2015-02-16T17:16:57-06:00 2014-04-30 382284921 BENDA GRACE STULZ & COMPANY PC 38800 VAN DYKE AVE STE 100 STERLING HEIGHTS MI 48312 990 2013-05-01 386098425 MICHIGAN BAC HEALTH CARE FUND MICH 5173217502 6525 CENTURION DRIVE LANSING MI 48917 NELSON MCMATH ANDY BRACY CHAIRMAN / SECRETARY 5173217502 2014-08-27 BRYAN STULZ P00265596 5868836240 2015-02-16 2013 2016-03-07 17:11:31Z 5853410 false X X 1964 MI PROVIDE HEALTH AND WELFARE BENEFITS 10 2 0 0 0 5295554 5448000 308352 361624 71911 43786 5675817 5853410 0 4847311 6336716 0 0 0 820452 779111 5667763 7115827 8054 -1262417 8610105 8085186 2090049 2734296 6520056 5350890 PROVIDE HEALTH AND WELFARE BENEFITS false false TO PROVIDE HEALTH CARE BENEFITS AND DISABILITY BENEFITS TO ELIGIBLE PLAN PARTICIPANTS. false false false false false false false false false false true false false true false true false false false false false false false false false false false false false false false false false false false false false false false false true false false true 3 0 0 false false false false false false X 10 2 true 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 NELSON MCMATH CHAIRMAN 1.00 40.00 X 0 46188 20652 JAMES BRYLOWSKI TRUSTEE 1.00 40.00 X 0 38889 22211 DARYL NICHOLS TRUSTEE 1.00 40.00 X 0 38889 22211 JAMES BUDD TRUSTEE 1.00 40.00 X 0 38889 22211 GREG LOBODZINSKI TRUSTEE 1.00 40.00 X 0 36680 22211 ANDY BRACY SECRETARY 1.00 40.00 X 0 0 0 BOB SPENCE III TRUSTEE 1.00 40.00 X 0 0 0 BART CARRIGAN TRUSTEE 1.00 0.00 X 0 0 0 SCOTT D FISHER TRUSTEE 1.00 0.00 X 0 0 0 ED DAVENPORT TRUSTEE 1.00 40.00 X 0 0 0 199535 109496 false false false BLUE CROSS BLUE SHIELD OF MICHIGAN 27000 WEST 11 MILE ROAD B494 SOUTHFIELD MI 48034 HEALTH ADMIN. 471190 TIC INTERNATIONAL CORPORATION 6525 CENTURION DRIVE LANSING MI 48917 PLAN ADMIN. 146439 2 EMPLOYER CONTRIBUTIONS 230000 4272815 4272815 PARTICIPANT SELF-PAYMENTS 900099 1175185 1175185 5448000 361624 361572 52 MEDICARE PART D SUBSIDY 900099 36810 36810 LIQUIDATED DAMAGES COLLECTED 900099 6976 6976 43786 5853410 5853358 52 6336716 588685 66235 28870 26328 11500 31884 10672 4997 MEMBER COMMUNICATIONS 6504 CONTRACT MONITORING FEE 1950 PARTICIPANT NOTICES 1486 7115827 0 0 0 593116 1393345 4215 241638 298311 281676 287745 5945284 6115737 748162 786062 8610105 8085186 116748 103147 1973301 2631149 2090049 2734296 X 6520056 5350890 6520056 5350890 8610105 8085186 -1262417 93251 X false true X true false LIMITED LIABILITY COMPANY 786062 F 786062 ACCUMULATED ELIGIBILITY CREDITS 1532000 CLAIMS INCURRED BUT NOT REPORTED 605000 HEALTH CARE CLAIMS PAYABLE 494149 2631149 5920333 93251 93251 5827082 26328 26328 5853410 7089499 7089499 26328 26328 7115827 FORM 990, PART VI LINE 2 - 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, TOP MANAGEMENT OFFICIAL, OR OTHER OFFICER OR KEY EMPLOYEES, AS THOSE TERMS ARE DEFINED IN THE INSTRUCTIONS. FORM 990, PAGE 6, PART VI, LINE 7A ALL BOARD MEMBERS ARE ELECTED BY THE MEMBERSHIP INTO OFFICER POSITIONS, FROM WHICH THEY HOLD THEIR TRUSTEESHIP. FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS PRESENTED AND APPROVED AT A MEETING OF TRUSTEES, SUBJECT TO APPROVAL AND REVIEW BY THE FUND ATTORNEY. UPON COMPLETION THE TRUSTEE'S ARE PROVIDED WITH THE FINAL FORM 990 (INCLUDING ALL REQUIRED SCHEDULES), AS ULTIMATLY FILED WITH THE IRS. 