2019-11-14T16:20:01-06:00 2018-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2018-01-01 416023461 MINNESOTA & NORTH DAKOTA BRICKLAYERS & ALLIED CRAFTWORKERS HEALTH FUND MINN 6512561801 2520 PILOT KNOB ROAD NO 325 MENDOTA HEIGHTS MN 55120 DOUGLAS SCHROEDER CHAIRMAN 6512561801 2019-11-14 1 DOUG BERTOSSI P00637990 6123764500 67.137.57.251 2019-11-14 12:09:59 CS P 06C6282D018575128FE0891D0F3A4E057D2D2323 0E88769D924135FAE6C91FF1C181B25E4DDFCADD 2018 2020-03-31 21:24:44Z DOUGLAS SCHROEDER 2520 PILOT KNOB ROAD NO 325 MENDOTA HEIGHTS MN 55120 76464233 0 X N/A X 1961 MN PROVIDE HEALTH & WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 8 1 26 8 0 0 0 0 23694817 23800862 4921912 5972107 0 0 28616729 29772969 0 0 19914891 21889127 0 0 0 0 0 1238952 1371123 21153843 23260250 7462886 6512719 76272682 74484003 130846 81433 76141836 74402570 PROVIDE HEALTH AND WELFARE BENEFITS TO UNION MEMBERS AND THEIR DEPENDENTS. 0 0 PAYMENT OF HOSPITAL, MEDICAL, DENTAL, DISABILITY, DEATH, AND VISION BENEFITS FOR 2,353 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 4 0 26 1 0 0 0 0 0 0 0 0 X 8 1 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 0 1 0 0 0 X ZENITH AMERICAN SOLUTIONS 6512561900 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 X X DOUGLAS SCHROEDER SEE SCHEDULE O 1.00 45.00 X X 0 0 0 PAUL WIESE MANAGEMENT TRUSTEE - SECRE 1.00 41.00 X X 0 0 0 DARRIN DROSKY MANAGEMENT - ALTERNATE TRU 1.00 42.00 X 0 0 0 MICHAEL GANZ SEE SCHEDULE O 1.00 44.00 X 0 0 0 FRANK GRAZZINI II MANAGEMENT TRUSTEE 1.00 41.00 X 0 0 0 MONICA KELLEY MANAGEMENT TRUSTEE 1.00 41.00 X 0 0 0 MICHAEL LAPENSKY MANAGEMENT - ALTERNATE TRU 1.00 42.00 X 0 0 0 STAN PACZYNSKI SEE SCHEDULE O 1.00 41.00 X 0 0 0 RON RASLEY MANAGEMENT TRUSTEE 1.00 41.00 X 0 0 0 TERRY WONG SEE SCHEDULE O 1.00 48.00 X 0 0 0 REBECCA NOHAVA UNION TRUSTEE - ALTERNATE 1.00 40.00 X 0 0 0 0 0 0 0 0 0 0 HEALTH PARTNERS 8170 33RD AVE S BLOOMINGTON MN 55425 PPO 1071783 ZENITH AMERICAN SOLUTIONS 2520 PILOT KNOB ROAD 325 MENDOTA HEIGHTS MN 55120 PLAN ADMINISTRATOR 760522 LOSGS 100 SOUTH FIFTH STREET SUITE 2500 MINNEAPOLIS MN 554021234 LEGAL 155615 MILLIMAN ONE PENNSYLVANIA PLAZA 38TH FLOOR NEW YORK NY 10119 ACTUARY 135644 4 CONTRIBUTIONS 525100 23800862 23800862 23800862 2137859 2137859 50525512 46691264 3834248 3834248 3834248 29772969 0 0 29772969 21889127 790927 155615 19750 146368 135644 90515 3620 21153 TRANSITIONAL REINSURANC 7531 23260250 2084073 3047300 7138681 8096749 2038637 1974031 13363 5969 3011 97746 58891445 53125639 5890247 7513904 213225 622665 76272682 74484003 108295 70793 22551 10640 130846 81433 X 0 0 0 0 76141836 74402570 76141836 74402570 