2017-11-06T15:03:36-06:00 2016-12-31 352123203 KSM BUSINESS SERVICES INC PO BOX 40857 INDIANAPOLIS IN 462400857 990 2016-01-01 350851694 ELECTRICAL WORKERS BENEFIT TRUST FUND ELEC 3179234577 1828 NORTH MERIDIAN STREET NO 103 INDIANAPOLIS IN 462021471 ROBERT CADWELL BENEFITS ADMINISTRATOR 3179234577 2017-10-26 1 CASSE TATE P01271193 3175802000 2017-10-26 64.132.79.19 2017-10-26 14:55:02 ED P 019CA3EE3F2C8A78E48DEC9828FFDFDF32C798E7 019CA3EE3F2C8A78E48DEC9828FFDFDF32C798E7 2016 2018-03-14 21:41:22Z ROBERT CADWELL 1828 NORTH MERIDIAN STREET NO 103 INDIANAPOLIS IN 462021471 81774730 0 X N/A X 1949 IN THE FUND PROVIDES VARIOUS BENEFITS TO PARTICIPANTS AND ELIGIBLE DEPENDENTS 7 7 62 0 0 0 0 0 23522426 26125893 3775429 4833205 0 0 27297855 30959098 0 0 26523223 29662125 472093 475105 0 0 0 2397200 2302648 29392516 32439878 -2094661 -1480780 111801621 112085646 270300 148795 111531321 111936851 THE FUND PROVIDES MEDICAL AND WELFARE BENEFITS TO PARTICIPANTS AND ELIGIBLE DEPENDENTS. 0 0 THE FUND PROVIDES VARIOUS MEDICAL AND WELFARE BENEFITS TO PARTICIPANTS AND ELIGIBLE DEPENDENTS 0 0 0 0 0 0 0 0 0 1 0 0 0 0 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 1 825 0 1 62 1 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 IN X ROBERT CADWELL ELECTRICAL WORKERS 3179234577 1828 NORTH MERIDIAN STREET SUITE INDIANAPOLIS IN 462021471 X JAMES TSAREFF TRUSTEE 1.00 X 0 0 0 BRIAN MILLER TRUSTEE 1.00 X 0 0 0 KEVIN SCHRADER TRUSTEE 1.00 X 0 0 0 STEVE MENSER TRUSTEE 1.00 X 0 0 0 KEVIN MARSHALL TRUSTEE 1.00 X 0 0 0 JEFF WHEELER TRUSTEE 1.00 X 0 0 0 TED UPPOLE TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 ANTHEM INSURANCE COMPANIES INC 220 VIRGINIA AVE INDIANAPOLIS IN 46204 MEDICAL NETWORK PROVIDER 1100115 UNITED HEALTHCARE INSURANCE COMPANY 8900 KEYSTONE XING STE 560 INDIANAPOLIS IN 46240 RX EWIP PROGRAM 660628 2 CONTRIBUTION INCOME 525920 26125893 26125893 26125893 2508713 2508713 53140124 50815632 2324492 2324492 2324492 30959098 28450385 0 2508713 29662125 346843 9681 87040 31541 39162 31781 169125 76250 40461 37890 30789 9794 3374 5170 ANTHEM CONTRACT SERVICE 1100115 PRESCRIPTION DRUG EMPLO 690932 OTHER EXPENSE 30092 BANK FEES - SERVICE CHA 22924 14789 32439878 X 531440 1290300 2106404 2388971 144278 133708 16854 10570 109146923 108395805 111801621 112085646 243671 42935 26629 105860 270300 148795 X 0 0 0 0 111531321 111936851 111531321 111936851 111801621 112085646 X -1480780 1854160 32150 X X 0 1 X 1 0 144278 133708 10570 10570 X 32644133 1854160 1854160 30789973 169125 169125 30959098 32270753 0 32270753 169125 169125 32439878 PART X, LINE 2: PART IV, LINE 11F - THE FUND MAINTAINS A QUALIFIED TRUST UNDER SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE AND HAS RECEIVED A DETERMINATION LETTER FROM THE IRS DATED JANUARY 1974 THAT THE TRUST IS EXEMPT FROM FEDERAL INCOME TAX. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES REQUIRE THE FUND'S MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FUND AND TO RECOGNIZE A TAX LIABILITY IF THE FUND HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER TAXING AUTHORITIES. THE FUND IS SUBJECT TO ROUTINE AUDITS BY TAXING AND REGULATORY AUTHORITIES; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROCESS. THE FUND ADMINISTRATOR BELIEVES THE FUND IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2013. FORM 990, PART VI, SECTION B, LINE 11B PREPARER PRESENTED COMPLETED FORM 990 IN DRAFT FORM TO THE TRUSTEES. THE TRUSTEES APPROVED THE FORM 990 BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES REFER TO ANNUAL FORMS WHEN CONSIDERING TRANSACTIONS FORM 990, PART VI, SECTION B, LINE 15A THE PROCESS OF DETERMINING THE COMPENSATION OF THE BENEFITS ADMNISTRATOR INCLUDES APPROVAL OF INDEPENDENT TRUSTEES, WHO CONSIDER COMPARABILITY OF WAGES WITH SIMILAR ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 ORGANIZATION'S FORMS ARE AT THE ORGANIZATION'S OFFICES UPON REQUEST. FORM 990 PART X, LINE 26 TOTAL LIABILITIES OF ELECTRICAL WORKERS BENEFIT TRUST FUND DOES NOT INCLUDE THE FOLLOWING ESTIMATED OBLIGATIONS: 2015: FUTURE BENEFIT OBLIGATIONS OTHER THAN POSTRETIREMENT BENEFITS OBLIGATIONS: 12,641,000 FUTURE POSTRETIREMENT BENEFIT OBLIGATIONS: 110,833,380 2016: FUTURE BENEFIT OBLIGATIONS OTHER THAN POSTRETIREMENT BENEFITS OBLIGATIONS: 14,814,000 FUTURE POSTRETIREMENT BENEFIT OBLIGATIONS: 120,134,985 FORM 990, PART XI, LINE 9: TRANSFERS FROM AFFILIATED PLANS 32,150. FORM 990, PART XII, LINE 2C: FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. IBEW 481 SUPPLEMENTAL UNEMPLOYMENT BENEFIT PLAN 1828 N MERIDIAN STREET INDIANAPOLIS IN 46202 474203459 PROVIDE SUPPLEMENTAL UNEMPLOYMENT BENEFITS TO PARTICIPANTS. IN 501(C)(9) 0 INDIANA ELECTRICAL WORKERS PENSION TRUST FUND 1828 N MERIDIAN STREET INDIANAPOLIS IN 46202 351102579 MULTIEMPLOYER DEFINED BENEFIT RETIREMENT PLAN FUNDED BY EMPLOYER CONT. IN 501(C)(9) 0 IBEW LOCAL UNION 481 DEFINED CONTRIBUTION PLAN AND TRUST 1828 N MERIDIAN STREET INDIANAPOLIS IN 46202 351501496 FUND PROVIDES VARIOUS BENEFITS TO PARTICIPANTS AND ELGIBLE DEPENDENTS IN 501(C)(9) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 IBEW 481 SUPPLEMENTAL UNEMPLOYMENT BENEFIT PLAN Q INDIANA ELECTRICAL WORKERS PENSION TRUST FUND Q IBEW LOCAL UNION 481 DEFINED CONTRIBUTION PLAN AND TRUST Q