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 1 ERISA WITH RESPECT TO DISCLOSURE OF ITS GOVERNING DOCUMENTS AND FINANCIAL INFORMATION. IT OPERATES IN COMPLIANCE WITH FIDUCIARY RESPONSIBILITY REQUIREMENTS OF SUBTITLE B, PART 4 OF ERISA. FORM 990, PART VII LINE 1A - NELSON MCMATH, DARYL NICHOLS, JAMES BRYLOWSKI, JAMES BUDD & GREG LOBODZINSKI SERVED AS TRUSTEES OF THE FUND WITHOUT COMPENSATION FROM THE FUND FOR THOSE SERVICES. HOWEVER, THEY WERE COMPENSATED AS EMPLOYEES OF BAC LOCAL 9, WHICH WAS A CONTRIBUTING EMPLOYER TO THE FUND AND, AS SUCH, A "RELATED ORGANIZATIONS" AS THAT TERM IS DEFINED IN THE INSTRUCTIONS. MICHIGAN BAC APPRENTICESHIP 6525 CENTURION DRIVE LANSING MI 48917 386158556 APPRENTICE MI 501C3 2 N/A false MICHIGAN BAC PENSION 6525 CENTURION DRIVE LANSING MI 48917 382895943 PENSION MI 401B N/A false BAC 9-MCE COOP & EDUC TRUST 6525 CENTURION DRIVE LANSING MI 48917 386771345 PROMOTION MI 501C5 N/A false MICHIGAN BAC LOCAL 9 3321 REMY DRIVE LANSING MI 48906 463778303 LOCAL MI 501C5 N/A false A AND G FLOOR COVERING INC N/A false AKINS CONSTRUCTION INC N/A false ALBANELLI CEMENT CONTRACTORS N/A false ALPHA FOAM INSULATION SYSTEMS N/A false AMALIO CORPORATION N/A false AMERICAN INTERNATIONAL CONST N/A false ARISTEO CONSTRUCTION N/A false ARTISAN TILE INC N/A false ASSOCIATED CONSTRUCTION CO N/A false ATLAS BUILDING SERVICES INC N/A false BAKER CONSTRUCTION N/A false BARTON MALLOW CO N/A false BOOMS STONE CO N/A false BORNOR RESTORATION INC N/A false BOUMA INTERIORS N/A false BRACY & JAHN MASONRY INC N/A false BRESCOL BROTHERS INC N/A false BRONNER WM AND SON CONTR N/A false BUCKLAND JOHN CONTR INC N/A false BYES D C COMPANY N/A false C S S CONTRACTING CO INC N/A false CAPITAL TILE INC N/A false CENTRAL TILE & TERRAZZO N/A false CHRISTMAN CONSTRUCTORS INC N/A false CLEVELAND MARBLE MOSAIC CO N/A false CLOSNER CONSTRUCTION N/A false COMMERCIAL SPECIALTY CONT INC N/A false COMSTOCK CONSTRUCTION COMPANY N/A false CONTEK INC N/A false COROTECH CONST ACQUISITION N/A false CUSACK'S MASONRY RESTORATION N/A false D'ALOISIO MASONRY N/A false DAVENPORT MASONRY INC N/A false DAY & ZIMMERMAN NPS N/A false DICLAUDIO MASON CONTRACTORS N/A false DIPONIO CONSTRUCTION CO INC N/A false DIXON INC N/A false DRAPER ARLAND MASONRY N/A false DRV JOINT SEALANT CONTRACTORS N/A false EMPIRE MARBLE & TILE CO N/A false EMPIRE REF SVC OF MICH LLC N/A false F&M TILE & TERRAZZO CO INC N/A false FABRIS PEARCE N/A false G A MASONRY CORP N/A false GARN RESTORATION SERVICES N/A false GEGARE TILE INC N/A false GEMELLI CONCRETE LLC N/A false GERACE CONSTRUCTION CO INC N/A false GLENN'S TILE N/A false