2019-11-11T11:24:32-06:00 2018-12-31 320043599 LEGACY PROFESSIONALS LLP 6800 FRANCE AVENUE SO SUITE 550 EDINA MN 55435 990 2018-01-01 456038633 DAKOTAS & WESTERN MN ELECTRICAL INDUSTRY HEALTH AND WELFARE FUND DAKO 7012374787 C/O NBPA PO BOX 1951 FARGO ND 58107 KORY RAWSTERN TRUSTEE 7012374787 2019-11-11 1 ERIC C BAERTSCH P00964071 9528413950 12.235.239.120 2019-11-11 10:52:48 CS P B13581F61A0FF7645CF32AFAB75FFCD9ED450A2E E2C35A8318D24212DDF67D3AF46D54948B54095C 2018 2020-03-31 21:24:44Z KORY RAWSTERN C/O NBPA PO BOX 1951 FARGO ND 58107 58702260 0 X N/A X 1966 ND TO PROVIDE HEALTH AND WELFARE BENEFITS 18 3 117 0 0 0 0 0 36973588 38329418 1665397 1879983 0 288 38638985 40209689 0 0 38740059 42106694 0 0 0 0 0 1109529 1102913 39849588 43209607 -1210603 -2999918 76342715 70933956 365540 753561 75977175 70180395 PAYMENT OF HEALTH CARE BENEFITS FOR ELIGIBLE PARTICIPANTS AND DEPENDENTS AS PROVIDED BY THE PLAN DOCUMENT. 0 0 THE PLAN PROVIDES HEALTH CARE AND PRESCRIPTION DRUG, DEATH BENEFITS, ACCIDENTAL DEATH AND DISMEMBERMENT, AND DISABILITY BENEFITS FOR ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS OR BENEFICIARIES. 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 25 0 1 117 1 0 0 0 0 0 0 0 0 0 0 X 18 3 0 1 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X NORIDIAN MUTUAL INSURANCE COMPANY 7012374787 C/O NBPA PO BOX 1951 FARGO ND 58107 KORY RAWSTERN TRUSTEE 1.00 40.00 X 0 97003 25672 RANDY BARTSCH TRUSTEE 1.00 40.00 X 0 124260 21544 RANDY STAINBROOK CHAIRMAN 1.00 55.00 X 0 92664 22724 JEREMY DENAULT TRUSTEE 1.00 40.00 X 0 110664 19656 CHRIS CALLIHAN TRUSTEE 1.00 48.00 X 0 70821 22074 DON BRUEMMER TRUSTEE 1.00 40.00 X 0 85456 11847 JOHN WEYER TRUSTEE 1.00 40.00 X 0 91826 15776 CHRIS BAKER TRUSTEE 1.00 50.00 X 0 78720 13640 RYAN O'LEARY TRUSTEE - PAST 1.00 40.00 X 0 42069 7412 CLYDE WETSCH TRUSTEE 1.00 X 0 0 0 BRIAN SPADER TRUSTEE 1.00 X 0 0 0 KEN KLEVER TRUSTEE 1.00 X 0 0 0 EDWARD CHRISTIAN SECRETARY 1.00 40.00 X 0 152500 18370 ALLAN HALE TRUSTEE 1.00 X 0 0 0 DUANE HAERTLING TRUSTEE 1.00 X 0 0 0 TOM KECK TRUSTEE 1.00 X 0 0 0 ANGELA BOWERSOX TRUSTEE 1.00 X 0 0 0 JILL CLARK TRUSTEE 1.00 X 0 0 0 JASON BOWMAN TRUSTEE 1.00 40.00 X 0 96346 12737 0 1042329 191452 0 0 1 0 NORIDIAN MUTUAL INSURANCE COMPANY 2000 44TH ST SUITE 104 FARGO ND 58103 PLAN ADMINISTRATION AND CLAIMS PROCESSIN 2630446 OPTUMRX DEPT NO 8765 LOS ANGELES CA 90088 CLAIMS PROCESSING FEES 127467 KUTAK ROCK LLP 60 SOUTH 6TH ST STE 3400 MINNEAPOLIS MN 55402 LEGAL FEES 112040 3 EMPLOYER CONTRIBUTIONS 900099 33585953 33585953 PARTICIPANT CONTRIBUTIONS 900099 2763826 2763826 PRESCRIPTION DRUG REBATES 900099 1956488 1956488 SUBROGATION SETTLEMENTS 900099 20000 20000 LIQUIDATED DAMAGES 900099 3151 3151 38329418 1996501 1996501 18376053 18492571 -116518 -116518 -116518 OTHER INCOME 900099 288 288 288 40209689 38329418 0 1880271 42106694 554357 112040 22745 99052 141206 88752 53497 12835 PCORI FEE 18429 43209607 -675435 -309096 3498694 2640472 4251589 4829094 107737 69267867 63665749 76342715 70933956 215678 229264 149862 199297 0 325000 365540 753561 X 0 0 0 0 75977175 70180395 75977175 70180395 76342715 70933956 -2999918 -2796862 0 X 0 1 X 1 0 0 DUE TO BROKER 325000 325000 X 37313775 -2796862 -2796862 40110637 99052 99052 40209689 43110555 0 43110555 99052 99052 43209607 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE PLAN TO EVALUATE TAX POSITIONS TAKEN AND RECOGNIZE A TAX LIABILITY IF THE PLAN HAS TAKEN AN UNCERTAIN TAX 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. 0 0 0 EDWARD CHRISTIAN SECRETARY 0 152500 0 0 0 0 0 9100 0 9270 0 170870 0 0 FORM 990, PART VI, SECTION A, LINE 3 ALTHOUGH THE TRUSTEES RETAIN THE ULTIMATE RESPONSIBILITY, THE TRUSTEES HAVE DELEGATED THE DAY TO DAY ADMINISTRATIVE DUTIES TO NORIDIAN MUTUAL INSURANCE COMPANY AS THE THIRD PARTY ADMINISTRATOR OF THE FUND. FORM 990, PART VI, SECTION A, LINE 7A NINE TRUSTEES ARE APPOINTED BY THE UNIONS AND NINE TRUSTEES ARE APPOINTED BY THE EMPLOYER CONTRACTORS ASSOCIATIONS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PROVIDED TO AND REVIEWED BY THE ENTIRE BOARD OF TRUSTEES PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE TRUSTEES REVIEW THE PLAN'S CONFLICT OF INTEREST POLICY ANNUALLY WITH THE PLAN ATTORNEY AND ARE REQUIRED TO SIGN AN ANNUAL CERTIFICATION OF COMPLIANCE WITH THE POLICY. IN ADDITION, TO ENSURE THE PLAN OPERATES IN A MANNER CONSISTENT WITH ITS PURPOSES AND DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS LAWFUL STATUS AND FIDUCIARY OBLIGATIONS, PERIODIC REVIEWS OF COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ARE CONDUCTED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST AT THE PLAN'S OFFICE. 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