2015-05-15T12:08:05-05:00 2014-09-30 382284921 BENDA GRACE STULZ & COMPANY PC 38800 VAN DYKE AVE STE 100 STERLING HEIGHTS MI 48312 990 2013-10-01 382026006 LABORERS METROPOLITAN DETROIT HEALTH AND WELFARE FUND LABO 5173217502 6525 CENTURION DRIVE LANSING MI 48917 WILLIAM BASSROBERT COPPERSMITH JR UNION & MANAGEMENT TRUSTEE 5173217502 2015-01-16 BRYAN STULZ P00265596 5868836240 2015-05-15 2013 2016-02-25 16:41:14Z SAME AS ABOVE 34014109 false X N/A X 1973 MI PROVIDE HEALTH AND WELFARE BENEFITS 12 7 0 0 0 18100473 20868578 1324786 1442631 23191 304951 19448450 22616160 0 21296220 23013835 0 0 0 1284910 1097441 22581130 24111276 -3132680 -1495116 38412825 40505056 6356181 8929514 32056644 31575542 PROVIDE HEALTH AND WELFARE BENEFITS false false 23013835 22062112 TO PROVIDE HOSPITALIZATION, MEDICAL, DEATH, SURGICAL AND OTHER RELATED HEALTH CARE BENEFITS TO ELIGIBLE PLAN PARTICIPANTS. 23013835 false false false false false false false false false false false false false true false true false false false false false false false false false false false false true false false false false false false false false false false false true false false false 0 0 0 false false false false false false X 12 7 false false false false false true false true true false false false false false false false false false X TIC INTERNATIONAL CORP 5173217502 6525 CENTURION DRIVE LANSING MI 48917 X MICHAEL AARON TRUSTEE 1.00 40.00 X 0 132863 46124 MARK PULICE TRUSTEE 1.00 40.00 X 0 132623 46124 BILL BASS CHAIRMAN 1.00 40.00 X 0 131624 35608 PAUL GASSEL TRUSTEE 1.00 40.00 X 0 131623 35608 JASON CHWALEK TRUSTEE 1.00 40.00 X 0 103229 35608 CHARLES WILSON SECRETARY 1.00 X 0 0 0 ROBERT COPPERSMITH TRUSTEE 1.00 X 0 0 0 WILLIAM GRUEBNAU TRUSTEE 1.00 X 0 0 0 DAVID KRUSE TRUSTEE 1.00 X 0 0 0 SCOTT FISHER TRUSTEE 1.00 X 0 0 0 MICHAEL P SMITH TRUSTEE 1.00 X 0 0 0 ALEX ZUREK TRUSTEE 1.00 X 0 0 0 631962 199072 false true false BLUE CROSS BLUE SHIELD OF MICHIGAN 27000 WEST 11 MILE ROAD B494 SOUTHFIELD MI 48034 HEALTH ADMIN 1304059 TIC INTERNATIONAL CORPORATION 6525 CENTURION DRIVE LANSING MI 48917 TPA 442230 2 EMPLOYER CONTRIBUTIONS 16539540 16539540 PARTICIPANT SELF-PAYMENTS 4329038 4329038 20868578 695662 141614 554048 12144918 11397949 746969 746969 746969 MEDICARE PART D SUBSIDY 253694 253694 LIQUIDATED DAMAGES 46283 46283 COBRA ASSISTANCE PROGRAM 4974 4974 304951 22616160 22062112 554048 23013835 23013835 442230 442230 28986 28986 21500 21500 199853 199853 234215 234215 88237 88237 1753 1753 14560 14560 SAFETY DUES 52354 52354 ERISA REPORTING COSTS 12493 12493 EDUCATIONAL FOUNDATION 1260 1260 24111276 23013835 1097441 0 3098875 3678600 994750 1677293 2480361 706351 864476 32350581 33066594 38412825 40505056 926181 1377514 5430000 7552000 6356181 8929514 X 32056644 31575542 32056644 31575542 38412825 40505056 -1495116 1014014 X false true X true false ACCUMULATED ELIGIBILITY CREDITS 4800000 CLAIMS INCURRED BUT NOT REPORTED 2752000 7552000 