2016-11-15T12:49:02-06:00 2015-12-31 381357951 PLANTE & MORAN PLLC 2601 CAMBRIDGE CT SUITE 500 AUBURN HILLS MI 48326 990 2015-01-01 476377585 UAW RETIREES OF DAIMLER TRUCKS NORTH AMERICA WELFARE BENEFIT TRUST UAWR 2488139800 700 TOWER DRIVE SUITE 300 TROY MI 48098 SUZANNE DANIELS CHAIRPERSON 2488139800 2016-11-15 1 LYNNE M HUISMANN P00053811 2483757100 2015 2017-02-10 21:41:12Z 25999683 0 X N/A X 2014 MI THE TRUST WAS ESTABLISHED AND IS CONTINUED FOR THE PURPOSE OF PROVIDING HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS 7 4 0 2 0 0 0 0 481322628 22675966 15641 2803457 0 0 481338269 25479423 0 0 0 10522915 0 109188 0 0 0 127457 966508 127457 11598611 481210812 13880812 481210812 488873780 0 3202273 481210812 485671507 THE TRUST WAS ESTABLISHED AND IS CONTINUED FOR THE PURPOSE OF PROVIDING HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 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 7 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X HEATHER CARMEN 2488139800 700 TOWER DRIVE STE 300 TROY MI 48098 SUZANNE DANIELS CHAIRPERSON 2.00 6.00 X 25650 89632 0 JACK MARTIN COMMITTEE MEMBER 0.50 1.50 X 21000 78988 0 FRANCINE PARKER COMMITTEE MEMBER 0.50 1.50 X 16500 74208 0 GARY PETRONI COMMITTEE MEMBER 0.50 1.50 X 21000 79621 0 ALLEN PENLEY COMMITTEE MEMBER 0.50 1.50 X 25038 0 0 TIM BRESSLER COMMITTEE MEMBER 0.50 1.50 X 0 0 0 CHUCK DAVENPORT COMMITTEE MEMBER 0.50 1.50 X 0 0 0 COMERICA BANK INSTITUTIONAL TRUSTEE 0.50 1.50 X 0 0 0 109188 322449 0 0 0 0 0 BENESYS INC 700 TOWER DR SUITE 300 TROY MI 48098 PLAN ADMINISTRATION 314504 MILLIMAN INC ONE PENNSYLVANIA PLAZA 38TH FLOOR NEW YORK NY 10119 ACTUARY AND BENEFIT CONSULTANT 228351 BLUE CROSS BLUE SHEILD OF MICHIGAN 600 E LAFAYETTE BLVD DETROIT MI 48226 ADMINISTRATIVE SERVICES 195358 3 PARTICIPANT CONTRIBUTIONS 900099 21432600 21432600 OTHER 900099 648723 648723 SELF PAYMENTS 900099 590413 590413 LITIGATION SETTLEMENT 900099 4230 4230 22675966 3323717 3323717 520260 -520260 -520260 -520260 25479423 22675966 0 2803457 10522915 109188 310000 71553 8600 228810 311438 22506 13174 CORPORATE BONDS 427 11598611 322543 2817972 4639226 70000000 605694 0 155231 410011403 427723396 52016262 876866 915999 481210812 488873780 0 1689021 0 1513252 0 3202273 X 481210812 481210812 0 0 0 4460695 481210812 485671507 481210812 488873780 13880812 -9420117 0 X 0 1 X 0 0 0 52016262 C 52016262 OTHER LIABILITIES 1513252 1513252 16059306 -9420117 -9420117 25479423 0 25479423 11598611 0 11598611 0 11598611 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 12500000 0 0 0 0 0 0 12500000 0 12500000 1 0 0 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE CHAIR, LEGAL COUNSEL, AND ADMINISTRATOR REVIEW THE 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE TRUST WAS ESTABLISHED BY COURT SETTLEMENT. THE COURT-APPROVED TRUST AGREEMENT INCLUDES A CODE OF ETHICS BY WHICH EACH COMMITTEE MEMBER AGREES TO ABIDE. IT IS REGULARLY REVIEWED WITH THE COMMITTEE. IN ADDITION, EACH COMMITTEE MEMBER MUST ANSWER THE FIDUCIARY LIABILITY INSURANCE RENEWAL QUESTIONNAIRE WHICH CONTAINS QUESTIONS REGARDING POTENTIAL AND ACTUAL CONFLICTS OF INTEREST. IF SUCH A CONFLICT IS PRESENT THE INVOLVED MEMBER(S) DO NOT PARTICIPATE IN THE DISCUSSION OR VOTING. FORM 990, PART VI, SECTION B, LINE 15 THE FUND IS COLLECTIVELY-BARGAINED AND WAS ESTABLISHED PURSUANT TO A COURT-APPROVED TRUST AGREEMENT. THE TRUST SETS FORTH THE COMPENSATION OF THE INDEPENDENT MEMBERS OF THE COMMITTEE AND SUCH COMPENSATION IS NOT SUBJECT TO ADJUSTMENT EXCEPT AS SPECIFICALLY PROVIDED THEREIN. FORM 990, PART VI, SECTION C, LINE 19 THE TRUST IS ESTABLISHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED. IT OPERATES IN COMPLIANCE WITH THE REPORTING AND DISCLOSURE REQUIREMENTS OF SUBTITLE B, PART 1 OF ERISA WITH RESPECT TO DISCLOSURE OF ITS GOVERNING DOCUMENTS AND FINANCIAL INFORMATION. IT OPERATES IN COMPLIANCE WITH THE FIDUCIARY RESPONSIBILITY REQUIREMENTS OF SUBTITLE B, PART 4 OF ERISA. UAW RETIREES OF THE DANA CORPORATION HEALTH AND WELFARE TRUST 700 TOWER DRIVE SUITE 300 TROY MI 48098 261851652 PROVIDE HEALTH & WELFARE BENEFITS MI 501(C)(9) N/A N/A 0 UAW ST JOSEPH RETIREES HEALTH AND WELFARE TRUST 700 TOWER DRIVE SUITE 300 TROY MI 48098 271401289 PROVIDE HEALTH & WELFARE BENEFITS MI 501(C)(9) N/A N/A 0 UAW RETIREES OF ACC BENEFIT TRUST 700 TOWER DRIVE SUITE 300 TROY MI 48098 276927927 PROVIDE HEALTH & WELFARE BENEFITS MI 501(C)(9) N/A N/A 0 UAW RETIREES OF MACK TRUCKS HEALTH BENEFIT FUND 700 TOWER DRIVE SUITE 300 TROY MI 48098 456488442 PROVIDE HEALTH & WELFARE BENEFITS MI 501(C)(9) N/A N/A 0 DAIMLER TRUCKS NORTH AMERICA LTD 2701 NW VAUGHN STREET PORTLAND OR 97201 AUTOMOTIVE OR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 DAIMLER TRUCKS NORTH AMERICA LLC S 973600659 SETTLEMENT AGREEMENT