2023-11-06T13:15:34-06:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2022-01-01 020656066 HEARTLAND HEALTHCARE FUND HEAR 9528540795 3001 METRO DRIVE 500 BLOOMINGTON MN 55425 DAVID ARGUBRIGHT CHAIRMAN 9528540795 2023-11-03 1 DAVID ARGUBRIGHT 999009999 0 DOUG BERTOSSI P00637990 6123764500 2023-11-03 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z DAVID ARGUBRIGHT 3001 METRO DRIVE 500 BLOOMINGTON MN 55425 38228325 0 X N/A X 2002 IA INSURED AND SELF FUNDED WELFARE BENEFITS FOR UNION MEMBERS AND THEIR DEPENDENTS. 6 0 0 6 0 0 0 0 29790616 31638183 8142529 529810 0 0 37933145 32167993 0 0 27993074 29263356 0 0 0 0 0 1186046 1240408 29179120 30503764 8754025 1664229 50908664 49348914 198082 334480 50710582 49014434 INSURED AND SELF-FUNDED WELFARE BENEFITS FOR UNION MEMBERS AND THEIR DEPENDENTS. 0 0 INSURED AND SELF FUNDED WELFARE BENEFITS FOR APPROXIMATELY 2,022 UNION 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 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 13 0 1 0 0 0 0 0 0 0 0 0 X 6 0 0 1 0 0 0 1 0 1 0 0 0 1 0 0 0 0 0 0 X NED REGAN WILSON MCSHANE CORPORATION 9528540795 3001 METRO DR STE 500 BLOOMINGTON MN 55425 X STEVEN P TONDI CHAIRMAN 1.00 40.00 X X 0 0 0 DAVID ARGUBRIGHT TRUSTEE 1.00 1.50 X 0 0 0 BRUCE WERNING SECRETARY 0.50 40.00 X X 0 0 0 GREG MULHERIN TRUSTEE 1.00 2.00 X 0 0 0 DANIEL AUSSEM TRUSTEE 1.00 6.00 X 0 0 0 JAMES BARK TRUSTEE 1.00 40.00 X 0 0 0 0 0 0 0 0 0 0 WILSON MCSHANE CORPORATION 3001 METRO DRIVE BLOOMINGTON MN 55425 FUND ADMINISTRATOR 820856 BLUELINK TPA 1305 CORPORATE CENTER DRIVE EAGAN MN 55121 MEDICAL CLAIMS NETWORK 602084 THE SEGAL COMPANY 7701 FRANCE AVE S SUITE 225 EDINA MN 55435 ACTUARY AND CONSULTANT 105757 DELTA DENTAL OF IOWA 9000 NORTHPARK DRIVE JOHNSTON IA 50131 DENTAL CLAIMS NETWORK 103771 4 EMPLOYER CONTRIBUTIONS 525100 30072905 30072905 EMPLOYEE CONTRIBUTIONS 525100 1565278 1565278 31638183 1117494 1117494 5472648 6060332 -587684 -587684 -587684 32167993 31638183 0 529810 29263356 815910 37216 68047 150436 105757 32927 2007 28108 30503764 1348304 4040991 114779 66340 3609688 3821347 21039 93474 28759687 23753173 17055167 17573589 50908664 49348914 51053 125827 147029 134107 0 74546 198082 334480 X 50710582 49014434 50710582 49014434 50908664 49348914 X 1664229 -5480051 2119674 X X 0 1 X 1 0 0 LIMITED PARTNERSHIP 5590194 F LIMITED LIABILITY COMPANY 11983395 F 17573589 OVERPAYMENT OF PHARMACY GUARANTEE 74546 74546 X 26537506 -5480051 -5480051 32017557 150436 150436 32167993 30353328 0 30353328 150436 150436 30503764 PART X, LINE 2: THE VEBA TRUST FUNDING BENEFITS OF THE PLAN RECEIVED AN EXEMPTION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS) DATED MAY 20, 2003, 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 PLAN'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 2022 AND 2021 FOR UNRELATED BUSINESS TAXABLE INCOME. IN ADDITION, THE PLAN AND TRUST ARE REQUIRED TO OPERATE IN CONFORMITY WITH THE