2017-02-13T11:12:53-06:00 2016-05-31 320043599 LEGACY PROFESSIONALS LLP 311 S WACKER DRIVE STE 4000 CHICAGO IL 60606 990 2015-06-01 510210922 NATIONAL ROOFERS UNION & EMPLOYERS JOINT HEALTH & WELFARE FUND NATI 9528540795 3001 METRO DRIVE NO 500 BLOOMINGTON MN 55425 JOHN PLESCIA TRUSTEE 9528540795 2017-02-13 1 CRAIG RESCH P00844633 3123680500 2015 2021-01-29 14:40:06Z X JOHN PLESCIA 3001 METRO DRIVE NO 500 BLOOMINGTON MN 55425 11277362 0 X N/A X 1976 MN TO PROVIDE HEALTH BENEFITS 6 4 0 0 0 0 0 0 7601851 8326042 374179 330541 4451 6269 7980481 8662852 0 0 6424189 7393897 0 0 0 0 0 678471 646622 7102660 8040519 877821 622333 12922558 13016807 68516 41942 12854042 12974865 PROVIDE HEALTH BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 1 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 X 6 4 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X WILSON MCSHANE 9528540795 3001 METRO DRIVE SUITE 500 BLOOMINGTON MN 55425 KINSEY ROBINSON TRUSTEE 1.00 35.00 X 0 327474 47462 JOHN PLESCIA TRUSTEE 1.00 X 0 0 0 DENNIS CONWAY TRUSTEE 1.00 X 0 0 0 MARK REEVES TRUSTEE 1.00 X 0 0 0 PAUL BLASKI TRUSTEE 1.00 X 0 0 0 DOUGLAS ZIEGLER TRUSTEE 1.00 17.00 X 0 74674 21291 0 402148 68753 0 0 1 0 CIGNA 8505 EAST ORCHARD ROAD GREENWOOD VILLAGE CO 80111 MEDICAL PPO PROVIDER 236144 FRINGE BENEFIT SERVICES INC 7010 N BROADWAY SUITE 106 DENVER CO 80221 THIRD PARTY ADMINISTRATOR 216691 2 EMPLOYER CONTRIBUTIONS 900099 8057021 8057021 STOP LOSS POLICY REIMBURSEMENTS 900099 121070 121070 PRESCRIPTION DRUG REBATES 900099 117943 117943 PARTICIPANT CONTRIBUTIONS 900099 30008 30008 8326042 352333 352333 2592718 2614510 -21792 -21792 -21792 MISCELLANEOUS REVENUE 900099 6269 6269 6269 8662852 8326042 0 336810 7393897 201036 169390 51212 23397 71811 39230 14688 7492 FEES MANDATED BY ACA 61744 MISCELLANEOUS 6622 8040519 326745 324328 988303 880835 1150124 1080186 2940 5034 9644057 10027892 810389 698532 12922558 13016807 68516 41942 68516 41942 X 0 0 0 0 12854042 12974865 12854042 12974865 12922558 13016807 622333 -501510 0 X 0 1 X 1 0 0 CLOSED END INVESTMENT COMPANY 456278 F COMMINGLED MORTGAGE FUND 242254 F 698532 X 8137945 -501510 -501510 8639455 23397 23397 8662852 8017122 0 8017122 23397 23397 8040519 PART X, LINE 2: THE PLAN FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM 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 KINSEY ROBINSON TRUSTEE 0 211169 0 0 0 116305 0 22173 0 25289 0 374936 0 0 FORM 990, PART VI, SECTION A, LINE 3 WHILE THE BOARD OF TRUSTEES RETAINS THE ULTIMATE RESPONSIBILITY, THEY HAVE DELEGATED THE DAY TO DAY MANAGEMENT DUTIES TO FRINGE BENEFIT SERVICES (WILSON MCSHANE AS OF 1/1/17), AS THIRD PARTY ADMINISTRATOR OF THE FUND. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 IS PROVIDED TO AND REVIEWED BY THE ORGANIZATION'S ENTIRE GOVERNING BODY BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C FUND PERSONNEL HAVE THE CONTINUING RESPONSIBILITY TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES. IN ANY DETERMINATION BY THE TRUSTEES OF A CONFLICT OF INTEREST, THE PERSON WITH THE CONFLICT OF INTEREST SHALL BE EXCLUDED FROM THE DISCUSSION AND DETERMINATION OF SUCH CONFLICT. DISCLOSURE OF A CONFLICT OF INTEREST SHOULD BE MADE TO THE ADMINISTRATIVE MANAGER, WHO SHALL BRING THE MATTER TO THE ATTENTION OF THE TRUSTEES OR A DULY CONSTITUTED COMMITTEE THEREOF. DISCLOSURE INVOLVING TRUSTEES SHOULD BE MADE TO THE CHAIRMAN OF THE BOARD OF TRUSTEES, WHO SHALL BRING THESE MATTERS TO THE TRUSTEES OR A DULY CONSTITUTED COMMITTEE THEREOF. THE TRUSTEES OR A DULY CONSTITUTED COMMITTEE THEREOF SHALL DETERMINE WHETHER A CONFLICT EXISTS AND, IN THE CASE OF AN EXISTING CONFLICT, WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR AND REASONABLE TO THE FUND. THE DECISION OF THE TRUSTEES OR A DULY CONSTITUTED COMMITTEE THEREOF ON THESE MATTERS WILL REST IN THEIR SOLE DISCRETION, AND THEIR CONCERN SHALL BE THE WELFARE OF THE PLAN AND THE ADVANCEMENT OF ITS PURPOSE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. 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