2021-07-12T14:54:36-05:00 2020-08-31 363168081 SIKICH LLP 13400 BISHOPS LANE SUITE 300 BROOKFIELD WI 53005 990 2019-09-01 237422786 WISCONSIN MASONS' HEALTH CARE FUND WISC 8003625474 2901 W BELTLINE HIGHWAY NO 100 MADISON WI 537134226 DAVID HAHN CHAIRMAN 8003625474 2021-07-08 1 JAMES B BOUTELLE CPA P01794129 2627549400 2021-07-06 2019 2022-09-23 18:48:47Z DAVID HAHN 2901 W BELTLINE HIGHWAY NO 100 MADISON WI 537134226 35697037 0 X N/A X 1973 WI TO PROVIDE HEALTH, LIFE, DENTAL, AND TEMPORARY DISABILITY BENEFITS TO ELIGIBLE PARTICIPANTS, SPOUSES, AND DEPENDENTS. 17 11 59 11 0 0 0 0 26594353 26002011 848303 659976 479614 185478 27922270 26847465 0 0 20606025 17092670 0 0 0 0 0 3669981 3896976 24276006 20989646 3646264 5857819 22522832 28387794 12551578 11789519 9971254 16598275 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 17 0 1 59 1 0 0 0 0 0 0 0 0 X 17 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 0 90439 67983 WYNN JONES TRUSTEE 1.00 X 0 89308 67190 TOBIN BOYLE TRUSTEE 1.00 35.00 X 0 86939 68936 WILLIAM BONLENDER TRUSTEE 1.00 35.00 X 0 88155 67590 MIKE HYATT TRUSTEE 1.00 35.00 X 0 89700 65497 FELIX RAMIREZ TRUSTEE 1.00 42.00 X 0 80574 72240 GARY BURNS THRU OCT 1ST PAST TRUSTEE 1.00 35.00 X 0 80091 63492 DAVID HAHN 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 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 TRUSTEE 1.00 X 0 0 0 LARRY RASCH TRUSTEE 1.00 X 0 0 0 JASON MATTILA TRUSTEE 1.00 X 0 0 0 JOHN TOPP TRUSTEE 1.00 X 0 0 0 RANDY WEYTENS THRU DEC 20TH PAST TRUSTEE 1.00 X 0 0 0 0 605206 472928 0 0 1 0 BENEFIT PLAN ADMINISTRATION 2901 WEST BELTLINE HIGHWAY SUITE 1 MADISON WI 53713 CONTRACT ADMINISTRATION 1008438 UNITED HEALTHCARE INSURANCE COMPANY PO BOX 88822 MILWAUKEE WI 53228 CLAIMS / PPO EXPENSE 628855 MERCER HEALTH & BENEFITS LLC 155 NORTH WACKER DRIVE STE 1500 CHICAGO IL 60606 CONSULTING 232910 US BANK NATIONAL ASSOCIATION PO BOX 1800 SAINT PAUL MN 55101 BANKING / INVESTMENTS 112653 4 EMPLOYER CONTRIBUTIONS 900099 23261176 23261176 SELF PAY CONTRIBUTIONS 900099 2740835 2740835 26002011 376593 376593 9132955 8849572 283383 283383 283383 SUBROGATION 900099 183960 183960 MISCELLANEOUS 900099 1518 1518 185478 26847465 26187489 0 659976 X 17092670 879781 107855 43685 323896 128107 27212 17162 9281 HRA REIMBURSEMENTS 844429 PPO SERVICE ADMIN FEES 802566 CHANGE IN MEMBER DOLLAR 443269 STOP-LOSS PREMIUMS 168731 101002 20989646 505 21478 4074366 9826925 4095960 3118307 159384 162098 14192617 15258986 22522832 28387794 257011 233581 26497 26497 12268070 11529441 12551578 11789519 X 0 0 0 0 9971254 16598275 9971254 16598275 22522832 28387794 5857819 769202 0 X 0 1 X 1 0 0 CLAIMS PAYABLE 1691084 MEMBER DOLLAR BANK 2771879 HRA LIABILITY 7066478 11529441 X 27572982 769202 769202 26803780 43685 43685 26847465 22127859 1181898 1181898 20945961 43685 43685 20989646 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. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES 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. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS AND WAS BEING AUDITED BY THE DEPARTMENT OF LABOR ("DOL") AND THE CASE WAS CLOSED IN SEPTEMBER 2019. PART XII, LINE 2D - OTHER ADJUSTMENTS: INCREASE IN BENEFIT OBLIGATIONS PAYABLE 1,181,898. 