2017-10-23T10:13:21-05:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2016-01-01 020656066 HEARTLAND HEALTHCARE FUND HEAR 9528540795 3001 METRO DRIVE NO 500 BLOOMINGTON MN 55425 STEVEN TONDI CHAIRMAN 9528540795 2017-10-16 1 DOUG BERTOSSI P00637990 6123764500 67.137.57.251 2017-10-16 09:32:54 CD P 04722FD5EDB86B5C651CCDD44AB35AA37EEDD5A5 EB257C677C23210A1BABF3CC3C8E15734A982BF5 2016 2021-01-29 14:40:06Z STEVEN TONDI 3001 METRO DRIVE NO 500 BLOOMINGTON MN 55425 35307070 0 X N/A X 2002 IA INSURED AND SELF FUNDED WELFARE BENEFITS FOR UNION MEMBERS AND THEIR DEPENDENTS. 6 0 44 6 0 0 0 0 26510554 28728098 618111 646138 0 0 27128665 29374236 0 0 27574653 28789908 0 0 0 0 0 1201419 1159978 28776072 29949886 -1647407 -575650 33744174 33963594 364803 318661 33379371 33644933 INSURED AND SELF-FUNDED WELFARE BENEFITS FOR UNION MEMBERS AND THEIR DEPENDENTS. 0 0 INSURED AND SELF FUNDED WELFARE BENEFITS FOR APPROXIMATELY 2,144 UNION MEMBERS 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 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 15 0 44 1 0 0 0 0 0 0 X 6 0 0 1 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X WILSON MCSHANE CORPORATION 9528540795 3001 METRO DR STE 500 BLOOMINGTON MN 55425 X X STEVEN P TONDI CHAIRMAN, SEE SCHEDULE O 1.00 40.00 X X 0 0 0 DAVE FOY TRUSTEE, SEE SCHEDULE O 1.00 2.00 X 0 0 0 DAVID ARGUBRIGHT TRUSTEE, SEE SCHEDULE O 1.00 1.50 X 0 0 0 BRUCE WERNING SECRETARY, SEE SCHEDULE O 1.00 40.00 X X 0 0 0 GREG MULHERIN TRUSTEE 1.00 2.00 X 0 0 0 DANIEL AUSSEM TRUSTEE, SEE SCHEDULE O 1.00 6.00 X 0 0 0 0 0 0 0 0 0 0 WILSON MCSHANE CORPORATION 3001 METRO DRIVE BLOOMINGTON MN 55425 FUND ADMINISTRATOR 734719 BLUELINK TPA 1305 CORPORATE CENTER DRIVE EAGAN MN 55121 MEDICAL CLAIMS NETWORK 581354 2 EMPLOYER CONTRIBUTIONS 525100 27022082 27022082 EMPLOYEE CONTRIBUTIONS 525100 1706016 1706016 28728098 704161 704161 5874811 5932834 -58023 -58023 -58023 29374236 28670075 0 704161 28789908 731002 55383 50971 106552 76276 25935 15417 TRANSITIONAL REINSURANC 98442 29949886 1484063 1153057 61623 93378 2538817 2222396 161962 177222 25168100 25835285 4329609 4482256 33744174 33963594 220546 161862 144257 156799 364803 318661 X 33379371 33644933 33379371 33644933 33744174 33963594 -575650 841212 0 X 0 1 X 1 0 0 LIMITED LIABILITY COMPANY 4482256 F 4482256 X 30108896 841212 841212 29267684 106552 106552 29374236 29843334 0 29843334 106552 106552 29949886 PART X, LINE 2: THE VEBA TRUST FUNDING BENEFITS OF THE PLAN RECEIVED AN EXEMPTION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS) DATED MAY 20, 2003, STATING THAT THE TRUST IS TAX-EXEMPT UNDER THE PROVISIONS OF SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE (IRC). HOWEVER, AS A RESULT OF THE PLAN'S FUNDING POLICY, FROM TIME TO TIME THE TRUST MAY BE SUBJECT TO INCOME TAXES. NO FEDERAL OR STATE INCOME TAXES HAVE BEEN RECORDED IN 2016 AND 2015 FOR UNRELATED BUSINESS TAXABLE INCOME. IN ADDITION, THE PLAN AND TRUST ARE REQUIRED TO OPERATE IN CONFORMITY WITH THE IRC TO MAINTAIN THE TAX-EXEMPT STATUS OF THE TRUST. THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC AND, THEREFORE, BELIEVES THAT THE RELATED TRUST IS TAX-EXEMPT. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 2851 2851 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 8584 8584 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 180 180 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 960 960 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 394 394 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 627 627 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 11084 11084 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 4188 4188 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 1472 1472 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 402 402 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 3925 3925 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 601 601 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 2294 2294 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 2454 2454 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 15029 15029 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 52465 52465 0 0 0 SUBSTANTIAL CONTRIBUTOR CONTRIBUTING CONTRACTOR EMPLOYER CONTRIBUTIONS X 69712 69712 0 0 0 177222 FORM 990, PART VI, SECTION A, LINE 3 WILSON-MCSHANE COMPANY WAS DELEGATED CONTROL OVER MANAGEMENT DUTIES AS PLAN ADMINISTRATOR. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON INFORMATION SUPPLIED BY THE ORGANIZATION. A REVIEW OF THE RETURN IS CONDUCTED BY THE ORGANIZATION AND PRESENTED TO THE BOARD OF TRUSTEES PRIOR TO FILING. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE MEMBERS UPON REQUEST. FORM 990 PART VII, SECTION A, LINE 1A TRUSTEES ARE NOT COMPENSATED BY THE FUND. COMPENSATION PAID TO TRUSTEES EMPLOYED BY OTHER RELATED ORGANIZATIONS IS REPORTED ON THE FORM 990 FILED WITH THE INTERNAL REVENUE SERVICE BY THE RELATED TAX-EXEMPT ORGANIZATION. THE FOLLOWING RELATED ORGANIZATIONS REPORTED COMPENSATION FOR A TRUSTEE LISTED ON THE HEARTLAND HEALTHCARE FUND 990: STEVEN P. TONDI, CHAIRMAN QUAD CITY CONSTRUCTION INDUSTRY ADVANCEMENT TRUST EIN: 36-2652144 DAVID ARGUBRIGHT, TRUSTEE UNITED BROTHERHOOD OF CARPENTERS & JOINERS LOCAL NO 195 EIN: 36-2419940 BRUCE WERNING, SECRETARY UNITED BROTHERHOOD OF CARPENTERS & JOINERS OF AMERICA EIN: 36-1894832 DANIEL AUSSEM, TRUSTEE ILLINOIS VALLEY CONTRACTORS ASSOCIATION EIN: 36-2150421 DAVE FOY MILLWRIGHT LOCAL UNION 2158 EIN: 42-1484016 CARPENTERS LOCAL #4 LOCAL #790 NO WEST ILL & EASTERN CARP JATC CARPENTERS TRAINING PROGRAM ILLOWA MILLWRIGHTS JATC CHICAGO DISTRICT COUNCIL NORTHERN ILLINOIS UNIVERSITY PHYSICAL PLANT CARROLL COUNTY TREASURE AGC OF ILLINOIS ILLINOIS VALLEY CONTRACTORS ASSOCIATION 1120 FIRST STREET LASALLE IL 61301 362150421 PROMOTE BETTER RELATIONS BETWEEN LOCAL CONTRACTORS, TRADE UNIONS, CONSTRUCTI IL 501(C)(6) N/A 0 MILLWRIGHT LOCAL UNION 2158 & ILLOWA BUILDING FUND 2707 62ND STREET COURT BETTENDORF IA 52722 421484016 OWNS AND LEASES OFFICE AND TRAINING SCHOOL FACILITIES TO MILLWRIGHT 2158 IA 501(C)(2) N/A 0 UNITED BROTHERHOOD OF