23430321 1014014 1014014 22416307 199853 199853 22616160 23911423 23911423 199853 199853 24111276 false false false MICHAEL AARON TRUSTEE 132863 46124 178987 MARK PULICE TRUSTEE 132623 46124 178747 BILL BASS CHAIRMAN 131624 35608 167232 PAUL GASSEL TRUSTEE 131623 35608 167231 FORM 990, PART VI LINE 2 - FAMILY RELATIONSHIP OR BUSINESS RELATIONSHIP - THE RELATIONSHIP BETWEEN THE TRUSTEES OF THE FUND IS A 'BUSINESS RELATIONSHIP'. THE FUND IS ESTABLISHED AND MAINTAINED PURSUANT TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED, THE FUND, AS A TAFT-HARTLEY FUND, IS ADMINISTERED BY A BOARD OF TRUSTEES WHICH IS COMPOSED OF AN EQUAL NUMBER OF UNION AND EMPLOYER REPRESENTATIVES. BECAUSE OF THIS ORGANIZATIONAL REQUIREMENT, THERE IS A BUSINESS RELATIONSHIP BETWEEN THE TRUSTEES. LINE 12 - ANNUALLY, EACH TRUSTEE MUST ANSWER THE FIDUCIARY LIABILITY INSURANCE RENEWAL QUESTIONAIRE, WHICH CONTAINS QUESTIONS REGARDING POTENTIAL AND ACTUAL CONFLICTS OF INTEREST. LINE 15 - THE FUND DID NOT HAVE A CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL, OR OTHER OFFICERS OR KEY EMPLOYEES, AS THOSE TERMS ARE DEFINED. FORM 990, PAGE 6, PART VI, LINE 7A TRUSTEES ARE APPOINTED BY SPONSORING PARTIES OF THE TRUST. UNION TRUSTEES ARE APPOINTED BY PERSONS AUTHORIZED BY THE EACH APPOINTING UNION ORGANIZATON'S EXECUTIVE BOARD, WHO ARE ELECTED PERIODICALLY BY MEMBERS IN GOOD STANDING WHO ARE ELEGIBLE TO VOTE CONSISTENT WITH THE CONSTITUTION OF THE APPOINTING UNION ORGANIZATION. EMPLOYER TRUSTEES ARE APPOINTED BY PERSONS AUTHORIZED BY THEIR EXECUTIVE BOARDS, WHO ARE ELECTED CONSISTENT WITH THE VOTING REQUIREMENTS OF EACH SPECIFIC EMPLOYER ASSOCIATION. FORM 990, PAGE 6, PART VI, LINE 11B NO REVIEW WAS OR WILL BE CONDUCTED. FORM 990, PAGE 6, PART VI, LINE 19 THE FUND 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 I 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. FORM 990, PART VII LINE 1A - MICHAEL AARON, MARK PULICE, BILL BASS, PAUL GASSEL, AND JASON CHWALEK SERVED AS TRUSTEES OF THE FUND WITHOUT COMPENSATION FORM THE FUND FOR THOSE SERVCIES. HOWEVER, THEY WERE COMPENSATED AS EMPLOYEES OF EITHER LOCAL 1076 OR 1191 WHICH WERE CONTRIBUTING EMPLOYERS TO THE FUND ANS, AS SUCH, "RELATED ORGANIZTIONS" AS THAT TERM IS DEFINED IN THE INSTRUCTIONS. LABORERS V & H TRUST FUND - D & V 700 TOWER DRIVE STE 300 TROY MI 48098 386195524 VAC & HOL MI 501C9 N/A false LABORERS PENSION TRUST FUND - D & V 700 TOWER DRIVE STE 300 TROY MI 48098 516030973 PENSION MI 401A N/A false 1 WAY SERVICE INC N/A false 3 LK CONSTRUCTION N/A false 6-K CONSTRUCTION CO N/A false API INC N/A false ADAMO DEMOLITION COMPANY N/A false ADAMS GENERAL CONTRACTING INC N/A false ALBANELLI CEMENT CONTRACTORS N/A false ALFORD CONSTRUCTION GROUP LLC N/A false ALLIED ERECTING & DISMANTLING N/A false ALLSTATE FOUNDATION CO N/A false ALPINE CONTRACTORS N/A false AMALIO CORPORATION N/A false AMERICAN UNDERGROUND SOLUTIONS N/A false ARBOR CONSTRUCTION PERSONNEL N/A false