76272682 74484003 6512719 -8251985 0 X 0 1 X 1 0 0 LIMITED PARTNERSHIPS 7513904 F 7513904 ADVANCE CONTRIBUTIONS FROM EMPLOYEES FOR FUTURE COVERAGE 10640 10640 X 21374616 -8251985 -8251985 29626601 146368 146368 29772969 23113882 0 23113882 146368 146368 23260250 PART X, LINE 2: THE VEBA TRUST FUNDING BENEFITS OF THE PLAN RECEIVED AN EXEMPTION LETTER FROM THE INTERNAL REVENUE SERVICES (IRS) DATED FEBRUARY 27, 1963, 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 2018 OR 2017 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. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. JOHNSON CARPET CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 1431 1431 0 0 0 MOSAICA LLC CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 3785 3785 0 0 0 SEBCO CONTRIBUTING EMPLOYER LATE CONTRIBUTIONS X 753 753 0 0 0 5969 FORM 990, PART VI, SECTION A, LINE 7A THE BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION 1 MINNESOTA/NORTH DAKOTA AND THE ASSOCIATED GENERAL CONTRACTORS OF MINNESOTA EACH APPOINT 50% OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BOARD. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 WAS REVIEWED BY THE BOARD OF TRUSTEES IN CONJUNCTION WITH THE REVIEW OF THE ANNUAL AUDIT. FORM 990, PART VI, SECTION B, LINE 12C THE POLICY IS DISCUSSED ANNUALLY BY THE BOARD OF TRUSTEES TO ENSURE THE TRUSTEES UNDERSTAND THE CONFLICT OF INTEREST POLICY AND UNDERSTANDS THE FUND IS A TAX-EXEMPT ORGANIZATION THAT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. PER THE POLICY, ANY PERSON DISCOVERING A CONFLICT SHOULD DISCLOSE IT IMMEDIATELY TO THE CHAIRMAN OF THE BOARD OF TRUSTEES. THE BOARD OF TRUSTEES DETERMINES IF A CONFLICT EXISTS AND MAY PLACE APPROPRIATE RESTRICTIONS ON THE INDIVIDUAL OR TRANSACTIONS AFFECTED AT THEIR DISCRETION. ANY CONFLICTS ARE DOCUMENTED IN MEETING MINUTES. NO SUCH CONFLICTS AROSE DURING THE YEAR. FORM 990, PART VI, SECTION C, LINE 19 THE FUND'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC. FORM 990 PART VII, SECTION A, LINE 1A TRUSTEES ARE NOT COMPENSATED BY THE FUND. COMPENSATION PAID TO TRUSTEES EMPLOYED BY OTHER RELATED ORGANIZATIONS IS REPORTED ON THE FORM 990 FILED WITH THE INTERNAL REVENUE SERVICE BY THE RELATED TAX-EXEMPT ORGANIZATION. THE FOLLOWING RELATED ORGANIZATIONS REPORTED COMPENSATION FOR A TRUSTEE LISTED ON THE MINNESOTA & NORTH DAKOTA BRICKLAYERS & ALLIED CRAFTWORKERS HEALTH FUND: DOUGLAS SCHROEDER, CHAIRMAN BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION NO. 1 MINNESOTA/NORTH DAKOTA EIN: 41-1716458 STAN PACZYNSKI, UNION - ALTERNATE TRUSTEE BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION NO. 1 