVE SMESTAD MANAGEMENT TRUSTEE 1.00 40.00 X 0 0 0 SCOTT WATSON LABOR TRUSTEE 1.00 40.00 X 0 118382 59522 MICHAEL ADAMAVICH LABOR TRUSTEE 1.00 40.00 X 0 124301 59522 PAT RODRIGUEZ LABOR TRUSTEE 1.00 40.00 X 0 138112 66136 CHRIS HILL LABOR TRUSTEE 1.00 40.00 X 0 78076 41305 WAYNE NORDIN LABOR TRUSTEE 1.00 40.00 X 0 207950 79084 COREY BIALCIK LABOR TRUSTEE 1.00 40.00 X 0 157863 66136 BURT JOHNSON TRUSTEE, CHAIRMAN 1.00 40.00 X X 0 225271 76374 ROBERT BARKER TRUSTEE, SECRETARY/TREASUR 1.00 40.00 X X 0 277440 47774 SID SAMUELS MANAGEMENT TRUSTEE 1.00 40.00 X 0 0 0 DAVID COENEN LABOR TRUSTEE 1.00 40.00 X 0 157863 66136 APOLONIO DURAN LABOR TRUSTEE 1.00 40.00 X 0 118382 59522 0 1923568 707784 0 0 1 0 ANTHEM BLUECROSS BLUESHIELD 3075 VANDERCAR WAY CINCINNATI OH 45209 CLAIMS PROCESSING 2012465 WILSON-MCSHANE CORPORATION 3001 METRO DR STE 500 BLOOMINGTON MN 55425 ADMINISTRATOR 1761376 EXPRESS SCRIPTS 4600 NORTH HANLEY ROAD ST LOUIS MO 63134 CLAIMS PROCESSING 1365051 CASE MANAGEMENT SPECIALISTS INC 553 S INDUSTRIAL DR HARTLAND WI 53029 CONTRACTED MEDICAL CONSULTANT 505542 DELTA DENTAL 2801 HOOVER ROAD PO BOX 828 STEVENS POINT WI 54481 CLAIMS PROCESSING 234464 8 EMPLOYER CONTRIBUTIONS 525100 76170560 76170560 EMPLOYEE CONTRIBUTIONS 525100 8806863 8806863 84977423 3217748 3217748 31817731 32409076 -591345 -591345 -591345 DRUG CLASS ACTIONS 525100 28831 28831 INVEST CLASS ACTIONS 525100 27280 27280 MISC INCOME 525100 14567 14567 11900 11900 82578 87686404 84977423 0 2708981 97534992 1760524 285204 42992 155785 841759 27034 49167 45233 PCORI FEE 26307 BANK CHARGES 8406 EDP MAINT./EDUCATION 5530 MISC EXPENSES 1976 100784909 1847805 3504606 6865378 7624260 3622 6240 34191 51506 0 0 0 0 76032017 69358778 52778184 52969468 2091629 2200055 139652826 135714913 309866 176785 437100 363600 746966 540385 X 0 0 0 0 138905860 135174528 138905860 135174528 139652826 135714913 -13098505 9367173 0 X 0 1 X 1 0 0 INVESCO INSTITUTIONAL TRUST 22344273 F NTGI DAILY ALL COUNTRY 30625195 F 52969468 RECIPROCITY CONTRIBUTIONS PAYABLE 363600 363600 X 96897792 9367173 9367173 87530619 155785 155785 87686404 100629124 0 100629124 155785 155785 100784909 PART X, LINE 2: THE VEBA TRUST FUNDING CERTAIN BENEFITS OF THE FUND RECEIVED AN EXEMPTION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS) DATED JULY 24, 1964, STATING THAT THE TRUST IS TAX-EXEMPT UNDER THE PROVISIONS OF SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE (IRC). HOWEVER, AS A RESULT OF THE FUND'S FUNDING POLICY, FROM TIME TO TIME THE TRUST MAY BE SUBJECT TO INCOME TAXES. NO FEDERAL OR STATE INCOME TAXES HAVE BEEN RECORDED IN 2023 AND 2022 FOR UNRELATED BUSINESS TAXABLE INCOME. IN ADDITION, THE FUND AND TRUST ARE REQUIRED TO OPERATE IN CONFORMITY WITH THE IRC TO MAINTAIN THE TAX-EXEMPT STATUS OF THE TRUST. THE FUND ADMINISTRATOR BELIEVES THAT THE FUND IS BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC AND, THEREFORE, BELIEVES THAT THE RELATED TRUST IS TAX-EXEMPT. 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 IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 0 0 0 PATRICK NILSEN LABOR TRUSTEE 0 319928 0 0 0 0 0 49504 0 36769 0 406201 0 0 ROBERT BARKER TRUSTEE, SECRETARY/TREASUR 0 194511 0 81148 0 1781 0 26183 0 21591 0 325214 0 0 BURT JOHNSON TRUSTEE, CHAIRMAN 0 225271 0 0 0 0 0 42669 0 33705 0 301645 0 0 WAYNE NORDIN LABOR TRUSTEE 0 207950 0 0 0 0 0 45379 0 33705 0 287034 0 0 COREY BIALCIK LABOR TRUSTEE 0 157863 0 0 0 0 0 41254 0 24882 0 223999 0 0 DAVID COENEN LABOR TRUSTEE 0 157863 0 0 0 0 0 41254 0 24882 0 223999 0 0 PAT RODRIGUEZ LABOR TRUSTEE 0 138112 0 0 0 0 0 41254 0 24882 0 204248 0 0 MICHAEL ADAMAVICH LABOR TRUSTEE 0 124301 0 0 0 0 0 37128 0 22394 0 183823 0 0 SCOTT WATSON LABOR TRUSTEE 0 118382 0 0 0 0 0 37128 0 22394 0 177904 0 0 APOLONIO