ARISTEO CONSTRUCTION N/A false ASSEMBLERS PRECAST & STEEL SER N/A false ASSEMBLERS INC N/A false ATLAS INDUSTRIAL CONTRACTORS N/A false AUCH GEORGE CO N/A false AUTHORITY CONCRETE GROUP INC N/A false B & B CONCRETE PLACEMENT INC N/A false BMI REFRACTORY SERVICE N/A false BAKER CONSTRUCTION N/A false BARNEY JJ CONSTRUCTION INC N/A false BARTON MALOW CO N/A false BERG DRYWALL LLC N/A false BIERLEIN SERVICES INC N/A false BJ'S SONS CONTRACTING CO INC N/A false BLAZE CONTRACTING INC N/A false BLUE RIBBON CONTRACTING INC N/A false BRAND ENERGY SERVICES N/A false BRANDENBURG INDUSTRIAL SERVICE N/A false BRAZEN & GREER MASONRY INC N/A false BRENCAL CONTRACTORS INC N/A false BRIX CORPORATION N/A false BROADCAST DESIGN & CONSTRUCTION N/A false BYERS D C COMPANY N/A false C & P CONSTRUCTION N/A false C B INCCHRIS VASSEUR N/A false CAMERON CONSTRUCTION COMPANY N/A false CENTRAL CONVEYOR ALSO SHOP N/A false CERCO INC N/A false CHAMPAGNE & MARX EXCAVATING N/A false CHEMSTEEL CONSTRUCTION COMPANY N/A false CHRISTMAN CONSTRUCTORS INC N/A false CI CONTRACTING INC N/A false CITY RENOVATION & TRIM INC N/A false CLARK CONSTRUCTION N/A false CLEAN GREEN ENERGY LLC N/A false COLASANTI SPECIALTY SERVICES N/A false COMET CONTRACTING CO UAP N/A false COMMERCIAL CONSTRUCTION INC N/A false COMMERCIAL CONTRACTING CORP N/A false CONSTRUCTION LABOR SERVICES N/A false CONTEK INC N/A false CONTI CORPORATION N/A false CONTRACTORS TRENCHING N/A false COSTELLA MONTE & CO N/A false COUGAR CONTRACTING INC N/A false CREATIVE CEMENT INC N/A false CREATIVE FLOOR COATING SYSTEMS N/A false CULVER DEVELOPMENT LLC N/A false D 2 ABATEMENT INC N/A false D-4 ENTERPRISES N/A false D'ALOISIO MASONRY N/A false DAN'S CEMENT N/A false DAN'S EXCAVATING INC N/A false DEARBORN MID-WEST CONVEYOR CO N/A false DE-CAL INC N/A false DELUCA OLIVER C CO N/A false DEMARIA BUILDING COMPANY INC N/A false DEMREX INDUSTRIAL SERV INC N/A false DENN-CO CONSTRUCTION INC N/A false DETROIT CONCRETE CONSTRUCTION N/A false DETROIT LABORERS DEL COMM N/A false DEVON INDUSTRIAL GROUP N/A false DIAMOND INDUSTRIAL N/A false DICLAUDIO MASON CONSTRACTORS N/A false DICOSMO CONSTRUCTION N/A false DIVERSIFIED CONSTRUCTION SPCL N/A false DIXON INC N/A false DRV JOINT SEALANT CONTRACTORS N/A false DULUTH ENVIRONMENTAL SERVICES N/A false DURR SYSTEMS INC N/A false DYCON INC N/A false E & L DEVELOPMENT INC N/A false E & R MASONRY CONST INC N/A false E L MECHANICAL N/A false E L S CONSTRUCTION N/A false EAGLE EXCAVATION INC N/A false EQUIPMENT RECYCLING SOLUTIONS N/A false ERICKSON & LINDSTROM N/A false EUGENIO PAINTING COMPANY N/A false FABCON INCORPORATED N/A false FANELLI CONST INC N/A false FASTDECKS INC N/A false FERRINI CEMENT COMPANY N/A false FESSLER & BOWMAN N/A false FIRM BUILT CONST CO N/A false FLAGG CLEANING SYSTEMS INC N/A false FORT WAYNE CONTRACTING INC N/A false G M REFRACTORIES INC N/A false GALLAGHER-KAISER CORPORATION N/A false GEMELLI CONCRETE LLC N/A false GIFFIN