2017-02-09T13:01:33-06:00 2016-05-31 320043599 LEGACY PROFESSIONALS LLP 311 S WACKER DRIVE STE 4000 CHICAGO IL 60606 990 2015-06-01 465193231 RETIREE MEDICAL PLAN OF THE PLUMBERS WELFARE FUND LOCAL 130 UA RETI 3122265000 1340 W WASHINGTON BLVD CHICAGO IL 60607 JAMES F COYNE TRUSTEE 3127574689 2017-02-09 1 RENEE SPECK P00201492 3123680500 2015 2021-01-29 14:40:06Z JAMES F COYNE 1340 W WASHINGTON BLVD CHICAGO IL 60607 21500060 0 X WWW.PLUMBERSLU130UA.ORG X 2014 IL TO PROVIDE HEALTH BENEFITS TO RETIRED PARTICIPANTS. 12 0 0 0 0 0 0 0 13744750 16977828 1561579 722232 0 0 15306329 17700060 0 0 10572077 12181187 280544 304814 0 0 0 357690 342269 11210311 12828270 4096018 4871790 31293541 35425855 1245653 1123434 30047888 34302421 TO PROVIDE HEALTH BENEFITS TO RETIRED PARTICIPANTS. 0 0 TO PROVIDE MEDICAL, DENTAL, VISION, AND PRESCRIPTION DRUG BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 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 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 739 0 1 0 0 0 0 0 0 0 0 0 0 0 X 12 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 X JOSEPH OHM - FUND ADMINISTRATOR 3122265000 1340 WEST WASHINGTON BOULEVARD CHICAGO IL 60607 X JAMES COYNE LABOR CO-CHAIRMAN 0.47 64.92 X 0 223078 322969 DAVID ARIANO MANAGEMENT CO-CHAIRMAN 0.47 X 0 0 0 KENNETH TURNQUIST LABOR TRUSTEE 0.47 51.25 X 0 185135 143376 SCOTT SPANGLE LABOR TRUSTEE 0.47 48.56 X 0 153923 136232 JIM MANSFIELD LABOR TRUSTEE 0.47 56.33 X 0 148878 87248 MICHAEL SHEA LABOR TRUSTEE 0.47 58.23 X 0 73845 36137 WILLIAM MATTHIES LABOR TRUSTEE 0.47 53.62 X 0 151459 80300 JAMES O'SULLIVAN MANAGEMENT TRUSTEE 0.47 X 0 0 0 DAVID KERRIGAN MANAGEMENT TRUSTEE - NEW 0.47 X 0 0 0 MICHAEL CHAPEL MANAGEMENT TRUSTEE 0.47 X 0 0 0 BRIAN BURNS MANAGEMENT TRUSTEE - NEW 0.47 X 0 0 0 SJ PETERS MANAGEMENT TRUSTEE 0.47 X 0 0 0 LORI ABBOTT MANAGEMENT CO-CHAIRMAN - PAST 0.47 X 0 0 0 JOHN S BYRNE LABOR TRUSTEE - PAST 0.47 51.22 X 0 109767 89342 MICHAEL KERRIGAN MANAGEMENT TRUSTEE - PAST 0.47 X 0 0 0 TERRY MUSTO FUND ADMINISTRATOR 0.00 55.00 X 0 183391 154377 ANTHONY ROTTMAN FIELD REPRESENTATIVE - NEW 0.00 59.54 X 0 130346 41261 0 1359822 1091242 0 0 1 0 EXPRESS SCRIPTS INC 1 EXPRESS WAY ST LOUIS MO 63121 PPO NETWORK PROVIDER 259579 BLUE CROSS BLUE SHIELD OF IL 300 EAST RANDOLPH STREET CHICAGO IL 60601 PPO NETWORK PROVIDER 154144 2 CONTRACTOR CONTRIBUTIONS 900099 14607203 14607203 PARTICIPANT CONTRIBUITONS 900099 2370625 2370625 16977828 722232 722232 3800000 3800000 0 17700060 16977828 0 722232 12181187 44695 115191 64223 70290 10415 51325 12000 7467 97950 46805 12365 21704 1494 633 5094 SHARED EXPENSES - LU 13 71874 FEES MANDATED BY THE AC 8391 BANK FEES 5167 12828270 1922549 1308755 168745 170894 1212528 2031291 0 7116 4148 5500 12654 633 0 12021 27985571 31890278 31293541 35425855 7696 19845 50074 49559 1187883 1054030 1245653 1123434 X 0 0 0 0 30047888 34302421 30047888 34302421 31293541 35425855 4871790 -617257 0 X 0 1 X 1 0 12654 633 12021 12021 DUE TO RELATED ORGANIZATION 1027966 DUE TO BROKER 26064 1054030 X 17075336 -617257 -617257 17692593 7467 7467 17700060 12820803 0 12820803 7467 7467 12828270 PART X, LINE 2: THE PLAN FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX AND FORM 5500, ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLAN. THE PLAN'S RETURNS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UNTIL THE APPLICABLE STATUTE OF LIMITATION EXPIRES. 0 0 0 JAMES COYNE LABOR CO-CHAIRMAN 0 211970 0 0 0 11108 0 294823 0 28146 0 546047 0 0 KENNETH TURNQUIST LABOR TRUSTEE 0 177963 0 0 0 7172 0 115230 0 28146 0 328511 0 0 SCOTT SPANGLE LABOR TRUSTEE 0 146638 0 0 0 7285 0 108086 0 28146 0 290155 0 0 JIM MANSFIELD LABOR TRUSTEE 0 146638 0 0 0 2240 0 59102 0 28146 0 236126 0 0 WILLIAM MATTHIES LABOR TRUSTEE 0 146638 0 0 0 4821 0 52154 0 28146 0 231759 0 0 JOHN S BYRNE LABOR TRUSTEE - PAST 0 109214 0 0 0 553 0 70462 0 18880 0 199109 0 0 TERRY MUSTO FUND ADMINISTRATOR 0 182581 0 0 0 810 0 126235 0 28142 0 337768 0 0 ANTHONY ROTTMAN FIELD REPRESENTATIVE - NEW 0 130316 0 0 0 30 0 13119 0 28142 0 171607 0 0 FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAS NO COMMITTEES THAT POSSESS THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PROVIDED TO THE FUND ADMINISTRATOR AND CO-CHAIRMEN OF THE BOARD OF TRUSTEES PRIOR TO THE FILING. AFTER THEIR REVIEW AND APPROVAL, THE FORM IS SIGNED AND FILED. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE FUND OFFICE. FORM 990, PART VII, SECTION A, LINE 1A THE ORGANIZATION'S ADMINISTRATOR AND FIELD REP ARE ALSO THE ADMINISTRATOR AND FIELD REP OF SEVERAL OTHER ENTITIES. ANNUALLY, REIMBURSEMENTS ARE EXCHANGED BETWEEN THE ORGANIZATIONS FOR THE ALLOCATED PORTION FO THEIR SALARY, FRINGES AND TAXES. THESE INDIVIDUALS ARE COMPENSATED DIRECTLY BY THE WELFARE FUND LISTED IN SCHEDULE R, PART II. ACCORDINGLY, THE AVERAGE HOURS PER WEEK HAS BEEN REPORTED ENTIRELY ON THE RELATED PARTY LINE AND IS REPRSEENTATIVE OF THE WEEKLY AMOUNT DEDICATED TO ALL ENTITIES. 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