DURAN LABOR TRUSTEE 0 118382 0 0 0 0 0 37128 0 22394 0 177904 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 740 740 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 288 288 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 2958 2958 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 204 204 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 449 449 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 890 890 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 711 711 0 0 0 6240 FORM 990, PART VI, SECTION A, LINE 7A THE ASSOCIATED GENERAL CONTRACTORS OF WISCONSIN, INC. AND THE NORTH CENTRAL STATES REGIONAL COUNCIL OF CARPENTERS (THE BARGAINING PARTIES), BOTH APPOINT 50% OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES THAT HAVE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE ORGANIZATION'S INDEPENDENT PUBLIC ACCOUNTING FIRM BASED ON INFORMATION PROVIDED BY MANAGEMENT. ONCE A DRAFT OF THE FILING IS AVAILABLE, IT IS REVIEWED BY MANAGEMENT AND ANY CHANGES INCORPORATED INTO THE FILING BEFORE BEING PRESENTED TO THE HEALTH BOARD FOR APPROVAL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE TRUSTEES ARE REQUIRED TO COMPLETE AN ANNUAL QUESTIONNAIRE REGARDING ANY POSSIBLE CONFLICTS OF INTEREST. ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST MUST BE DISCLOSED TO THE APPROPRIATE BOARD OR COMMITTEE AND THEY WILL DETERMINE IF A CONFLICT EXISTS AND IF THEY CAN OBTAIN A MORE ADVANTAGEOUS ARRANGEMENT THAT WOULD NOT GIVE RISE TO A CONFLICT. IF NOT, THE BOARD OR COMMITTEE WILL DETERMINE BY A MAJORITY VOTE OF DISINTERESTED TRUSTEES WHETHER THE TRANSACTION IS IN THE FUNDS BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE AND WILL DECIDE WHETHER TO ENTER INTO THE TRANSACTION ON THAT BASIS. IF THE BOARD OR COMMITTEE BELIEVES THAT A TRUSTEE HAS FAILED TO DISCLOSE, IT WILL GIVE THE TRUSTEE AN OPPORTUNITY TO EXPLAIN. IF THE BOARD OR COMMITTEE DETERMINES THE TRUSTEE HAS FAILED TO DISCLOSE, IT WILL TAKE DISCIPLINARY AND CORRECTIVE ACTION. THE TRUSTEE WITH A CONFLICT MUST LEAVE THE MEETING WHILE THE BOARD OR COMMITTEE MAKES THE DECISION WHETHER A CONFLICT EXISTS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. CARPENTERS LU #314 NORTH CENTRAL STATES REG CNCL (BA) NORTH CENTRAL STATES REG CNCL OF CARPS UBC NATIONAL JOB CORPS TRAININ NCSRCC TRAINING FUND 1704 DEVNEY DRIVE ALTOONA WI 54720 391243343 TRAINING BENEFITS WI 501(C)(3) LINE 11 N/A 0 LABOR MGMT COOPERATIVE TRUST OF THE NCSRCC & AGC OF WI INC 1704 DEVNEY DRIVE ALTOONA WI 54720 680572562 DRUG TESTING AND REIMBURSMENT FOR CLASSES WI 501(C)(6) N/A 0 NCSRCC PENSION FUND 1704 DEVNEY DRIVE ALTOONA WI 54720 396079856 PENSION BENEFITS WI 401 (A) N/A 0 NCSRCC SUPPLEMENTAL RETIREMENT PLAN 1704 DEVNEY DRIVE ALTOONA WI 54720 800234499 DEFINED CONTRIBUTIONS BENEFITS WI 401 (A) N/A 0 ADVANTAGE INDUSTRIAL SYSTEMS LLC BADGER SCAFFOLD LLC BRUNSWICK BOWLING & BILLIARDS CCF LABOR LLC CECO CONCRETE CONSTRUCTION COPPER CREEK ROOFING AND CONST LLC HARRIOTT CONTRACTING LLC MISSION DRYWALL COMPANY LLC PRICE ERECTING INC RHI LLC SCHMITT ACOUSTICS LLC SHEET PILING SERVICES LLC TWIN CITY TILE & MARBLE CO U S VET GENERAL CONTRACTING LLC KRAEMER NORTH AMERICA LLC A P COM POWER INC ATLANTIC PLANT MAINTENANCE BILFINGER INDUSTRIAL SERVICES INC BADGER ACOUSTICS INC BENNETT CONSTRUCTION INC BERES JOHN BUILDERS INC CAMOSY INC CENTRAL MECHANICAL SYSTEMS INC (SHOP) CONTEMPORARY HAMMER WORKS INC DORAL CORPORATION DOYLE CONTRACTORS INC EAU CLAIRE ACOUSTICS INC GAGNON CONST CO INC GENESYS CORP HUNZINGER CONST CO IEI GENERAL CONTRACTORS INC INSULATED PANEL COMPANY INTERIOR INSTALLATION SERVICE INC KPH CONSTRUCTION SERVICES LLC KOTZE CONSTRUCTION CO INC KRAUS ANDERSON CONST CO INC (MPLS) LUNDA CONST CO - 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