CARPENTERS & JOINERS OF AMERICA 12 EAST ERIE STREET CHICAGO IL 60611 361894832 LABOR UNION IL 501(C)(5) N/A 0 QUAD CITY CONSTRUCTION INDUSTRY ADVANCEMENT TRUST 520 - 24TH STREET ROCK ISLAND IL 61201 362652144 PROMOTING, IMPROVING, AND ADVANCING THE CONSTRUCTION INDUSTRY IN QUAD-CITY IL 501(C)(6) N/A 0 HAYES MECHANICAL INC CORNERSTONE CONSTRUCTION GROUP LLC INTERIOR BUILDING SYSTEMS D CONSTRUCTION INC 3D CONCRETE INC ALLIED CONSTRUCTION SERVICES INC ALLOY SPECIALITES INC ANDERSON COMMERCIAL CON AREA RIGGING & MILLWRIGHT ARTISAN CONTRACTING INC ARZEE CONSTRUCTION INC ATLANTIC PLANT MAINT INC AUSTED & SONS INC AXIS MECHANICAL GROUP BABCOCK & WILCOX COMPANY BAUM OTTO & SON'S INC BENNETT CONSTRUCTION INC BILFINGER INDUST SERVICE BLACKHAWK FOUNDATIONS BLAHNIK CONSTRUCTION CO BRAND ENERGY SERVICES BRECKE BG INC BRENNAN J F CO INC BUILDERS SALES & SERVICES BURKS DRYWALL BUSH CONSTRUCTION CO INC CALACCI CONSTRUCTION CARPET WEAVERS COMMERCIAL CENTENNIAL CONTRACTOR CENTRAL CEILING SYSTEMS CENTRAL MILLWRIGHT SER CIVIL CONSTRUCTORS INC CONCRETE SYSTEMS INC CONTROL INSTALLATIONS OF IOWA INC CRUZ CONCRETE CURNYN CONSTRUCTION CO CURRY KEN CONSTRUCTION INC DAVES FLOOR COVERINGS DAY & ZIMMERMAN NPS INC DIAMOND CUT INC DOHERTY CONSTRUCTION DOORS INC DORAL CORPORATION ESTES COMPANY FINELINE INC FORRISTALL CONCRETE CO FRANCK D G INC GENERAL CONSTRUCTORS INC GOETZ CONCRETE CONSTRUCTION H&H BUILDERS INC HARGER'S ACOUSTICS HEITKOTTER INC HODGE CONSTRUCTION CO INC HODGE CONSTRUCTION CO HOFFMAN BUILDERS INC ICON INDUSTRIAL SERVICE ILLINOIS VALLEY MACHINE INDUSTRIAL SERVICES GROUP INC INTERIOR INSTALLATION INTERNATIONAL DECORATOR IRVING CONSTRUCTION CO J B ROBERTSON CONSTRUCTION JOHNSTON W F CONSTRUCTION JUST RITE ACOUSTICS KINETIC CONSTRUCTION KNIGHT FLOORING INC KOESTERS LINOLEUM SHOP KOJA CONSTRUCTION INC KOOLMASTER CO INC KUDELA BUILDERS L & L FLOORCOVERING L P W INC LADZINSKI CEMENT FINISH LARSEN KLAUER BUILDERS LAVERDIERE CONSTRUCTION LEANDER CONSTRUCTION INC LIEBHART CONSTRUCTION LITE CONSTRUCTION M&M CONCRETE INC MACHINERY & CONVEYOR MARKET & JOHNSON INC MAYOU D H ROOFING CO MCGRATH & ASSOCIATES INC MEDINA BUILDERS INC MIDWEST MOWING INC MILLARD FRANK & COMPANY MILLWRIGHT SERVICE INC MODULAR INSTAL & DESIGN MORTENSON CONSTRUCTION MTE MILLER TRUCKING NELSON CONSTRUCTION CONTRACTING NEWELL MACHINERY CO INC NICAM CONSTRUCTION NORTHERN ILL WALL & CEILING ONSITE WOODWORKING CORPORTION PARAMOUNT MILLWRIGHT PERFORMANCE FLOORS CORP PINTER GENERAL CONTRACTING PINTO CONSTRUCTION GRP PRECISION BUILDERS PRIESTER CO INC QUAD CITY ACOUSTICAL R G CONSTRUCTION SERVICE RACK-IT INSTALLATIONS RAYNOR DOOR CO INC RAYNOR MANUFACTURING RINGLAND JOHNSON INC RIVER VALLEY CONSTRUCTION ROBERTSON JB CONSTRUCTION ROCKWELL GROUP ROGERS AUTOMATED ENTRAN RYAN & ASSOCIATES RYAN COMPANIES US INC SEITHER & CHERRY QUAD SHEPARD CONSTRUCTION SJOSTROM & SONS SMITH CA BUILDERS INC SPELICH GENERAL CONTRACTING STARK EXCAVATING INC SUITABLE BUILDERS INC SUPERIOR FLOOR COVERING SWEDBERG & ASSOCIATES TIEMAN BUILDERS TREIBER CONSTRUCTION CO TRUSS PLUS INC VALLEY