INC N/A false GILARDONE COMPANY LLC N/A false GLASSROCKOMI N/A false GRANGER CONSTRUCTION CO N/A false GREAT LAKES REG ORGANIZING N/A false GREENE JOHN E COMPANY N/A false GRUNWELL CASHERO COMPANY N/A false HAMON CUSTODIS INC N/A false HANSCHMANN MASONRY N/A false HARDMAN CONSTRUCTION INC N/A false HARMON CONSTRUCTION INC N/A false HARNISH FIREPROOFING N/A false HARNISH WILLIAM E ACOUSTICAL N/A false HARSCO INFRA FKA PATENT CONST N/A false HARTWELL CEMENT N/A false HATZEL & BUEHLER INC N/A false HMCHICKS MASON CONTRACTORS N/A false HOLLY CONSTRUCTION CO N/A false HOLLY J C CONTRACTING N/A false HOOVER WELLS LLC N/A false IAFRATE ANGELO CONSTRUCTION N/A false IDEAL CONTRACTING N/A false IMPERIAL CONSTRUCTION CO INC N/A false INDEPENDENCE EXCAVATING N/A false INTEGRITY INTERIORS INC N/A false INTERNATIONAL CHIMNEY CORP N/A false INTERNATIONAL IND CONTR CORP N/A false ISIS LAND ENTERPRISES INC N/A false JASMAN CONSTRUCTION INC N/A false JAY DEE CONTRACTORS INC N/A false JERICO CONSTRUCTION INC N/A false JOHNSON CONTROLS INC N/A false K & W CONCRETE CONST INC N/A false KING MASONRY INC N/A false KVAERNER NAC N/A false LJH CONSTRUCTION N/A false LV PAINTING & CONSTRACTING INC N/A false LABELLE ELECTRIC SERVICE INC N/A false LABOR SERVICES LLC N/A false LABORERS L-1076 N/A false LABORERS L-1191 N/A false LANDRY GEORGE INC N/A false LDJ ASSOCIATES INC N/A false LEE MACHINERY MOVERS INC N/A false LEIDAL & HART MASON CONTRACTOR N/A false LESCO DESIGN & MFG COMPANY N/A false LOWE CONSTRUCTION CO INC N/A false MANFREDI CONSTRUCTION INC N/A false MASONRY DEVELOPERS INC N/A false MATRIX CONSTRUCTION SERVICES N/A false MATRIX NORTH AMERICAN CONSTRUCTION N/A false MCCARTHY & SMITH INC N/A false MCCORMICK WILLIE AND ASSOC N/A false MCINTOSH GEORGE INC N/A false MEDINA GLASS BLOCK INC N/A false METALLIZERS OF MID-AMERICA N/A false MICRO ELECTRIC LTD N/A false MID AMERICAN CONSTRUCTION SERV N/A false MID-AMERICAN GUNITE INC N/A false MIG EAST LLC N/A false MONARCH WELDING & ENG INC N/A false MOORTRENCH AMERICAN CORP N/A false MORETTI FOUNDATION CO INC N/A false MOTOR CITY ELECTRIC COMPANY N/A false MUIRHEAD CONSTRUCTION N/A false MUNRO ELECTRIC CO INC N/A false N B PROCESSING INC N/A false NSS CONSTRUCTION INC N/A false NATIONAL ENVIRONMENTAL GROUP N/A false NATIONAL MICROBIOLOGICAL MGMT N/A false NAVETTA MASON CONTRACTORS N/A false NEDROW REFRACTORIES N/A false NEHEMIAH MASONRY N/A false NICHOLSON CONSTRUCTION N/A false NIEMI CORPORATION THE N/A false NILES INDUSTRIAL LLC N/A false NORTH AMERICAN DISMANTLING N/A false NORTH CHANNEL CONST CO INC N/A false NORTHERN INDUSTRIAL CONST INC N/A false NOWAK R C AND COMPANY N/A false OAKLAND PLUMBING COMPANY N/A false OMI REFRACTORIES LLC N/A false ORION WATERPROOFING LLC N/A false PACITTO & FOREST CONST CO N/A false PALLISCO CONCRETE CO INC N/A false PAPALAS JOHN A & COMPANY N/A false PCI CONSTRUCTION SERVICES LLC N/A false POMPONIO CONSTRUCTION N/A false POURED BRICK WALLS INC