2023-07-10T11:22:00-05:00 2022-08-31 363168081 SIKICH LLP 13400 BISHOPS LANE SUITE 300 BROOKFIELD WI 53005 990 2021-09-01 237422786 WISCONSIN MASONS' HEALTH CARE FUND WISC 8003625474 2901 W BELTLINE HIGHWAY 100 MADISON WI 537134226 JIM VICK CHAIRMAN 8003625474 2023-07-10 1 JIM VICK 999009999 JILL M BOYLE CPA P01246734 2627549400 2023-07-10 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z JIM VICK 2901 W BELTLINE HIGHWAY 100 MADISON WI 537134226 32089422 0 X N/A X 1973 WI TO PROVIDE HEALTH, LIFE, DENTAL, AND TEMPORARY DISABILITY BENEFITS TO ELIGIBLE PARTICIPANTS, SPOUSES, AND DEPENDENTS. 18 11 34 11 0 0 0 0 19098014 17519573 1217754 1444396 3095858 645367 23411626 19609336 0 0 13737651 16622894 0 0 0 0 0 3651008 4300051 17388659 20922945 6022967 -1313609 30780214 25145408 8645764 8273094 22134450 16872314 TO PROVIDE HEALTH, LIFE, DENTAL, AND TEMPORARY DISABILITY BENEFITS TO ELIGIBLE PARTICIPANTS, SPOUSES, AND DEPENDENTS. 0 0 TO PROVIDE HEALTH, LIFE, DENTAL, AND TEMPORARY DISABILITY BENEFITS TO ELIGIBLE PARTICIPANTS, SPOUSES, AND DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 0 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 1 0 34 1 0 0 0 0 0 0 0 0 X 18 11 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X BENESYS INC 8003625474 2901 W BELTLINE HWY SUITE 100 MADISON WI 537134226 JIM VICK TRUSTEE 1.00 35.00 X X 0 103831 73241 WYNN JONES TRUSTEE 1.00 X 0 95430 71100 TOBIN BOYLE TRUSTEE 1.00 35.00 X 0 93202 72770 WILLIAM BONLENDER TRUSTEE 1.00 35.00 X 0 95394 70676 MIKE HYATT TRUSTEE 1.00 35.00 X 0 98538 69659 FELIX RAMIREZ TRUSTEE 1.00 42.00 X 0 86639 76117 DAVID HAHN THRU 43022 CHAIRMAN 1.00 2.00 X X 0 0 0 MATT QUASIUS SECRETARY/TREASURER 1.00 X X 0 0 0 JEFF LECKWEE TRUSTEE 1.00 X 0 0 0 JERRY SHEA THRU 103121 TRUSTEE 1.00 X 0 0 0 BARRY SCHOLZ TRUSTEE 1.00 X 0 0 0 DAVID BOHL TRUSTEE 1.00 X 0 0 0 JEFF STAVER TRUSTEE 1.00 X 0 0 0 DEAN BASTEN THRU 43022 TRUSTEE 1.00 X 0 0 0 LARRY RASCH THRU 9121 TRUSTEE 1.00 X 0 0 0 JASON MATTILA TRUSTEE 1.00 X 0 0 0 MATT MARCELLIS TRUSTEE 1.00 X 0 0 0 PATRICK MCCABE TRUSTEE 1.00 X 0 97140 69764 ANDREW REED TRUSTEE 1.00 X 0 95430 71100 TYLER SWANSON FROM 12022 TRUSTEE 1.00 X 0 0 0 TERRY OWENS FROM 41822 TRUSTEE 1.00 X 0 0 0 DEREK ALLEN FROM 81122 TRUSTEE 1.00 X 0 0 0 0 765604 574427 0 0 1 0 BENEFIT PLAN ADMINISTRATION 2901 WEST BELTLINE HIGHWAY SUITE 1 MADISON WI 53713 CONTRACT ADMINISTRATION 1014007 UNITED HEALTHCARE INSURANCE COMPANY PO BOX 88822 MILWAUKEE WI 53228 CLAIMS / PPO EXPENSE 469531 MERCER HEALTH & BENEFITS LLC 155 NORTH WACKER DRIVE STE 1500 CHICAGO IL 60606 CONSULTING 143605 US BANK NATIONAL ASSOCIATION PO BOX 1800 SAINT PAUL MN 55101 BANKING / INVESTMENTS 116340 4 