MINNESOTA/NORTH DAKOTA EIN: 41-1716458 MICHAEL GANZ, UNION TRUSTEE BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION NO. 1 MINNESOTA/NORTH DAKOTA EIN: 41-1716458 TERRY WONG, UNION TRUSTEE BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION NO. 1 MINNESOTA/NORTH DAKOTA EIN: 41-1716458 MN & ND BRICKLAYERS AND ALLIED CRAFTSWORKERS PENSION FUND 2520 PILOT KNOB RD MENDOTA HEIGHTS MN 55120 516029930 PROVIDE RETIREMENT BENEFITS TO UNION MEMBERS MN 401(A) N/A N/A 0 MN & ND BRICKLAYERS AND ALLIED CRAFTSWORKERS VACATION FUND 2520 PILOT KNOB RD MENDOTA HEIGHTS MN 55120 237068471 PROVIDE VACATION BENEFITS TO UNION MEMBERS. MN 501(C)(9) N/A N/A 0 BRICKLAYERS LOCAL NO 1 APPREN 35420 INTERNATIONAL PARKWAY NEW HOPE MN 55428 416319702 PROVIDE TRAINING AND RETRAINING TO CURRENT AND PROSPECTIVE UNION MEMBERS MN 501(C)(5) N/A N/A 0 BRICKLAYERS AND ALLIED CRAFTWORKERS LOCAL UNION NO 1 MINNESOTANORTH DAKOTA 312 CENTRAL AVE SUITE 328 MINNEAPOLIS MN 55414 411716458 PROTECT AND IMPROVE THE GENERAL WELFARE OF ITS MEMBERS AND EMPLOYEES MN 501(C)(5) N/A N/A 0 MINNESOTA CERAMIC TILE AND ALLIED TRADES RETIREMENT FUND 2520 PILOT KNOB RD MENDOTA HEIGHTS MN 55120 416059404 TO PROVIDE RETIREMENT BENEFITS TO UNION MEMBERS MN 401(A) N/A N/A 0 ASSOCIATED GENERAL CONTRACTORS OF MINNESOTA INC 525 PARK STREET NO 110 ST PAUL MN 55103 410132580 REPRESENTING MEMBERS INVOLVED IN MINNESOTA'S CONSTRUCTION INDUSTRY MN 501(C)(6) N/A N/A 0 ARIZONA TRUST FUNDS LOCAL 3 CITY OF MINNEAPOLIS CITY OF ST PAUL HEALTH REIMBURSEMENT ARANGEMEN INTERNATIONAL PENSION FUND INTERNAT'L MASONRY INSTITUTE IOWA BUILDERS RETIREMENT PLAN IOWA LABORERS DISTRICT COUNCIL MASONRY INSTITUTE NEW JERSEY BAC SPECIAL SCHOOL DISTRICT #1 ST PAUL PUBLIC SCHOOLS UNIVERSITY OF MINNESOTA D R FRANTZ CONCRETE CONST OPUS CORPORATION RAM CONSTRUCTION SERVICES BRICKLAYERS AND ALLIED CRAFTWORKERS SERVICE CORPORATION 2520 PILOT KNOB ROAD MENDOTA HEIGHTS MN 55120 811520819 ADMINISTRATIVE SERVICES TO RELATED FUND MN N/A C 60256 75097 0.20000 0 A D B CONSTRUCTION CO INC A J SPANJERS CO ACME TUCKPOINTING & RESTOR ACOUSTICS ASSOCIATES INC ADVANCE TERRAZZO & TILE CO ADVANCED MASONRY RESTORATION ALVIN BENIKE INC ALWAYS TILE & STONE LLC AMERICAN MAS RESTORATION CORP ANCHOR GLASS CONTAINER INC ANDERSON MAS & CONCRETE INC AXEL H OHMAN INC B & D ASSOCIATES INC B & M MASONRY INC BEDROCK-FLINT INC BLACKHAWK TILE & STONE INC BOB'S SPARKLE WASH C R MEYER & SONS COMPANY CAMCO CONSTRUCTION INC CARCIOFINI COMPANY INC CARLSON-LAVINE INC CD TILE & STONE INC COMMERCIAL MASONRY INC COMMERCIAL SPECIALTY CONTRACT CON'S MASONRY INC CONTRACT CAULKING CONTRACT TILE & CARPET INC CROSSTOWN MASONRY