2018-07-23T08:34:44-05:00 2017-12-31 271235638 MCM CPAS & ADVISORS LLP 462 S FOURTH ST SUITE 2600 LOUISVILLE KY 402023445 990 2017-01-01 237017526 KENTUCKY LABORERS DISTRICT COUNCIL HEALTH & WELFARE FUND KENT 5028398166 1996 BY-PASS SOUTH LAWRENCEBURG KY 40342 JAMES BLEVINS CHAIRMAN 5028398166 2018-07-18 1 REBECCA L PHILLIPS CPA P00024055 5027491900 2017 2022-09-23 18:48:47Z MARK ISAACS 1996 BY-PASS SOUTH LAWRENCEBURG KY 40342 34434880 0 X N/A X 1967 KY EMPLOYEE BENEFIT PLAN PROVIDING ACCIDENT, SICKNESS, VISION, DENTAL, DEATH AND ACCIDENTAL DEATH & DISMEMBERMENT BENEFITS FOR ACTIVE PARTICIPANTS AND ACCIDENT, SICKNESS, VISION, DENTAL AND DEATH BENEFITS FOR RETIRED PARTICIPANTS. 8 8 11 9 0 0 0 0 23202114 22316040 702191 1291191 59280 59274 23963585 23666505 0 0 23465415 26284423 947287 991060 0 0 0 1151672 1218505 25564374 28493988 -1600789 -4827483 30410044 25865286 794074 1124846 29615970 24740440 EMPLOYEE BENEFIT PLAN PROVIDING ACCIDENT, SICKNESS, VISION, DENTAL, DEATH AND ACCIDENTAL DEATH & DISMEMBERMENT BENEFITS FOR ACTIVE PARTICIPANTS AND ACCIDENT, SICKNESS, VISION, DENTAL AND DEATH BENEFITS FOR RETIRED PARTICIPANTS. 0 0 EMPLOYEE BENEFIT PLAN PROVIDING ACCIDENT, SICKNESS, VISION, DENTAL, DEATH AND ACCIDENTAL DEATH & DISMEMBERMENT BENEFITS FOR ACTIVE PARTICIPANTS AND ACCIDENT, SICKNESS, VISION, DENTAL AND DEATH BENEFITS FOR RETIRED PARTICIPANTS. 0 0 0 0 0 0 0 0 0 1 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 1009 0 1 11 1 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X D CROUCH FUND ADMINISTRATORS GRIFFIETH FUND ASSISTANT 5028398166 1996 BY-PASS SOUTH LAWRENCEBURG KY 40342 X MARK ISAACS CHAIRMAN 1.00 X X 0 0 0 DOUG HACKER SECRETARY/TREASURER 1.00 X X 0 0 0 PERRY BLADES TRUSTEE 1.00 X 0 0 0 MITCHELL ONEY TRUSTEE 1.00 X 0 0 0 DONALD TRAVIS TRUSTEE 1.00 X 0 0 0 JEFF STORY TRUSTEE 1.00 X 0 0 0 ANTHONY WICKLINE TRUSTEE 1.00 X 0 0 0 LARRY HENDERSON TRUSTEE 1.00 X 0 0 0 DWAYNE MCCAULEY ALTERNATE TRUSTEE (ALTERNATE) 1.00 X 0 0 0 0 0 0 0 0 0 0 CIGNA PO BOX 644546 PITTSBURGH PA 152644546 REPRICING OF CLAIMS, PRE-CERTIFICATION 444814 ZELIS 2 CROSSROADS DRIVE BEDMINSTER NJ 07921 REPRICING OF NON-PPO CLAIMS 123984 BENESYS 700 TOWER DR SUITE 300 TROY MI 48098 CONSULTING AND ELIGIBILITY AND CLAIMS PR 117652 2 EMPLOYER CONTRIBUTIONS 900099 20626734 20626734 EMPLOYEE CONTRIBUTIONS 900099 1689306 1689306 22316040 415481 415481 11644085 10768375 875710 875710 875710 CONTRIBUTION RECORDS F 900099 59274 59274 59274 23666505 22375314 0 1291191 26284423 605175 207097 129554 49234 56819 39411 55723 671298 151725 111822 40524 14139 6831 13842 INTERNATIONAL FOUNDATIO 24729 EMPLOYEE ASSISTANCE PLA 23727 PCORI TAX 7915 28493988 500836 46011 2521823 2216265 18054 25475 104637 89171 22297 15466 27347034 23562069 30410044 25865286 794074 948830 0 176016 794074 1124846 X 29615970 24740440 0 0 0 0 29615970 24740440 30410044 25865286 -4827483 -48047 0 X X 0 1 X 1 0 28610 28610 0 76027 60561 15466 15466 CHECKS WRITTEN IN EXCESS OF CASH 176016 176016 X 23666505 -48047 -48047 23714552 -48047 -48047 23666505 28493988 0 28493988 0 28493988 PART X, LINE 2: THE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS INTENDED TO QUALIFY PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE ("IRC"), AND, ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE TRUST HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER DATED MAY 14, 1969 FROM THE INTERNAL REVENUE SERVICE ("IRS"), AND THE PLAN ADMINISTRATOR AND THE PLAN'S TAX COUNSEL BELIEVE THAT THE TRUST, AS AMENDED, CONTINUES TO QUALIFY AND TO OPERATE IN ACCORDANCE WITH APPLICABLE PROVISIONS OF THE IRC. U.S. GAAP REQUIRES PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2017 AND 2016, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 4B - OTHER ADJUSTMENTS: NET UNREALIZED GAIN/LOSS -48,047. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE FUND AUDITOR. IT IS REVIEWED BY THE FUND ATTORNEY, FUND CONSULTANT AND FUND ADMINISTRATOR PRIOR TO PRESENTATION TO THE BOARD OF TRUSTEES. THE BOARD OF TRUSTEES THEN REVIEW THE FORM 990 BEFORE APPROVAL AND SIGNING. AFTER APPROVAL AND EXECUTION BY BOARD OF TRUSTEES, THE FORM 990 IS FILED. (IN THIS CASE, IT IS E-FILED BY THE FUND AUDITOR) FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE OR EMPLOYEE OF THE FUND HAS THE DUTY TO DISCLOSE ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST. EACH TRUSTEE OR EMPLOYEE MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE TRUSTEES DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, THE BOARD OF TRUSTEES WILL DISCUSS AND VOTE TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE CHAIRPERSON OF THE BOARD OF TRUSTEES SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. THE BOARD OF TRUSTEES SHALL THEN DETERMINE WHETHER THE FUND CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OF TRUSTEES SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED TRUSTEES WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE FUND'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. FORM 990, PART VI, SECTION B, LINE 15 IN DETERMINING WAGE INCREASES FOR FUND EMPLOYEES, THE TRUSTEES REVIEW THE CURRENT AND PROJECTED FINANCIAL STATUS OF THE FUND, INCLUDING CURRENT AND PROJECTED ADMINISTRATIVE COSTS, AND TAKE INTO CONSIDERATION THE WAGES FOR SIMILAR POSITIONS IN OTHER TAFT-HARTLEY TRUST FUNDS, PROJECTED COST OF LIVING TRENDS, AND EMPLOYEES' WORK HISTORIES AND JOB PERFORMANCES. THE TRUSTEES HAVE ALSO IMPLEMENTED A POLICY WHEREIN THE ADMINISTRATOR WILL PERFORM ANNUAL JOB PERFORMANCE REVIEWS FOR EACH FUND EMPLOYEE. THE FUND TRUSTEES DO NOT RECEIVE COMPENSATION OF ANY KIND. THERE IS NO CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL OF THIS FUND. FORM 990, PART VI, SECTION C, LINE 19 THEY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. THE FUND'S ADMINISTRATOR AND ASSISTANT ADMINISTRATOR CONTINUE TO OVERSEE THE AUDIT PROCESS OF ITS FINANCIAL STATEMENTS. HOWEVER, THE FULL BOARD OF TRUSTEES FOR THE FUND ASSUMES RESPONSIBILITY FOR THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE BOARD OF TRUSTEES REVIEWS AND APPROVES ALL MONTHLY FINANCIAL STATEMENTS AT THEIR QUARTERLY MEETINGS AND REVIEWS THE ANNUAL FINANCIAL REPORT AT A QUARTERLY MEETING. 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