2016-04-06T11:02:52-05:00 2015-08-31 510435869 Needles & Associates LLC 350 Interlocken Blvd STE 360 Broomfield CO 80021 990 2014-09-01 730790052 Oklahoma Operating Engineers Welfare Plan OKLA 4056822323 1300 S Meridian Street No 110 Oklahoma City OK 73108 Michael L Stark Jr Chairman 4056822323 2016-04-01 1 Kurt D Needles CPA P00850236 3034304225 2016-04-06 2014 2016-08-17 19:52:53Z Michael L Stark Jr 1300 S Meridian Street No 110 Oklahoma City OK 73108 9632979 0 X N/A X 1969 OK Provide health & welfare benefits to eligible participants. 4 0 0 0 0 0 0 0 7461150 5529750 225540 241366 0 0 7686690 5771116 0 0 4876967 5438712 0 0 0 0 0 562601 560920 5439568 5999632 2247122 -228516 18964834 17589355 4289073 3062662 14675761 14526693 Provide health & welfare benefits to eligible participants. 0 0 Provide health & welfare benefits to eligible participants. 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 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X Board of Trustees 4056822323 1300 S Meridian Street No 110 Oklahoma City OK 73108 X Mike Stark Chairman 1.00 X 0 0 0 Sam Vanmeter Co-Chairman 1.00 X 0 0 0 Alan Farris Trustee 1.00 X 0 0 0 Mark Little Trustee 1.00 X 0 0 0 0 0 0 0 0 0 0 Blue Cross Blue Shield 3401 NW 63rd St Oklahoma City OK 73116 Access Fee/Admin 184256 Zenith American Solutions Inc 1300 S Meridian STE 110 Oklahoma City OK 73108 Administrative 150332 2 Employers' contributions 525100 3848824 3848824 Net Reciprocity 525100 1564362 1564362 Participants' contributions 525100 116564 116564 5529750 221066 221066 3882163 3861863 20300 20300 20300 5771116 5529750 0 241366 5438712 150332 49495 33613 255130 15749 684 9482 Transitional Reinsuranc 46435 5999632 544019 511367 3702300 1870101 1216645 1826692 32712 0 13469158 13381195 18964834 17589355 1182395 64880 3106678 2997782 4289073 3062662 X 14675761 14526693 14675761 14526693 18964834 17589355 -228516 79448 0 X 0 1 X 1 0 0 Hour Bank Liability 2011282 Claims Incurred but Not Reported 986500 2997782 X 5850564 79448 79448 5771116 0 5771116 6108528 108896 108896 5999632 0 5999632 Part X, Line 2: The Internal Revenue Service has determined that the Plan is exempt from federal income tax under Internal Revenue Code Section 501(c)(9). The Trust established to hold the Plan's assets obtained its original determination letter, in which the Internal Revenue Service stated that the trust, as then designed, was in compliance with the applicable requirements of the Internal Revenue Code. The trust has been amended since receiving the determination letter. However, the Plan's administrator and tax counsel believe that the trust is currently designed and being operated in compliance with the applicable requirements of the Internal Revenue Code. Management has evaluated the Plan's tax positions and concluded that the Plan has maintained its tax exempt status and had taken no uncertain tax positions that would require financial statement adjustment or disclosure for the years ended August 31, 2015 and 2014. With few exceptions, the Plan is no longer subject to income tax examinations by tax authorities for years preceding August 31, 2011. Part XII, Line 2d - Other Adjustments: Change CIBNR -76,500. Change in Hour Bank 185,396. Form 990, Part VI, Section B, line 11 Form 990 was provided to the Board of Trustees for their review. Form 990, Part VI, Section B, line 12c Trustees review policies annually. Form 990, Part VI, Section C, line 18 Form 990 is available for public inspection upon request. Form 990, Part VI, Section C, line 19 Governing documents are available to the public upon request. Information maintained by administrator N/A NA OK 73108 000000000 N/A OK 0 0 Information maintained by administrator N/A NA OK 73108 000000000 N/A OK N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0