IRC TO MAINTAIN THE TAX-EXEMPT STATUS OF THE TRUST. THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN 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 (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 674 674 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 59744 59744 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 24726 24726 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 6573 6573 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 1757 1757 0 0 0 93474 FORM 990, PART VI, SECTION A, LINE 3 WILSON-MCSHANE COMPANY WAS DELEGATED CONTROL OVER MANAGEMENT DUTIES AS PLAN ADMINISTRATOR. FORM 990, PART VI, SECTION A, LINE 7A THREE OF THE TRUSTEES ARE DESIGNATED BY THE CHICAGO REGIONAL COUNCIL OF CARPENTERS. THREE OF THE TRUSTEES ARE DESIGNATED BY THE ILLINOIS VALLEY CONTRACTORS ASSOCIATION, ILLOWA MILLWRIGHT CONTRACTORS ASSOCIATION AND THE ASSOCIATED GENERAL CONTRACTORS OF THE QUAD CITIES. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES THAT HAVE BEEN GRANTED AUTHORITY TO ACT ON BEHALF OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON INFORMATION SUPPLIED BY THE ORGANIZATION. A REVIEW OF THE RETURN IS CONDUCTED BY THE ORGANIZATION AND PRESENTED TO THE BOARD OF TRUSTEES PRIOR TO FILING. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE MEMBERS UPON REQUEST. FORM 990 PART XII, LINE 2C THE ORGANIZATION HAS NOT CHANGED THEIR PROCESS FOR THE OVERSIGHT OR THE SELECTION OF THE INDEPENDENT ACCOUNTANT FROM THE PRIOR YEAR. FORM 990, PART XI, LINE 9 ADJUSTMENT FOR TRANSFER IN FROM ANOTHER QUALIFIED PLAN. ON DECEMBER 23, 2022 THE PLAN ENTERED INTO A TRANSFER AGREEMENT WITH THE MILLWRIGHT & TECHNICAL ENGINEER LOCAL 2158 HEALTH & WELFARE FUND (LOCAL 2158 FUND) BOARD OF TRUSTEES TO RECEIVE HEALTH REIMBURSEMENT ACCOUNT (HRA) FUNDS TOTALING $2,119,674. FUNDS WERE RECEIVED BY THE PLAN ON DECEMBER 27, 2022. ILLINOIS VALLEY CONTRACTORS ASSOCIATION 1120 FIRST STREET LASALLE IL 61301 362150421 PROMOTE BETTER RELATIONS BETWEEN LOCAL CONTRACTORS, TRADE UNIONS, CONSTRUCTI IL 501(C)(6) N/A 0 MILLWRIGHT LOCAL UNION 2158 & ILLOWA BUILDING FUND 2707 62ND STREET COURT BETTENDORF IA 52722 421484016 OWNS AND LEASES OFFICE AND TRAINING SCHOOL FACILITIES TO MILLWRIGHT 2158 IA 501(C)(2) N/A 0 UNITED BROTHERHOOD OF CARPENTERS & JOINERS OF AMERICA 12 EAST ERIE STREET CHICAGO IL 60611 361894832 LABOR UNION IL 501(C)(5) N/A 0 QUAD CITY CONSTRUCTION INDUSTRY ADVANCEMENT TRUST 520 - 24TH STREET ROCK ISLAND IL 61201 362652144 PROMOTING, IMPROVING, AND ADVANCING THE CONSTRUCTION INDUSTRY IN QUAD-CITY IL 501(C)(6) N/A 0 LOCAL#790OFFICE PERSON NORTHERN ILLINOIS UNIVE ILLOWA MILLWRIGHTS JATC CRC CARPENTERS APPR & T CITY OF FULTON CARROLL COUNTY TREASURE GOLEY INSULATION OF IND D & H ENERGY MANAGEMENT AIMS MECHANICAL LLC AMEX NOOTER LLC HERITAGE CONSTRUCTION ALL PHASES CONSTRUCTION A M KERNS CONSTRUCTION PRECISION 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