MUELLER SUPPLY COMPANY INC HEALTH PLAN: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization: MUELLER SUPPLY COMPANY INC HEALTH PLAN (EIN 75-2118065)
Tax period: 2017-01-01 to 2017-12-31
Filed: 2018-10-24
IRS object ID: 201822979349300912
Schema version: 2017v2.3
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-10-24T10:37:53-05:00	ReturnTs
Tax Period End	2017-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	450250958	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	EIDE BAILLY LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	400 PINE ST STE 600	AddressLine1Txt
City	ABILENE	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	796015190	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2017-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	752118065	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MUELLER SUPPLY COMPANY INC HEALTH PLAN	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	MUEL	BusinessNameControlTxt
Phone	8772683553	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1915 HUTCHINS AVENUE	AddressLine1Txt
City	BALLINGER	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	76821	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JEFF BENTON	PersonNm
Person Title	HR MANAGER	PersonTitleTxt
Phone	8772683553	PhoneNum
Signature	2018-10-13	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JOE MELSON CPA	PreparerPersonNm
PTIN	P00158111	PTIN
Phone	3256724000	PhoneNum
Preparation	2018-10-13	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	154.45.214.18	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2018-10-13	IPDt
IP Tm	14:00:35	IPTm
IP Timezone	CD	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	4B7FEDDDB59CEC5B972D12EC8AB2EFC11308F9F0	AtSubmissionCreationDeviceId
At Submission Filing Device Id	DFB555FE225C921DCBFA4A71AF078D82D8FE5EDF	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2017	TaxYr
Build TS	2018-06-14 16:35:46Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Gross Receipts	$8,602,283	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c	Yes (X)	Organization501cInd
Website Address	N/A	WebsiteAddressTxt
Type Of Organization Trust	Yes (X)	TypeOfOrganizationTrustInd
Formation	1988	FormationYr
Legal Domicile State	TX	LegalDomicileStateCd
Activity Or Mission	PROVIDE HEALTH CARE BENEFITS	ActivityOrMissionDesc
Voting Members Governing Body	1	VotingMembersGoverningBodyCnt
Voting Members Independent	1	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$0	PYContributionsGrantsAmt
CY Contributions Grants	$0	CYContributionsGrantsAmt
PY Program Service Revenue	$7,110,520	PYProgramServiceRevenueAmt
CY Program Service Revenue	$8,602,283	CYProgramServiceRevenueAmt
PY Investment Income	$0	PYInvestmentIncomeAmt
CY Investment Income	$0	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$7,110,520	PYTotalRevenueAmt
CY Total Revenue	$8,602,283	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$6,864,850	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$6,197,324	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$0	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$0	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$636,080	PYOtherExpensesAmt
CY Other Expenses	$1,717,636	CYOtherExpensesAmt
PY Total Expenses	$7,500,930	PYTotalExpensesAmt
CY Total Expenses	$7,914,960	CYTotalExpensesAmt
PY Revenues Less Expenses	-$390,410	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$687,323	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,456,739	TotalAssetsBOYAmt
Total Assets EOY	$1,899,873	TotalAssetsEOYAmt
Total Liabilities BOY	$910,380	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$666,191	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$546,359	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$1,233,682	NetAssetsOrFundBalancesEOYAmt
Mission	PROVIDE HEALTH CARE BENEFITS	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$7,914,960	ExpenseAmt
Revenue	$8,602,283	RevenueAmt
Desc	PROVIDE HEALTH CARE BENEFITS	Desc
Total Program Service Expenses	$7,914,960	TotalProgramServiceExpensesAmt
Described In Section501c3	0	DescribedInSection501c3Ind
Schedule B Required	0	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	0	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	0	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	0	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	1	GoverningBodyVotingMembersCnt
Independent Voting Member	1	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	0	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	0	ConflictOfInterestPolicyInd
Whistleblower Policy	0	WhistleblowerPolicyInd
Document Retention Policy	0	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JEFF BENTON	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	8772683553	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1915 HUTCHINS AVENUE	AddressLine1Txt
City	BALLINGER	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	76821	ZIPCd

