2020-11-05T13:22:27-06:00 2019-12-31 320043599 LEGACY PROFESSIONALS LLP 4 WESTBROOK CORPORATE CTR 700 WESTCHESTER IL 60154 990 2019-01-01 350851694 ELECTRICAL WORKERS BENEFIT TRUST FUND ELEC 3179234577 1828 N MERIDIAN ST NO 103 INDIANAPOLIS IN 46202 DAVID RAY PLAN ADMINISTRATOR 3179234577 2020-11-05 1 ADAM SIMAGA P01649025 3123680500 2020-11-04 12.235.239.120 2020-11-05 13:22:22 CS P 904E9CDA588F20E710ED2700B2ADC35F22F92C31 013BD4BEA457AB31DE8385915B9401809CC4B7ED 2019 2021-04-22 16:20:28Z DAVID RAY 1828 N MERIDIAN ST NO 103 INDIANAPOLIS IN 46202 77388935 0 X N/A X 1949 IN PROVIDE HEALTH BENEFITS 6 4 80 0 0 0 0 0 28307029 37912416 3356474 3784426 0 0 31663503 41696842 0 0 37286541 34997853 546160 642105 0 0 0 2819479 689772 40652180 36329730 -8988677 5367112 105303565 125996485 350689 538610 104952876 125457875 PROVIDE HEALTH BENEFITS 0 0 TO PROVIDE HEALTH AND WELFARE, LONG-TERM DISABILITY AND DEATH BENEFIT TO MEMBERS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 1 0 0 0 0 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 1 395 0 1 80 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 4 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 1 0 0 0 IN X DAVID RAY - PLAN ADMINISTRATOR 3179234577 1828 NORTH MERIDIAN STREET STE 103 INDIANAPOLIS IN 46202 X JEFF WHEELER TRUSTEE 1.00 48.00 X 0 98231 53910 KEVIN SCHRADER TRUSTEE 1.00 1.00 X 0 0 0 STEVE MENSER TRUSTEE 1.00 48.00 X 0 103348 55567 JON HOOKER ALTERNATE TRUSTEE 1.00 48.00 X 0 98231 53910 JIM TSAREFF TRUSTEE 1.00 1.00 X 0 0 0 TIM WHICKER TRUSTEE 1.00 1.00 X 0 0 0 TED UPPOLE TRUSTEE 1.00 1.00 X 0 0 0 LARRY VAN TRIES ALTERNATE TRUSTEE 1.00 1.00 X 0 0 0 DAVID RAY PLAN ADMINISTRATOR 16.00 24.00 X 117792 0 58644 117792 299810 222031 1 0 1 0 ANTHEM INSURANCE COMPANIES INC 3075 VANDERCAR WAY CINCINNATI OH 45209 PPO NETWORK PROVIDER 1148456 UNITED HEALTHCARE INSURANCE COMPANY 4316 RICE LAKE ROAD DULUTH MN 55811 HEALTH PROVIDER 763230 ULLICO 8403 COLESVILLE ROAD SILVER SPRING MD 20901 STOP LOSS PROVIDER 199851 3 EMPLOYER CONTRIBUTIONS 900099 33010965 33010965 PARTICIPANT CONTRIBUTIONS 900099 3352934 3352934 PRESCRIPTION REBATES 900099 1210148 1210148 STOP LOSS REFUNDS 900099 266746 266746 SUBROGATION RECOVERIES 900099 60151 60151 11472 11472 37912416 2802593 2802593 36673926 35692093 981833 981833 981833 41696842 37912416 0 3784426 34997853 53931 327667 117820 116206 26481 88723 35429 217991 77457 128704 28270 28793 1222 23954 24594 9583 PCORI FEES 25052 36329730 4696331 389811 1630990 2815153 4265174 68721 277665 111106 29249 166559 102000631 115237431 105303565 125996485 283004 252322 67685 286288 350689 538610 X 0 0 0 0 104952876 125457875 104952876 125457875 105303565 125996485 5367112 15137887 0 X X 0 1 X 1 0 261382 104593 156789 16283 6513 9770 166559 X 56616738 15137887 15137887 41478851 217991 217991 41696842 36111739 0 36111739 217991 217991 36329730 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN, 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 TAX AUTHORITIES. