2018-07-19T09:47:33-05:00 2017-12-31 320043599 LEGACY PROFESSIONALS LLP 222 INDIANAPOLIS BOULEVARD SUITE 103 SCHERERVILLE IN 46375 990 2017-01-01 356327302 IRONWORKERS LOCAL 395 TRUST FUND IRON 3126491200 18861 90TH AVENUE SUITE A MOKENA IL 60448 JEFFREY CHIDESTER CHAIRMAN 3126491200 2018-07-19 1 RENEE SPECK P00201492 3123680500 2017 2022-09-23 18:48:47Z X JEFFREY CHIDESTER 18861 90TH AVENUE SUITE A MOKENA IL 60448 168623064 0 X N/A X 1977 IN PROVIDE HEALTH BENEFITS 4 2 106 0 0 0 0 0 13282358 16288814 1613556 2810228 0 0 14895914 19099042 0 0 14533938 15589907 0 0 0 0 0 868950 784642 15402888 16374549 -506974 2724493 50735623 53922637 206801 166352 50528822 53756285 TO PROVIDE HEALTH BENEFITS 0 0 TO PROVIDE HEALTH, LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DENTAL, AND VISION BENEFITS FOR ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 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 38 0 1 106 1 0 0 0 0 0 0 0 0 X 4 2 0 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 X ZENITH AMERICAN SOLUTIONS 3126491200 18861 90TH AVENUE SUITE A MOKENA IL 60448 JEFFREY CHIDESTER UNION TRUSTEE 2.00 40.00 X 0 136904 59365 STEVE MICHAELS EMP TRUSTEE 1.00 X 0 0 0 SAMUEL TIPTON EMP TRUSTEE 1.00 X 0 0 0 RON WARE JR UNION TRUSTEE 2.00 40.00 X 0 139226 59365 0 276130 118730 0 0 1 0 BENISTAR PO BOX 36029 NEWARK NJ 07188 MEDICARE PREMIUM FEE 1632302 UNITED HEALTH CARE GROUP PO BOX 329675 HOT SPRINGS AR 71903 MEDICARE PREMIUM FEE 897979 ANTHEM BLUE CROSS BLUE SHIELD 220 VIRGINIA AVE INDIANAPOLIS IN 46204 FEE FOR PROVIDING PPO ACCESS 364321 STEWART C MILLER & CO INC 2111 WEST LINCOLN HIGHWAY MERRILLVILLE IN 46410 PROVIDES ADMINISTRATIVE SERVICES 361081 FIDELITY SECURITY LIFE INSURANCE CORP 16132 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 STOP-LOSS PREMIUMS 261685 5 EMPLOYER CONTRIB. 900099 13920093 13920093 PARTICIPANT CONTRIB. 900099 2054362 2054362 PRESCRIPTION REBATES 900099 312256 312256 SUBROGATION 900099 2103 2103 16288814 1474115 1474115 150860135 149524022 1336113 1336113 1336113 19099042 16288814 0 2810228 15589907 344599 26952 32432 190551 124873 40778 7695 11510 FEES MANDATED BY ACA 5252 16374549 3544242 3569456 917203 152 1417767 1459535 13676 113556 44656942 48716858 185793 63080 50735623 53922637 130006 166352 76795 0 206801 166352 X 0 0 0 0 50528822 53756285 50528822 53756285 50735623 53922637 2724493 502970 0 X 0 1 X 1 0 0 X 19411461 502970 502970 18908491 190551 190551 19099042 16183998 0 16183998 190551 190551 16374549 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 WAS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 0 0 0 JEFFREY CHIDESTER UNION TRUSTEE 0 136904 0 0 0 0 0 37646 0 21719 0 196269 0 0 RON WARE JR UNION TRUSTEE 0 139226 0 0 0 0 0 37646 0 21719 0 198591 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE BOARD OF TRUSTEES HAS DELEGATED THE DAY TO DAY MANAGEMENT DUTIES TO ZENITH AMERICAN SOLUTIONS, AS THIRD PARTY ADMINISTRATOR OF THE FUND. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAS 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 ENTIRE BOARD OF TRUSTEES PRIOR TO FILING. THE TRUSTEES REVIEW THE FORM AND UPON FULLY UNDERSTANDING THE COMPLETED FORM 990, THE FORM IS APPROVED AND SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO ANY PARTICIPANT IN THE PLAN WHO COMES INTO THE FUND OFFICE AND REQUESTS TO SEE THEM. 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