EMPLOYER CONTRIBUTIONS 900099 15274328 15274328 SELF PAY CONTRIBUTIONS 900099 2245245 2245245 17519573 531023 531023 13393459 12480086 913373 913373 913373 CHANGE IN MEMBER DOLLAR BANK 900099 463477 463477 SUBROGATION 900099 177789 177789 MISCELLANEOUS 900099 3747 3747 354 354 645367 19609336 18164940 0 1444396 16622894 882245 137090 52476 237066 99126 50084 10874 11874 MEDICARE ADVANTAGE PREM 1125982 HRA REIMBURSEMENTS 750776 PPO SERVICE ADMIN FEES 620813 STOP-LOSS PREMIUMS 157268 164377 20922945 21477 0 3987627 3213564 2539367 2424836 242832 221547 23988911 19285461 30780214 25145408 336960 503746 26497 0 8282307 7769348 8645764 8273094 X 0 0 0 0 22134450 16872314 22134450 16872314 30780214 25145408 -1313609 -3948527 0 X 0 1 X 1 0 0 CLAIMS PAYABLE 1217000 HRA LIABILITY 6408725 CASH OVERDRAFT 143623 7769348 X 15144856 -3948527 -3948527 19093383 52476 463477 515953 19609336 20600097 193105 193105 20406992 52476 463477 515953 20922945 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS INTENDED TO QUALIFY PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE ("IRC"). THE TRUST HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE ("IRS") AND IS THEREFORE NOT SUBJECT TO TAX UNDER PRESENT INCOME TAX LAWS. THE PLAN SPONSOR BELIEVES THAT THE TRUST, AS AMENDED, CONTINUES TO QUALIFY AND TO OPERATE IN ACCORDANCE WITH APPLICABLE PROVISIONS OF THE IRC. U.S. GAAP REQUIRES PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) 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. PART XI, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN MEMBER DOLLAR BANK 463,477. PART XII, LINE 2D - OTHER ADJUSTMENTS: INCREASE IN BENEFIT OBLIGATIONS PAYABLE 193,105. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN MEMBER DOLLAR BANK 463,477. 0 0 0 JIM VICK TRUSTEE 0 103831 0 0 0 0 0 52961 0 20280 0 177072 0 0 MIKE HYATT TRUSTEE 0 98538 0 0 0 0 0 49785 0 19874 0 168197 0 0 PATRICK MCCABE TRUSTEE 0 97140 0 0 0 0 0 49484 0 20280 0 166904 0 0 WYNN JONES TRUSTEE 0 95430 0 0 0 0 0 50820 0 20280 0 166530 0 0 ANDREW REED TRUSTEE 0 95430 0 0 0 0 0 50820 0 20280 0 166530 0 0 WILLIAM BONLENDER TRUSTEE 0 95394 0 0 0 0 0 50396 0 20280 0 166070 0 0 TOBIN BOYLE TRUSTEE 0 93202 0 0 0 0 0 52490 0 20280 0 165972 0 0 FELIX RAMIREZ TRUSTEE 0 86639 0 0 0 0 0 55380 0 20737 0 162756 0 0 FORM 990, SCHEDULE J, PART I LINE 3 THE RELATED ORGANIZATION, OPERATIVE PLASTERERS & CEMENT MASONS LOCAL 599, USES EXECUTIVE BOARD APPROVAL TO ESTABLISH COMPENSATION. FORM 990, PART VI, SECTION B, LINE 11B THE OFFICERS AND ADMINISTRATIVE MANAGER REVIEWS THE FORM 990 WITH THE ACCOUNTANT BEFORE SIGNING AND MAKING A COPY OF THE FORM 990 AVAILABLE FOR ALL TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C THERE ARE ANNUAL TRUSTEE QUESTIONNAIRES. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. BAC DISTRICT COUNCIL PO BOX 510617 NEW BERLIN WI 53151 391590426 LABOR UNION WI 501(C)(5) 0 BOARD OF TRUSTEES WI MASONS' HEALTH CARE FUND 2901 W BELTLINE HIGHWAY STE 100 MADISON WI 537134226 237422786 JOINT BOARD OF TRUSTEES WI 501(C)(9) 0 MILWAUKEE AREA BRICKLAYERS APPRENTICESHIP TRAINING FUND 17125 W CLEVELAND AVENUE NEW BERLIN WI 531510741 391333915 APPRENTICESHIP TRAINING WI 501(C)(3) 0 OPERATIVE PLASTERERS & CEMENT MASONS LOCAL 599 8701 N LAUER STREET MILWAUKEE WI 53224 391960564 LABOR UNION WI 501(C)(5) 0 HANSON MASONRY & CONCRETE LLOYD HAMM MASONRY MAVID CONSTRUCTION SERVICE LLC WALLY KING MASONRY LLC AGC OF GREATER MILWAUKEE API INC APPLETON LATHING CORP ARNIE MACKEY CONSTRUCTION ARTEAGA CONSTRUCTION INC BANE NELSON BEDROCK FLINT INC BENEFIT PLAN ADMINISTRATOR OF WI BERGHAMMER CORP BOLDT OSCAR CONSTRUCTION CO BORTH-WILSON INC BUKACEK CONSTRUCTION INC C&S CONSTRUCTION INC CAMOSY INC CAPELLE BROTHERS & DIEDRICH INC CASTELLAN TILE & TERRAZZO INC CAULKING PLUS INC CH SCHMIDT INC CLASSIC MARBLE & GRANITE CM MORRIS GROUP INC CONCRETE MASONRY INC CORNERSTONE CONSTRUCTION CROWLEY MASONRY INC D&M MASONRY LLC DAROLD BERGER MASONRY DICKOW & CYZAK TILE DOYLE CONTRACTORS INC EDGAR PRAGER & SONS EXECUTIVE PLASTERING CO FABCON INC FINDORFF & SON INC FOWLER & HAMMER INC FOX VALLEY & CONSTRUCTION G&W PLASTERING INC GAGNON INC GEGARE TILE INC GEORGE SIEGFRIED CONSTRUCTION CO HARBOR CITY MASONRY INC HAROLD ARDNT HEIN WILLIAM CONSTRUCTION INC HETZEL TILE HEULER TILE COMPANY HILLSIDE DAMPROOFING INC HOMBURG CONTRACTORS INC HUNZINGER CONSTRUCTION CO IEI GENERAL CONTRACTORS INC INTERIOR INSTALLATION J&J LEE CONSTRUCTION JAC MASONRY INC JH HASSINGER INC JOHNSON TERRAZZO COMPANY JP CULLEN & SONS INC JUROWSKI RJ CONSTRUCTION INC KENNETH F SULLIVAN INC KMI CONSTRUCTION LLC KOTZE CONSTRUCTION COMPANY INC LEWIS CONSTRUCTION INC LIPPERT TILE CO INC LUNDA CONSTRUCTION MA MORTENSON CO MAAS BROS CONSTRUCTION COMPANY MACCO'S COMMERCIAL INTERIORS MARKET & JOHNSON INC MARTELL CONSTRUCTION MEGAL CONSTRUCTION COMPANY MEYER CR & SONS CO MIDDLETON CONSTRUCTION INC MIRON CONSTRUCTION COMPANY INC MORTL RESTORATIONT NATIONAL MACHINERY PLATT CONSTRUCTION COMPANY POELLINGERS INC PUKALL COMPANY INC QUASIUS BROTHERS INC RASCH CONSTRUCTION & ENGINE REFRACTORY SERVICE INC RESCH'S TILE INC RICE IVAN & SONS RILEY CONSTRUCTION INC ROSSI CONSTRUCTION SCHERRER CONSTRUCTION COMPANY INC SCHLEIS FLOOR COVERING SCHMITT JOSEPH & SONS CO SCIACHITANO CAULKING INC SERVAIS TILE & STONE INC SID'S SEALANTS SMITH CD CONSTRUCTION COMPANY INC STEBBIBS ENGINEERING COMPANY STRETAR