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. X 0 0 0 JEFF WHEELER TRUSTEE 0 97469 0 0 0 762 0 33755 0 20155 0 152141 0 0 STEVE MENSER TRUSTEE 0 102586 0 0 0 762 0 35412 0 20155 0 158915 0 0 JON HOOKER ALTERNATE TRUSTEE 0 97469 0 0 0 762 0 33755 0 20155 0 152141 0 0 DAVID RAY PLAN ADMINISTRATOR 117792 0 0 0 0 0 37435 0 21209 0 176436 0 0 0 FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF FORM 990 IS PROVIDED TO THE ORGANIZATION'S ENTIRE GOVERNING BODY FOR ITS REVIEW AND APPROVAL BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES ARE REQUIRED TO DISCLOSE TO THE PLAN ADMINISTRATOR THEIR INTERESTS WHICH MAY GIVE RISE TO CONFLICTS OF INTERESTS OR THE APPEARANCE OF CONFLICT OF INTEREST ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1A THE PLAN ADMINISTRATOR ALSO PROVIDES SERVICES TO OTHER FUNDS AFFILIATED WITH THE REPORTING ORGANIZATION. THE REPORTING ORGRANIZATION IS REIMBURSED BY THE AFFILIATED FUNDS FOR THEIR SHARE OF THESE SALARIES AND RELATED EXPENSES. THE AVERAGE HOURS REPORTED ON LINE 1A IS THE WEEKLY HOURS DEDICATED TO THE REPORTING ORGANIZATION. THE TOTAL COMPENSATION RECEIVED ON LINE 1A IS THE TOTAL COMPENSATION PAID TO THE PLAN ADMINISTRATOR AND REPORTED ON FORM W-2 REPORTED BY THE REPORTING ORGANIZATION. FORM 990, PART V, LINE 2A THE NUMBER OF EMPLOYEES REPORTED ON FORM W-3, TRANSMITTAL OF WAGE AND TAX STATEMENTS, FILED FOR THE CALENDAR YEAR ENDING WITH OR WITHIN THE YEAR COVERED BY THIS RETURN INCLUDES BOTH EMPLOYEES OF THE OFFICE AND PARTICIPANTS OF THE FUND THAT HAVE RECEIVED DISABILITY PAYMENTS DURING THE YEAR. IBEW 481 SUPPLEMENTAL UNEMPLOYMENT BENEFIT PLAN 1828 N MERIDIAN STREET INDIANAPOLIS IN 46202 474203459 PROVIDES SUPPLEMENTAL UNEMPLOYMENT BENEEFITS TO PARTICIPANTS IN 501(C)(9) 0 INDIANA ELECTRICAL WORKERS PENSION TRUST FUND 1828 N MERIDIAN STREET INDIANAPOLIS IN 46202 351102579 PROVIDES PENSION BENEFITS TO PARTICIPANTS IN 401A 0 IBEW LOCAL UNION 481 DEFINED CONTRIBUTION PLAN AND TRUST 1828 N MERIDIAN STREET INDIANAPOLIS IN 46202 351501496 PROVIDES PENSION BENEFITS TO PARTICIPANTS IN 401A 0 IBEW LOCAL UNION 481 1828 N MERIDIAN STREET INDIANAPOLIS IN 46202 350289840 LABOR UNION IN 501(C)(5) 0 INDIANAPOLIS ELECTRICAL JATC 1751 S LAWNDALE AVENUE INDIANAPOLIS IN 46241 351004324 TRAINING FUND IN 501(C)(3) LINE 2 0 INDIANA PLAN FOR EQUAL EMPLOYMENT 2122 DR MARTIN LUTHER KING ST INDIANAPOLIS IN 46202 CONTRIBUTING EMPLOYER IN 501(C)(3) 0 SHAMBAUGH & SON LP CONTRIBUTING EMPLOYER 0 0 ACKER ELECTRIC CONTRIBUTING EMPLOYER 0 ALPHA ELECTRIC INC CONTRIBUTING EMPLOYER 0 ALPHA OMEGA ELECTRIC LLC CONTRIBUTING EMPLOYER 0 APPLE ELECTRIC CONTRIBUTING EMPLOYER 0 AREA WIDE ELECTRIC INC CONTRIBUTING EMPLOYER 0 ATEC ELECTRICAL CONTRACTORS CONTRIBUTING EMPLOYER 0 BANTA ELECTRICAL CONTRACTORS CONTRIBUTING EMPLOYER 0 BARTH ELECTRIC CO CONTRIBUTING EMPLOYER 0 BMWC CONSTRUCTORS INC CONTRIBUTING EMPLOYER 0 BOTT ELECTRIC INC CONTRIBUTING EMPLOYER 0 CACHE VALLEY ELECTRIC CO CONTRIBUTING EMPLOYER 0 CARLIN ELECTRIC LLC CONTRIBUTING EMPLOYER 0 CENTRAL IN BUILDING & CONSTR CONTRIBUTING EMPLOYER 0 COMPLETE CONSTRUCTION SERVICES CONTRIBUTING EMPLOYER 0 COMPLETE ELECTRICAL & COMMUN CONTRIBUTING EMPLOYER 0 CONNECT ELECTRIC INC CONTRIBUTING EMPLOYER 0 DAVE O'MARA