INC D & D STONE LLC D J KRANZ CO INC DAROLD BERGER MASONRY INC DAYCO CONCRETE DEBCON II DBA O'CONNOR CONST DEL'S CONSTRUCTION CO INC DZIEDZIC CAULKING INC EAGLE CAULKING EICHOLTZ MASONRY INC EXTERIOR BUILDING SERVICES INC FABCON INC FLEMMING TILE INC FOWLER & HAMMER INC FRANDRUP MASONRY INC GABEL MASONRY CONSTRUCTION INC GAGE BROTHERS CAULKING GAGNON INCORPORATED GEORGE SIEGFRIED CONST CO GORDON CONST OF MAHNOMEN INC GRANITE-TOPS INSTALLATION INC GRAZZINI BROTHERS CO GRESSER COMPANIES INC GUSTAFSON & GOUDGE INC HANSON MASONRY & CONCRETE LLC HARBOR CITY MASONRY INC HARLAN FALCK & SON INC HARRISON TILE CO INC HAUGEN MASONRY CONTRACTORS INC HOLLENBACK & NELSON INC HOVLAND INC HUESMAN SCHREIBER MASONRY INCOR INSTALLATION INC INSTALLATION CONCEPTS INC J E DUNN CONSTRUCTION COMPANY J STAY TILE LLC JOHN FOLEY MASONRY JOHNNY MASONRY INC JOHNSON & NELSON JOHNSON CARPET JOHNSON TERRAZZO CO INC KASELLA CONCRETE INC KIFFMEYER INC KNUTSON CONSTRIUCTION SERVICES LAKEHEAD CONSTRUCTORS INC LANGER CONSTR CO LARSON MASONRY CONSTRUCTION LEE'S CERAMICS INC LOUHI & KIVELA MASONRY INC M A MORTENSON CO M C MAGNEY CONST MACPHERSON-TOWNE CO MAERTENS-BRENNY CONSTRUCTION MAJESTIC TILE & STONE INC MARK 1 RESTORATION COMPANY MARKET & JOHNSON MAVERICK CUTTING & BREAKING MAVO SYSTEMS INC MCGOUGH CONSTRUCTION CO INC MEDINA GLASS BLOCKINC DBA BGA METROPOLITAN TILE & MARBLE MIDWEST PRECAST SERVICES LLC MIDWESTERN MASONRY INC MOLIN CONCRETE PRODUCTS MORTENSON MASONRY INC MOSAICA LLC NIKKEL TILE INC NORTHLAND CONCRETE & MASONRY NORTHWEST ADMINISTRATORS INC PARAMOUNT CONCRETE & MAS INC PATZOLDT CONCRETE & MASONRY LL PELLAND-SWENSON & ASSOC REFRACTORY SERVICE INC RESCH'S TILE INC RESTORATION SYSTEMS INC RICE LAKE CONSTRUCTION GROUP RIGHTWAY CAULKING ROYL MASONRY SCHLEIS FLOOR COVERING INC SERICE CONSTRUCTION INC SERVAIS TILE & STONE INC SHEEHY CONSTRUCTION CO SMITH-SHARPE FIRE BRICK SUPPLY STEBBINS ENGINEERING STEENBERG - WATRUD CONST INC STONE CONSTRUCTION INC STRETAR MASONRY & CONCRETE INC SUMMIT CONCRETE & MAS CONST SUNRISE SPECIALTY CONTR TCR ENTERPRISES DBA J&K MASON TED KENNE CONSTRUCTION THE CAULKERS COMPANY INC THE JAMAR COMPANY TOTAL CONSTRUCTION & EQUIPMENT TWIN CITY TILE & MARBLE CO UNITED MASONRY INC UNITED REFACTORIES INC WEISE MASONRY INC WELLS CONCRETE PRODUCTS CO WENDT MASONRY INC WESTERN REFRACTORY CONST WESTERN SPECIALTY CONTRACTORS WTG TERRAZZO & TILE INC YOUNG MASONRY INC ZACHMAN PRECAST INC ICE COLD EVENTS LLC GUY NIELSON COMPANY DIV INC MN CONCRETE SPECIALTIES INC QUALITY DRYWALL & PLASTERING SEBCO INC SIECO CONSTRUCTION INC WYSAN PRECAST SERVICES LLC 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1