N/A false POWER PROCESS PIPING INC N/A false PREFERRED BLDG SERVICES LLC N/A false PRO IMAGE FACILITY SERVICES N/A false PROCESS PIPING & EQUIPMENT N/A false PROGRESSIVE MECHANICAL INC N/A false PRO-POUR CONCRETE CONSTRUCTION N/A false R & R CONSTRUCTION SERVICES N/A false R B V CONTRACTING INC N/A false R J INDUSTRIAL EMPLOYEES N/A false R M F NOOTER INC N/A false RPB CLEANING SPECIALISTS N/A false RAM CONSTRUCTION SERVICES N/A false RAYMOND EXCAVATING CO N/A false REESE CONTRACTING INC N/A false REICHENBACH CEILING & N/A false RESCO PRODUCTS INC N/A false REWOLD FRANK & SONS N/A false RIC MAN DETROIT N/A false RIC-MANN CONSTRUCTION INC N/A false RIVER CONTRACTING INC N/A false RK HYDRO-VAC INC N/A false ROHRSCHEIB SONS CAISSONS INC N/A false RONCELLI ELC3 LLC N/A false ROSATI MASONRY COMPANY INC N/A false ROYAL OAK MILLWORK CO LLC N/A false ROYAL RESTORATION & WATERPROOF N/A false RUDOLPHLIBBE INC N/A false S C ENVIRONMENTAL SERVICES N/A false SSS INC N/A false SAFEWAY SERVICES LLC 89 N/A false SAK CONSTRUCTION LLC N/A false SALVATORE EXEC CO INC N/A false SAYLOR'S INC N/A false SCAFFOLD DESIGN & ERECTION N/A false SCAFFOLDING INC N/A false SCHAD BOILER SETTING COMPANY N/A false SCHENA ROOFING AND SHEET METAL N/A false SCHIFFER MASON CONTRACTORS INC N/A false SCHNITZER STEEL N/A false SERES-CASTLE MASONRY INC N/A false SERVICE CONSTRUCTION LLC N/A false SET CONSTRUCTION INC N/A false SHARED SYSTEMS TECHNOLOGY N/A false SHEKELL RL INC N/A false SHMINA AZ INC N/A false SIMONE CONTRACTING CORP N/A false SINELLI & SONS CHARLES N/A false SITE DEVELOPMENT INC N/A false SIWEK CONSTRUCTION COMPANY N/A false SKANSKA USA BUILDING INC N/A false SOLE CONSTRUCTION INC N/A false SORENSON GROSS N/A false SPENCE BROTHERS N/A false STANTE EXCAVATING CO INC N/A false SUPERIOR EXCAVATING INC N/A false TAYLOR BROTHERS CONSTRUCTION N/A false TEAM INDUSTRIAL SERVICES N/A false TEERA CONSTR CO INC N/A false THE STATE GROUP IND(USA)LIMIT N/A false TIMMER CONSTRUCTION COMPANY N/A false TOOLES CONTRACTING GROUP INC N/A false TRI-CITY GOUNDBREAKERS INC N/A false TROELSEN EXCAVATING CO N/A false TURNER CONSTRUCTION CO N/A false TURNER-BROOKS INC N/A false TWENTY-FIRST CENTURY SALVAGE N/A false URS WASHINGTON DIVISION N/A false US BUILDERS GROUP INC N/A false V & O CONTRACTING COMPANY N/A false V I L CONSTRUCTION INC N/A false VIG J S CONSTRUCTION CO N/A false W & G LLC N/A false W C CONSTRUCTORS INC N/A false WPM INC N/A false W-3 CONSTRUCTION COMPANY N/A false WALBRIDGE ALDINGER N/A false WALBRIDGE EAST N/A false WALBRIDGE EQUIPMENT INSTALLATION N/A false WALBRIDGE TOOLING SERVICES N/A false WALSH CONSTRUCTION COMPANY N/A false WASHINGTON GROUP N/A false WAYNE STATE UNIVERSITY N/A false WCI CONSTRUCTION INC N/A false WEISS CONSTRUCTION CO LLC N/A false WHITE CONSTRUCTION CO N/A false WICKERSHAM HOMES INC N/A false false false false false false false false false false false false false false false false false false false false