MASONRY & CONCRETE STRUCTURAL APPLICATORS INC SUPERIOR MASONRY BUILDERS TRI NORTH BUILDERS INC TRIERWEILER CONSTRUCTION VOGEL BROTHERS BUILDING COMPANY VONASEK & SCHIEFFER INC WALSH MASONRY INC WINKLER MASONRY INC WISCONSIN TERRAZZO TILE INC ZEISE FRANK CONSTRUCTION INC 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FORM 990, SCHEDULE R, PARTS II-IV IN ADDITION TO THE CONTRIBUTING EMPLOYERS REPORTED AS RELATED ORGANIZATIONS ON SCHEDULE R, PARTS II-IV, THE FUND HAD ADDITIONAL EMPLOYERS THAT HAVE NOT YET RESPONDED TO THE FUNDS EFFORT TO OBTAIN THE TAX CLASSIFICATION. THE CONTRIBUTING EMPLOYERS ARE: AARON KOWALSKI MASONRY LLC, ACOUSTICS ASSOCIATES INC., B&D MASONRY AND RESTORATION, B&D ASSOCIATES, BAC LOCAL UNION 15 WELFARE, BADGER WASHING, BARTHENHEIER CONSTRUCTION, BERGLUND CONSTRUCTION, BRICK MASONS, CARIOFINI COMPANY, CE KORSGARD COMPANY, CEMENT M&P LOCAL 518, CEMENT M&P LOCAL 519, CEMENT M&P LOCAL 520, CEMENT M&P LOCAL 521, CEMENT M&P LOCAL 522, CEMENT M&P LOCAL 523, CHICAGO MASONRY LOCAL 21, CHICAGO MASONRY LOCAL 22, CHICAGO MASONRY LOCAL 23, CHICAGO MASONRY LOCAL 24, CHICAGO MASONRY LOCAL 25, CHICAGO MASONRY LOCAL 26, CHICAGO TILE #67, CHICAGO TILE #68, CHICAGO TILE #69, COMMERCIAL FLOORING INSTALLATIONS, CONSTRUCTION & TURNAROUND, CONSTRUCTION INDUSTRY, CONTRACT TILE & CARPET, CORNERSTONE PAVERS, CREATIVE ERECTORS, DIAMOND MASONRY, EMPIRE REFRACTORY SERVICES, EMPRESS SURFACE SOLUTIONS, FOSBEL INC, G FONTANA AND SONS, GILLESPIE & POWERS, H&S CONCRETE CONSTRUCTION, H.E.S.S CAULKING & REST, HEAVY & HWY EDUCATION, HEELEIN & SONS 86471, HOUSE OF STONE, IMTEF, INTERNATIONAL HEALTH, IOWA BUILDERS HEALTH FUND, INTERNATIONAL PENSION, IOWA LABORERS DC HEALTH & WELFARE, J.P. PHILLIPS INC, JIMMY Z MASONRY, JOHNSON'S CARPET ONE 55807, JS MASONRY LLC, JT THORPE & SON, JW FLOORING INC, JW SEALANTS, KINGSTON TILE CO., KNIGHT MATERIAL TECHNOLOGY, KOCH KNIGHT LLC, MASONRY WELFARE TRUST, MASS BRICLAYERS , MEL BJURSTROM MASONRY LLC, MICHIGAN BAC HEALTH/PENSION, MN & ND BRICKLAYERS, MOUNT HOREB MASONRY, NORTHERN ILL & IOWA LAB, NPA - CONTINENTAL ERECTORS, OHIO BRICKLAYERS, PREFERRED CONCRETE & EXCA, QUALITY BUILDING RESTORATION INC., RAY THEOBALD MASONRY CONSTRUCTION, READY TITLE LLC, REVOLUTION INDUSTRIAL SERVICES, ROCKFOARD CENTRAL TILE & T, SCHAEFER GROUP, INC., STEINHAMMER MASSORY LLC, SUMMIT CONCRETE & MASONRY, SWANSON SPRAY SYSTEMS, TAPPING TROWEL MASONRY, THE CAULKERS COMPANY INC, TITAN CITY CEMENT MASONS, TVJ MASONRY, INC., TWIN CITY CEMENT MASONS, WAUMANDEE CREEK SEALANTS, WAYNES CAULKING INC., WELLS SEALANTS & RESTORATION, WEX/HRA, HRA, WI LABORERS FUND, WISCONSIN MASON WEX S/P DESPOSITS, WM DISABILITY CREDIT, WR WEIS COMPANY INC.