2016-11-14T09:46:04-06:00 2015-12-31 320043599 LEGACY PROFESSIONALS LLP 222 INDIANAPOLIS BOULEVARD SUITE 103 SCHERERVILLE IN 46375 990 2015-01-01 356327302 IRONWORKERS LOCAL 395 TRUST FUND IRON 2197696944 2111 WEST LINCOLN HIGHWAY MERRILLVILLE IN 46410 JEFFREY CHIDESTER CHAIRMAN 2197696944 2016-11-14 1 RENEE SPECK P00201492 3123680500 2015 2017-02-10 21:41:12Z JEFFREY CHIDESTER 2111 WEST LINCOLN HIGHWAY MERRILLVILLE IN 46410 38994430 0 X N/A X 1977 IN PROVIDE HEALTH BENEFITS 4 2 57 0 0 0 0 0 15660952 14007085 1304316 1167004 0 0 16965268 15174089 0 0 15576799 15180896 0 0 0 0 0 678756 877655 16255555 16058551 709713 -884462 52548446 51007604 411794 421702 52136652 50585902 TO PROVIDE HEALTH BENEFITS 0 0 TO PROVIDE HEALTH, LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DENTAL, AND VISION BENEFITS FOR ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 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 1 465 0 1 57 1 0 0 0 0 0 0 0 0 X 4 2 0 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 X STEWART C MILLER INC 2197696944 2111 W LINCOLN HIGHWAY MERRILLVILLE IN 46410 JEFFREY CHIDESTER UNION TRUSTEE 2.00 40.00 X 0 139985 54122 STEVE MICHAELS EMP TRUSTEE 1.00 X 0 0 0 SAMUEL TIPTON EMP TRUSTEE 1.00 X 0 0 0 RON WARE JR UNION TRUSTEE 2.00 40.00 X 0 143252 54122 0 283237 108244 0 0 1 0 BENISTAR PO BOX 36029 NEWARK NJ 07188 MEDICARE PREMIUM FEE 1468894 ANTHEM BLUE CROSS BLUE SHIELD 220 VIRGINIA AVE INDIANAPOLIS IN 46204 FEE FOR PROVIDING PPO ACCESS 433082 STEWART C MILLER & CO INC 2111 WEST LINCOLN HIGHWAY MERRILLVILLE IN 46410 PROVIDES ADMINISTRATIVE SERVICES 350445 FIDELITY SECURITY LIFE INSURANCE CORP 16132 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 STOP-LOSS PREMIUMS 344402 4 EMPLOYER CONTRIB. 900099 11908528 11908528 PARTICIPANT CONTRIB. 900099 1770703 1770703 PRESCRIPTION REBATES 900099 327854 327854 14007085 1337616 1337616 23649729 23820341 -170612 -170612 -170612 15174089 14007085 0 1167004 15180896 331448 13468 36425 246157 78743 48101 16666 11060 AFFORDABLE CARE ACT - P 95587 16058551 2904550 5614010 803497 1553929 1465847 13756 85140 45159366 45573184 207385 175386 52548446 51007604 278348 198180 133446 223522 411794 421702 X 0 0 0 0 52136652 50585902 52136652 50585902 52548446 51007604 -884462 -666288 0 X 0 1 X 1 0 0 DUE TO BROKER 223522 223522 X 14261644 -666288 -666288 14927932 246157 246157 15174089 15812394 0 15812394 246157 246157 16058551 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 JEFFREY CHIDESTER UNION TRUSTEE 0 139985 0 0 0 0 0 35055 0 19067 0 194107 0 0 RON WARE JR UNION TRUSTEE 0 143252 0 0 0 0 0 35055 0 19067 0 197374 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE BOARD OF TRUSTEES HAS DELEGATED THE DAY TO DAY MANAGEMENT DUTIES TO STEWART C. MILLER, INC., AS THIRD PARTY ADMINISTRATOR OF THE FUND. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION HAS NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES PRIOR TO FILING. THE TRUSTEES REVIEW THE FORM AND UPON FULLY UNDERSTANDING THE COMPLETED FORM 990, THE FORM IS APPROVED AND SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO ANY PARTICIPANT IN THE PLAN WHO COMES INTO THE FUND OFFICE AND REQUESTS TO SEE THEM. 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