CONST CO VISSERING CONSTRUCTION VOITH SIEMENS HYDRO POW WEAVER CONSTRUCTION INC WEITZ ABELL-HOWE WILLIAMS BROS CONSTRUCTION INC WINKLER CONSTRUCTION CO WINTER CONSTRUCTION INC WOZNIAK CONCRETE FINISHING YAKLICH JIM HOME IMPROVEMENTS 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE R, PART VII THE FOLLOWING COMPANIES ARE CONTRIBUTING EMPLOYERS TO THE HEARTLAND HEALTHCARE FUND AND DEEMED TO BE A RELATED ORGANIZATION. HOWEVER, THE FUND WAS UNABLE TO OBTAIN THE SPECIFIC TAX CLASSIFICATION OF THE ORGANIZATIONS. AS SUCH, THE ENTITIES ARE NOT LISTED BY THE TAX CLASSIFICATION IN PARTS II - IV OF THE SCHEDULE R. SEE EMPLOYER LIST BELOW: ADVANTAGE INDUSTRIAL SYSTEMS AFFORDABLE DECORATING AHC MECHANICAL SERVICES AIMS MECHANICAL, LLC ALBERT INSTALLATIONS ALL PHASES CONSTRUCTION AMERICAN RIGGING & MILL BI STATE SEAMLESS GUTTERS BOLDT OSCAR J CONSTRUCT BRIESER CONSTRUCTION CO BROWN CONSTRUCTION BRYDIE CONSTRUCTION BUILDERS CONCRETE SERVICES BUTLER DRYWALL & PAINT BYRNE & JONES MARINE CATALANELLO BUILDERS CECO CONCRETE CONSTRUCTION CETWINSKI CONSTRUCTION CITY OF FULTON CITY WIDE INSULATION COLD SHEILD INC COLLINS CONCRETE LTD COMMERCIAL FLOOR COVERING CONTEMPORARY HAMMERWORK COOKS FLOORCOVERING INC CORNERSTONE CARPENTRY CPI OF THE MIDWEST CREATION CARPENTRY CO DASHCO, INC. DICKS FLOOR COVERING DRESSER-RAND PRODUCT EDON CONSTRUCTION FOUNDATION SERVIECS GALE CONSTRUCTION CO OF ILLINOIS GANDT BUILDERS INC GENSINI EXCAVATING & TR GILLESPIE & POWERS INC GREGORY CONSTRUCTIO GRP MECHANCIAL CO, INC. HARGRAVE BUILDERS, INC. HART ERECTORS HEIN CONSTRUCTION CO, INC. HERITAGE CONSTRUCTION HOERR P J INC HOUSE OF DOORS INC ILLINOIS CONSTRUCTOR CO INSTALLATION SERVICES INSULATED PANEL COMPANY INTEGRAL FLOORING SYSTEM INTERIOR CONSTRUCTION IPC LYDON LLC JM INDUSTRIAL SUPPLY JMS CONSTRUCTION JONES-BLYTHE CONSTRUCTION JOSH BAHL CONSTRUCTION K&S ENGINEERS INC KEEN CO KINGSTON TILE COMPANY KRAEMER NORTH AMERICA LAKES & RIVERS CONTRACT LEOPARDO COMPANIES INC. LILJA MECHANICAL CONSTR LOWER JOHN CONSTRUCTION MANUSOS GENERAL CONTRACTING MARIN BROS INC MARLEY COOLING TOWER CO MARTIN & COMPANY EXCAV MCCARTHY IMPROVEMENT MCCOY CONSTRUCTION CO MID VALLEY CONCRETE INC. MONARCH CONSTRUCTION MORSE L. J. CONSTRUCTION MR DAVID'S CARPET SERVICE NORTH CETRAL STATES RE NORTHSIDE CONSTRUCTION PAN AMERICAN CONCRETE PETERSON BERTEL CO PORTZEN CONSTRUCTION PRECISION MECHANICAL PRIME CONSTRUCTION SERVICES PRODIGY CONSTRUCTION LL RAVENSBERG INC RAYNOR DOOR AUTH OF DE RECORD AUTOMATIC DOORS REDBUD RIDGE CUSTOM RIGID CONSTRUCTION INC RIVER CITY CONSTRUCTION ROCKFORD CARPETLAND USA ROSE CONCRETE RUIZ CONSTRUCTION CO RUSSELL CONSTRUCTION S&S FLOORING INSTAL SAFWAY SERVICES LLC SCAFFOLD INSTALLATION SCURTO CEMENT CONSTRUCT SINGLEY CONSTRUCTION INC. STONE & WEBSTER CONSTRUCTION SWANSON PROFESSIONAL FL SYSTEMS ENTERPRISE CORP THEIL R & D INC TURBINE PROS, LLC UNIVERSAL PLANT SERVICE VANGUARD CONTRACTORS INC W SOULE & CO WALBRIDGE EQUIPMENT INSTALL WE CARLSON CORP WILLMAN CONSTRUCTION WINGER MECHANICAL WOODS CONSTRUCTION CO WRIGHT-WAY INTERIOR SYSTEMS