CONTRACTOR INC CONTRIBUTING EMPLOYER 0 DEBRA-KUEMPEL CONTRIBUTING EMPLOYER 0 ELECTRIC PLUS INC CONTRIBUTING EMPLOYER 0 ELECTRICAL MAINTENANCE & TESTI CONTRIBUTING EMPLOYER 0 ELECTRICAL MAINTENANCE SPECIAL CONTRIBUTING EMPLOYER 0 ELECTRICAL SPECIALISTS LLC CONTRIBUTING EMPLOYER 0 ELITE ELECTRICAL SERVICES LLC CONTRIBUTING EMPLOYER 0 ELLISON ELECTRIC INC CONTRIBUTING EMPLOYER 0 ERMCO INC CONTRIBUTING EMPLOYER 0 ESI ELECTRIC INC CONTRIBUTING EMPLOYER 0 FAIRCHILD COMMUNICATION SYS CONTRIBUTING EMPLOYER 0 FERRILL FISHER LLC CONTRIBUTING EMPLOYER 0 GENESIS FACTOR LLC CONTRIBUTING EMPLOYER 0 HIGH VOLTAGE MAINTENANCE CORP CONTRIBUTING EMPLOYER 0 HILLIARD ELECTRIC LLC CONTRIBUTING EMPLOYER 0 HOOSIER INDUSTRIAL ELECTRIC CONTRIBUTING EMPLOYER 0 HUSTON ELECTRIC INC CONTRIBUTING EMPLOYER 0 INDUSTRIAL ELECTRIC INC CONTRIBUTING EMPLOYER 0 J & J ELECTRIC OF INDIANA INC CONTRIBUTING EMPLOYER 0 JAMES H DREW CORPORATION CONTRIBUTING EMPLOYER 0 KK HALL INC CONTRIBUTING EMPLOYER 0 KOCHS ELECTRIC INC CONTRIBUTING EMPLOYER 0 KW CONSTRUCTION SERVICES LLC CONTRIBUTING EMPLOYER 0 LEYDEN ELECTRIC INC CONTRIBUTING EMPLOYER 0 LIVE WIRE CONSULTING INC CONTRIBUTING EMPLOYER 0 LOGICAL LIGHTING AND CONTROLS CONTRIBUTING EMPLOYER 0 LONG ELECTRIC CO INC CONTRIBUTING EMPLOYER 0 MADDOX ELECTRIC COMPANY INC CONTRIBUTING EMPLOYER 0 MAJESTIC ELECTRIC INC CONTRIBUTING EMPLOYER 0 MARSHALL ELECTRICAL CONTRACTIN CONTRIBUTING EMPLOYER 0 MAVERICK COMMUNICATIONS CONTRIBUTING EMPLOYER 0 MIDWESTERN ELECTRIC INC CONTRIBUTING EMPLOYER 0 MILLER-EADS COMPANY INC CONTRIBUTING EMPLOYER 0 MJ ELECTRIC LLC CONTRIBUTING EMPLOYER 0 NEWKIRK ELECTRIC ASSOCIATES I CONTRIBUTING EMPLOYER 0 NRK INC CONTRIBUTING EMPLOYER 0 NUGENT ELECTRIC INC CONTRIBUTING EMPLOYER 0 OWENS ELECTRICAL GROUP LLC CONTRIBUTING EMPLOYER 0 PAYNE ELECTRIC COMPANY CONTRIBUTING EMPLOYER 0 PULSE ELECTRIC LLC CONTRIBUTING EMPLOYER 0 QUALITY CONTROLS & ELECTRICAL CONTRIBUTING EMPLOYER 0 R & M ELECTRIC INC CONTRIBUTING EMPLOYER 0 RED HAWK CONTRIBUTING EMPLOYER 0 RIVERSIDE ELECTRIC INC CONTRIBUTING EMPLOYER 0 SERVICE ELECTRIC OF ALLEN CONTRIBUTING EMPLOYER 0 SEXSON MECHANICAL CORPORATION CONTRIBUTING EMPLOYER 0 SOLAR ELECTRIC TURBINE CO LLC CONTRIBUTING EMPLOYER 0 STALEY SIGNS INC CONTRIBUTING EMPLOYER 0 STELKO ELECTRIC INC CONTRIBUTING EMPLOYER 0 STORMS-MCMULLEN ELECTRIC INC CONTRIBUTING EMPLOYER 0 SUMMIT ELECTRICAL COMPANY LLC CONTRIBUTING EMPLOYER 0 SUN ELECTRIC INC CONTRIBUTING EMPLOYER 0 SUPERIOR ELECTRIC LLC CONTRIBUTING EMPLOYER 0 SWAN ELECTRICAL SYSTEMS LLC CONTRIBUTING EMPLOYER 0 SYCAMORE ENGINEERING INC CONTRIBUTING EMPLOYER 0 TC ELECTRIC CONTRIBUTING EMPLOYER 0 TECH ELECTRONICS OF INDIANA CONTRIBUTING EMPLOYER 0 THE HOOSIER COMPANY INC CONTRIBUTING EMPLOYER 0 THE STATE GROUP INDUSTRIAL CONTRIBUTING EMPLOYER 0 THOMPSON ELECTRONICS COMPANY CONTRIBUTING EMPLOYER 0 TOTAL ELECTRICAL SYSTEMS TESTI CONTRIBUTING EMPLOYER 0 WEB CONNECTIVITY LLC CONTRIBUTING EMPLOYER 0 WEST ELECTRIC INC CONTRIBUTING EMPLOYER 0 WHALEN ELECTRIC CONTRIBUTING EMPLOYER 0 XL INDUSTRIAL SERVICES INC CONTRIBUTING EMPLOYER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1