2020-11-05T10:43:24-06:00 2019-12-31 510435869 Needles & Associates LLC 350 Interlocken Blvd STE 360 Broomfield CO 80021 990 2019-01-01 526279969 Mid-South Carpenters Regional Council Health and Welfare Fund MID- 6158590131 PO Box 1449 Goodlettsville TN 37070 Clyde Tyree Trustee 6158590131 2020-11-04 1 Kurt D Needles CPA P00850236 3034304225 2020-11-05 23.24.139.241 2020-11-05 09:38:09 MS P B131DC643218E4936EDB18C0E004AAA77630580D 8194432BB8C053795966120F8A797969BBAE10F5 2019 2021-04-22 16:20:28Z Clyde Tyree PO Box 1449 Goodlettsville TN 37070 29126600 0 X N/A X 1985 TN Provide health and welfare benefits to eligible participants. 11 0 0 0 0 0 0 0 20156140 20896942 765865 -1884176 0 54363 20922005 19067129 0 0 16569694 17178679 0 0 0 0 0 1603768 1722763 18173462 18901442 2748543 165687 31694180 35801345 10679198 11136012 21014982 24665333 Provide health and welfare benefits to eligible participants. 0 0 Provide health and welfare benefits to eligible participants. 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 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 72 0 1 0 0 0 0 0 0 0 0 0 0 0 X 11 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X Board of Trustees 6158590131 2001 Caldwell Drive Goodlettsville TN 37072 X Ray Trawick Trustee 1.00 X 0 0 0 Victor White Trustee 1.00 X 0 0 0 Steve Williams Trustee 1.00 X 0 0 0 Michael Pfieffer Trustee 1.00 X 0 0 0 Clyde Tyree Trustee 1.00 X 0 0 0 Russ Lambert Trustee 1.00 X 0 0 0 Larry Parks Trustee 1.00 X 0 0 0 Timothy Burns Trustee 1.00 X 0 0 0 Lloyd Hicks Trustee 1.00 X 0 0 0 William McCall Trustee 1.00 X 0 0 0 Tom Jenkins Trustee 1.00 X 0 0 0 0 0 0 0 0 0 0 Blue Cross Blue Shield of Tennessee 1 Cameron Hill Circle Chattanooga TN 37402 Administrative 956511 Southern Benefit Administrators 2001 Caldwell Drive Goodlettsville TN 37072 Administrative 439254 2 Employer Contributions 525100 17955056 17955056 Reciprocity (net) 525100 2568227 2568227 Employee Contributions 525100 373659 373659 20896942 1009689 1009689 7165606 10059471 -2893865 -2893865 -2893865 54363 54363 54363 19067129 20951305 0 -1884176 17178679 512100 18032 41350 95762 990865 37481 2663 12059 PCORI fee 10586 1865 18901442 2690033 1567627 1297061 1608160 2739546 2369154 24967540 30256404 31694180 35801345 239009 107430 10440189 11028582 10679198 11136012 X 21014982 24665333 21014982 24665333 31694180 35801345 165687 3484664 0 X 0 1 X 1 0 0 Hour Bank Liability 8912820 Claims Payable - IBNR 2115762 11028582 X 22551793 3484664 3484664 19067129 0 19067129 18313049 0 18313049 588393 588393 18901442 Part X, Line 2: The trust funding benefits of the Plan received an exemption letter from the Internal Revenue Service stating that the trust is tax-exempt under the provision of Section 501(c)9 of the Internal Revenue Code. The Plan and the trust are required to operate in conformity with the Internal Revenue Code to maintain the tax-exempt status of the trust. Plan management believes that the Plan is being operated in compliance with the applicable requirements of the Internal Revenue Code. 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 it has taken an uncertain position that more likely than not would not be sustained upon examination by the Internal Revenue Service. Plan management has evaluated the Plan's tax positions and concluded that the Plan has taken no uncertain tax positions that would require financial statement recognition or disclosure for the years ended December 31, 2019 and 2018. The Plan is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. With few exceptions, the Plan is no longer subject to tax examinations by tax authorities for years preceding December 31, 2015. Part XII, Line 4b - Other Adjustments: Change in Hour Bank Liability 1,637,251. Change in Claims Payable -1,048,858. Form 990, Part VI, Section B, line 11b Form 990 was provided to the Trustees for their review prior to filing. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy during board of trustee meetings. Form 990, Part VI, Section C, line 18 The Form 990 is available for public inspection upon request. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents available upon request. Contact fund adminstrator for information needed for Sch R Part II N/A NA TN 37214 000000000 N/A TN 0 Contact fund administrator for information needed for Sch R Part III & IV N/A NA TN 37214 000000000 N/A TN 0 0 Contact fund administrator for information needed for Sch R Part III & IV N/A NA TN 37072 000000000 N/A TN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0