Field	Value	IRS element (for citing)
No Listed Persons Compensated	Yes (X)	NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp

Field	Value	IRS element (for citing)
Person	BRYAN DAVENPORT	PersonNm
Title	TRUSTEE	TitleTxt
Average Hours Per Week	1.00	AverageHoursPerWeekRt
Individual Trustee Or Director	Yes (X)	IndividualTrusteeOrDirectorInd
Reportable Comp From Org	$0	ReportableCompFromOrgAmt
Reportable Comp From Rltd Org	$0	ReportableCompFromRltdOrgAmt
Other Compensation	$0	OtherCompensationAmt

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$0	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BLUE CROSS BLUE SHIELD OF TEXAS	BusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4242 SUNSET DRIVE	AddressLine1Txt
City	SAN ANGELO	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	769045652	ZIPCd

Field	Value	IRS element (for citing)
Services	BENEFITS ADMINISTRAT	ServicesDesc
Compensation	$461,715	CompensationAmt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	1	CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
SPONSOR CONTRIBUTIONS	$8,166,946	$8,166,946
PARTICIPANT CONTRIBUTI	$434,439	$434,439
MISCELLANEOUS	$898	$898

Field	Value	IRS element (for citing)
Total Program Service Revenue	$8,602,283	TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,602,283	TotalRevenueColumnAmt
Related Or Exempt Func Income	$8,602,283	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$6,197,324	TotalAmt
Program Services	$6,197,324	ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$1,717,636	TotalAmt
Program Services	$1,717,636	ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$7,914,960	TotalAmt
Program Services	$7,914,960	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$834,648	BOYAmt
EOY	$1,046,921	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$622,091	BOYAmt
EOY	$852,952	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,456,739	BOYAmt
EOY	$1,899,873	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$910,380	BOYAmt
EOY	$666,191	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$910,380	BOYAmt
EOY	$666,191	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$546,359	BOYAmt
EOY	$1,233,682	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$546,359	BOYAmt
EOY	$1,233,682	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,456,739	BOYAmt
EOY	$1,899,873	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$687,323	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$0	TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt	$8,602,283	TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported	$0	RevenueNotReportedAmt
Revenue Subtotal	$8,602,283	RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$8,602,283	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$8,211,146	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$8,211,146	ExpensesSubtotalAmt
Other Expenses Not Included	-$296,186	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	-$296,186	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$7,914,960	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART XII, LINE 4B - OTHER ADJUSTMENTS:	FormAndLineReferenceDesc
Explanation	CHANGE IN CLAIMS PAYABLE	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 8B	NO SEPARATE COMMITTEES.
FORM 990, PART VI, SECTION B, LINE 11B	COPY OF FORM 990 PROVIDED TO TRUSTEES TO REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION C, LINE 19	NO OTHER DOCUMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11G	ADMINISTRATION FEES: PROGRAM SERVICE EXPENSES 964,910. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 964,910. PREMIUMS PAID TO INSURANCE COMPANIES: PROGRAM SERVICE EXPENSES 752,726. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 752,726.

MUELLER SUPPLY COMPANY INC HEALTH PLAN: Form 990, tax year 2017

Return header ReturnHeader

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Preparer US Address PreparerUSAddress

Filer Filer

Business Name BusinessName

US Address USAddress

Business Officer BusinessOfficerGrp

Preparer Person PreparerPersonGrp

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Form 990 IRS990

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

US Address USAddress

Form990 Part VII Section A Form990PartVIISectionAGrp

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

Contractor Address ContractorAddress

US Address USAddress

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

Total Revenue TotalRevenueGrp

Benefits To Members BenefitsToMembersGrp

Fees For Services Other FeesForServicesOtherGrp

Total Functional Expenses TotalFunctionalExpensesGrp

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Accounts Receivable AccountsReceivableGrp

Total Assets TotalAssetsGrp

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Total Liabilities TotalLiabilitiesGrp

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FS Audited Basis FSAuditedBasisGrp

Schedule D IRS990ScheduleD

Supplemental Information Detail SupplementalInformationDetail

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Comments