2018-03-29T17:03:34-05:00 2017-05-31 310800053 CLARK SCHAEFER HACKETT & CO 3166 N Republic Blvd Toledo OH 43615 990 2016-06-01 344442536 Union Construction Workers Health Plan UNIO 4192482401 P O Box 1330 Holland OH 43528 Brian Seeger Chairman 4192482401 2018-03-14 1 Lee D Wunschel P00088726 4198412848 2018-03-14 72.240.120.3 2018-03-14 16:08:00 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 D41268BA6B9B48484F7675C44F2FADFB9D057250 2016 2021-01-29 14:40:06Z P O Box 1330 Holland OH 43528 58871405 0 X N/A X 1952 OH The fund provides health benefits for eligible members of the contruction trade unions covered by the fund. 10 10 0 0 0 0 0 0 23570280 26048248 1031201 1247855 1028 5590 24602509 27301693 0 0 23985318 19641934 0 0 0 0 0 1817746 1865055 25803064 21506989 -1200555 5794704 47676780 53153845 19841339 18363460 27835441 34790385 The fund provides health benefits for eligible members of the construction trade unions covered by the fund. 0 0 The fund provides health benefits for eligible members of the construction trade unions covered by the fund. 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 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 1 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X Stacie J Ralph 4192482401 7142 Nightingale Dr Holland OH 43528 Corey Beaubien Trustee 0.00 X 0 0 0 Gregory Myers Trustee 0.00 X 0 0 0 Kevin Smith Trustee 0.00 X 0 0 0 Brian Seeger Trustee 0.00 X 0 0 0 Kenneth Gabel Trustee 0.00 X 0 0 0 Eric Kahle Trustee 0.00 X 0 0 0 Jamie Peppers Trustee 0.00 X 0 0 0 Michael Kujawa Trustee 0.00 X 0 0 0 Matt Aberl Trustee 0.00 X 0 0 0 Michelle Scherer Trustee 0.00 X 0 0 0 Trust Company of Toledo Institutional Trustee 1.00 X 92877 0 0 92877 0 0 0 0 0 0 Northwestern Ohio Administrators 7142 Nightingale Dr Holland OH 43528 Administrative Mgr 1322109 Anthem 4361 Irwin Simpson Rd Mason OH 45040 Health Insurance 732079 Vision Services Plan PO Box 60000 San Francisco CA 94160 Vision Insurance 177873 3 Employer Contributions 900099 25892248 25892248 HRA Bonus 900099 156000 156000 26048248 1137407 1137407 31680160 31569712 110448 110448 110448 Liquidated Damages 900099 5590 5590 5590 27301693 26048248 0 1253445 19641934 72830 31012 9235 9222 Administrative Expenses 1336214 Transitional Reinsuranc 129510 Custodial Trust Fees 92877 Consultant 73561 110594 21506989 2240375 3523815 1908468 3275678 3815680 4905848 7518 39517985 41262601 186754 185903 47676780 53153845 412679 700835 19428660 17662625 19841339 18363460 X 27835441 34790385 27835441 34790385 47676780 53153845 5794704 1160240 0 X X 0 1 X 1 0 0 IBNR 2695000 Reserve for Extended Eligibility 14967625 17662625 X 28369057 1160240 1160240 27208817 92876 92876 27301693 23180148 1766035 1766035 21414113 92876 92876 21506989 Part X, Line 2: The Plan has determined that there are no uncertain tax positions that require disclosure in these financial statements under the FASB Accounting Standards Codification topic, Income Taxes. The tax years 2013 through 2016 are subject to possible examination by the Internal Revenue Service. Part XII, Line 2d - Other Adjustments: Change in Estimated Future Benefits Change- Estimated Unpaid Claims Incurred 1,766,035. Form 990, Part VI, Section B, line 11b Line 11a explanation - Each trustee is provided with a draft copy of the 990 for their review and approval prior to the filing of the form. Form 990, Part VI, Section B, line 12c The plan administrator and attorney follow up with each trustee to ensure that each completes the annual conflict of interest disclosure. Form 990, Part VI, Section C, line 19 All governing documents, policies and finanical statements are available upon request to Northwestern Ohio Administrators, Inc., the plan administrator. Form 990, Part XII, Line 2c: No changes from prior year. IRONWRKRS JOINT APPRENTICE PAINTER LU 7 APPR COMMITTEE BRICKLAYERS LU 3OADC BRICKLAYERS MICHIGAN BAC BRICKLAYERS OF INDIANA IRONWORKERS LU 8 BRICKLAYERS LU 6 OF INDIANA PAINTING INDUSTRY FUNDS SHEETMETAL LOCAL 36 IRONWORKERS LU 549 & 550 IRONWORKERS TRI-STATE LU 393 SOUTHEASTERN IRONWORKERS SHEETMETAL WORKERS LOCAL 7 ZON SHEET METAL LOCAL 100 IRONWORKERS LOCAL 207 SHEETMETAL WORKERS LU 020 SHEET METAL LOCAL 33 IRONWORKERS LOCAL 378 IRONWORKERS ST LOUIS DISTRICT SOUTHEASTERN IRONWORKERS LU 39 IRONWORKERS LU#5 WASHINGTON DC MO-KAN IRONWORKERS LU #10 IRONWORKERS LU 25 MI IRONWORKERS LU 28 VA BRICKLAYERS INTERNATIONAL BRICKLAYERS LU#2 ALBANY NY BRICKLAYERS LOCAL 3 ROCHESTER IRONWORKERS LU#798 ALABAMA SHEET METAL WORKERS LOCAL 104 BOILERMAKERS NATIONAL FUND SHEET METAL LU 110 SHEET METAL WORKERS LU 45 SHEET METAL LU# 5 TN IRONWORKERS DISTRICT OF TN TWIN CITIES IRONWORKERS LU 512 PAINTERS SOUTHERN OHIO IRONWORKERS DC SOUTHERN OHIO IRONWORKERS LOCAL NO 17 INTERMOUNTAIN IW LU 21 UTAH TEXAS 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