0 0 0 JIM VICK TRUSTEE 0 90439 0 0 0 0 0 48483 0 19500 0 158422 0 0 WYNN JONES TRUSTEE 0 89308 0 0 0 0 0 47690 0 19500 0 156498 0 0 TOBIN BOYLE TRUSTEE 0 86939 0 0 0 0 0 49436 0 19500 0 155875 0 0 WILLIAM BONLENDER TRUSTEE 0 88155 0 0 0 0 0 48090 0 19500 0 155745 0 0 MIKE HYATT TRUSTEE 0 89700 0 0 0 0 0 46912 0 18585 0 155197 0 0 FELIX RAMIREZ TRUSTEE 0 80574 0 0 0 0 0 65732 0 6508 0 152814 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. FORM 990, PART IX, LINE 24E BIOMETRIC AND WELLNESS EXPENSE 67,826. STORAGE AND UNCLASSIFIED 15,849. EDUCATIONAL PROGRAM EXPENSES 10,080. GOVERNMENTAL FEES AND ASSESSMENTS 7,247. OPERATIVE PLASTERERS & CEMENT MASONS LOCAL 599 8701 N LAUER STREET MILWAUKEE WI 53224 391960564 LABOR UNION WI 501(C)(5) 0 BAC DISTRICT COUNCIL PO BOX 510617 NEW BERLIN WI 53151 391590426 LABOR UNION WI 501(C)(5) 0 MILWAUKEE AREA BRICKLAYERS APPRENTICESHIP TRAINING FUND 17125 W CLEVELAND AVENUE NEW BERLIN WI 531510741 391333915 APPRENTICESHIP TRAINING WI 501(C)(3) 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 LLOYD HAMM MASONRY HANSON MASONRY & CONCRETE MAVID CONSTRUCTION SERVICE LLC WALLY KING MASONRY LLC AW OAKES & SON AGC OF GREATER MILWAUKEE APPLETON LATHING CORP ARNIE MACKEY CONSTRUCTION ARTEAGA CONSTRUCTION INC AUGELLI CONCRETE & EXCAVATING BANE NELSON BENEFIT PLAN ADMINISTRATOR OF WI BOLDT OSCAR CONSTRUCTION CO BORTH-WILSON INC BUKACEK CONSTRUCTION INC CG SCHMIDT INC C&S CONSTRUCTION INC CAMOSY INC CAPELLE BROTHERS & DIEDRICH INC CARDINAL CONSTRUCTION CASTELLAN TILE & TERRAZZO INC CATTELL RAYMOND INC CAULKING PLUS INC CLASSIC MARBLE & GRANITE CM MORRIS GROUP INC CONCRETE MASONRY INC CORNERSTONE CONSTRUCTION CORNERSTONE PAVERS LLC CROWLEY MASONRY INC JP CULLEN & SONS INC D&M MASONRY LLC DAROLD BERGER MASONRY DICKOW & CYZAK TILE DOYLE CONTRACTORS INC EDGAR PRAGER & SONS FABCON INC FINDORFF & SON INC FIVE STAR MASONRY LLC FOWLER & HAMMER INC FOX VALLEY & CONSTRUCTION G&W PLASTERING INC GAGNON INC GEGARE TILE INC HARBOR CITY MASONRY INC 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 JH HASSINGER INC JW SCHULTZ CONSTRUCTION INC JAC MASONRY INC JOHNSON TERRAZZO COMPANY JUROWSKI RJ CONSTRUCTION INC KMI CONSTRUCTION LLC KOTZE CONSTRUCTION COMPANY INC KRAEMER EDWARD LEWIS CONSTRUCTION INC LUNDA CONSTRUCTION MA MORTENSON CO MAAS BROS CONSTRUCTION COMPANY MACCO'S COMMERCIAL INTERIORS MARKET & JOHNSON INC MEGAL CONSTRUCTION COMPANY MEYER CR & SONS CO MICHELS CORPORATIONS MIDDLETON CONSTRUCTION INC MIRON CONSTRUCTION COMPANY INC MORTL RESTORATIONT NATIONAL MACHINERY PARISI CONSTRUCTION COMPANY PLATT CONSTRUCTION COMPANY POELLINGERS INC PUKALL COMPANY INC QUASIUS CONSTRUCTION INC RASCH CONSTRUCTION & ENGINE REFRACTORY SERVICE INC RESCH'S TILE INC RICE IVAN & SONS RILEY CONSTRUCTION INC 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 SOMMERS CONSTRUCTION COMPANY INC SPANCRETE INC SPEEDWAY SAND & GRAVEL STEBBIBS ENGINEERING COMPANY STRETAR MASONRY & CONCRETE STRUCTURAL APPLICATORS INC KENNETH F SULLIVAN INC SUPERIOR MASONRY BUILDERS THOMAS A MASON COMPANY INC TRI NORTH BUILDERS INC TRIERWEILER CONSTRUCTION VINTON CONSTRUCTION COMPANY VOGEL BROTHERS BUILDING COMPANY VONASEK & SCHIEFFER INC WALSH MASONRY INC WINKLER MASONRY INC WISCONSIN TERRAZZO TILE INC ZEISE FRANK CONSTRUCTION INC ZENITH TECH API INC BERHAMMER CORP LIPPERT TILE CO INC ROSSI CONSTRUCTION MARTELL CONSTRUCTION J&A POHL INC AECOM ENERGY & CONSTRUCTION INC BEDROCK FLINT INC EXECUTIVE PLASTERING CO GEORGE SIEGFRIED CONSTRUCTION CO HAROLD ARDNT HEIMBROCK 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 ON FILE AT THE PLAN OFFICE.