2016-07-14T11:00:09-05:00 2015-11-30 510435869 Needles & Associates LLC 350 Interlocken Blvd STE 360 Broomfield CO 80021 990 2014-12-01 736104291 Mid-South Iron Workers Welfare Fund MID- 4056822323 1300 S Meridian No 125 Oklahoma City OK 73108 Walter Ashford Trustee 4056822323 2016-06-27 1 Kurt Needles P00850236 3034304225 2016-07-14 2014 2016-09-27 15:27:22Z Walter Ashford 1300 S Meridian No 125 Oklahoma City OK 73108 3641665 0 X N/A X 1964 OK To provide health benefits to eligible participants and their dependents. 6 0 0 0 0 0 0 0 3137599 3622810 70504 18855 0 0 3208103 3641665 0 0 2617336 3155943 0 0 0 0 0 439092 411801 3056428 3567744 151675 73921 3836141 4239615 1414521 1708906 2421620 2530709 To provide health benefits to eligible participants and their dependents. 0 0 To provide health benefits to 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 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 6 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 South Meridian Street Oklahoma City OK 73108 X Michael Richards Trustee 1.00 X 0 0 0 Chris Kinder Co-Chairman 1.00 X 0 0 0 Tiffany Mythen Trustee 1.00 X 0 0 0 Walter Ashford Chairman 1.00 X 0 0 0 Dave Bennett Trustee 1.00 X 0 0 0 Willie Wright Trustee 1.00 X 0 0 0 0 0 0 0 0 0 0 Blue Cross Blue Shield 225 North Michigan Ave Chicago IL 60601 PPO/Access Fees 128760 Zenith American Solutions 1300 S Meridian Street Oklahoma City OK 73108 Administrative 116993 2 Employers' Contributio 525100 3428565 3428565 Reciprocity In 525100 238844 238844 Employees' Contributio 525100 134840 134840 Reciprocity Out 525100 -179439 -179439 3622810 18855 18855 3641665 3622810 0 18855 3155943 117088 26555 25734 187558 11980 540 10177 Transitional Reinsuranc 32126 Misc. 43 3567744 163084 402422 630747 521969 381799 604598 2660511 2710626 3836141 4239615 161312 155539 1253209 1553367 1414521 1708906 X 2421620 2530709 2421620 2530709 3836141 4239615 73921 35168 0 X 0 1 X 1 0 0 Hour Bank Liability 873367 Claims Incurred but Not Reported 680000 1553367 X 3676833 35168 35168 3641665 0 3641665 3267586 0 3267586 300158 300158 3567744 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 November 30, 2015 and 2014. With few exceptions, the Plan is no longer subject to income tax examinations by tax authorities for years preceding November 30, 2011. Part XII, Line 4b - Other Adjustments: Change in Hour Bank and IBNR liabilities 300,158. Form 990, Part VI, Section B, line 11 Form 990 was provided to the Trustees prior to filing. Form 990, Part VI, Section B, line 12c During Board of Trustee meetings, Trustees discuss and enforce compliance with the conflict of interest policy. Form 990, Part VI, Section C, line 18 The 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. Oklahoma Iron Workers Direct Contribution Plan 1300 S Meridian STE 200 Oklahoma City OK 73108 736278639 The Plan provides pension benefits. OK 403(b) 0 Contact fund administrator for info needed for Sch R Part III & IV N/A NA OK 73108 000000000 N/A OK 0 0 Contact fund administrator for info needed for Sch R Part III & IV N/A NA OK 73108 000000000 N/A OK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0