GRUNWELL CASHERO COMPANY N/A false GUNDLACH CHAMPION INC N/A false HACKETT CONSTRUCTION N/A false HANSCHMANN MASONRY N/A false HARTLEY MASONRY SERVICES N/A false HELM M MASONRY INC N/A false HELMS CAULKING & MERCURY REST N/A false HENKELS & MCCOY INC N/A false HMCHICKS MASON CONTRACTORS N/A false HOFFMAN PLASTERING N/A false INDUSTRIAL FIREBRICK CORP N/A false INDUSTRIAL MAINTENANCE SERVICE N/A false INDUSTRIAL SVC INC-WASHTENAW N/A false INTEGRITY INTERIORS INC N/A false INTERIOR FINISHES INC N/A false INT'L MASONRY INSTITUTE N/A false JPB CONTRACTING INC N/A false KING MASONRY INC N/A false KOCH MASONRY INC N/A false KRULL CONSTRUCTION CO INC N/A false LEIDAL & HART MASON CONTRACTOR N/A false LEWIS CONSTRUCTION INC N/A false MARSON L TILE & MARBLE N/A false MCGUIRE'S PROFESSIONAL CONST N/A false MCMATH MASONRY INC N/A false MERIDIAN RESTORATION LLC N/A false MEYER C R & SONS COMPANY N/A false MICHIELUTTI BROTHERS INC N/A false MIDWEST INDUSTRIAL SERVICES N/A false MIDWEST TILE & INTERIORS INC N/A false MIRON CONSTRUCTION CO INC N/A false NC BUILDERS INC N/A false NSS CONSTRUCTION INC N/A false NATIONAL ACID PROOFING N/A false NAVETTA MASON CONTRACTORS N/A false NEDROW REFRACTORIES N/A false NEHEMIAH MASONRY N/A false NESS ROY CONTRACTING & SALES N/A false NOTEBAERT CONSTRUCTION SERVICE N/A false NUCO INTERNATIONAL INC N/A false ONEX INC N/A false PCI CONSTRUCTION SERVICES LLC N/A false PEARSON EQUIPMENT & SERVICE N/A false PLUMMER MASONRY INC N/A false PREMIER CAULKING INC N/A false PYRO INDUSTRIAL SERVICES INC N/A false QUALITY CONST SERV OF MI N/A false RANCK J ELECTRIC INC N/A false REICHENBCH CEILING & PARTITION CO N/A false RIVER CITY CONTRACTING LLC N/A false RIVERVIEW REFRACTORY SRVS INC N/A false ROSATI MASONRY COMPANY INC N/A false ROYAL RESTORATION & WATER PRF N/A false SCHAD BOILER SETTING COMPANY N/A false SCHAEFER GROUP INC THE N/A false SCHIFFER MASON CONTRACTORS INC N/A false SER DEVELOPMENT LLC N/A false SLATILE ROOFING & RESTORATIONS N/A false SOUTHWEST MICH MACON MSNRY N/A false SPARTAN CONSTRUCITON CO INC N/A false SPENCE BROTHERS N/A false STANDARD TILE INC N/A false STEWART'S SERVICES LLC N/A false STORER S A & SONS N/A false STRUCTURAL GROUP INC N/A false TAILORED FOAM INC N/A false TEACHOUT'S INDUSTRIAL N/A false THE AUSTIN COMPANY N/A false THORPE JT & SONS INC N/A false TRI-CITY ACOUSTICAL CO N/A false TRISCO SYSTEMS N/A false TWIN CITY MASONRY INC N/A false UNITED CONSTRUCTION CO INC N/A false UNIVERSAL BASTCO MICH TILE DV N/A false VALCON INC DBA PIAZZA MASONRY N/A false VANDERMAN CONSTRUCTION INC N/A false VANSTONO'BRIEN INC N/A false WASHAW CONSTRUCTION INC N/A false WEIGAND CONSTRUCITON CO INC N/A false WELLMAN MASONRY INC N/A false WHITE JJ INC N/A false WINES AND SONS MASONRY LLC N/A false WISCONSIN TERRAZZO & TILE INC N/A false WOBIG CONSTRUCTION C OMPANY N/A false ZANETTI ENT GROUP LLC N/A false false false false false false false false false false false false false false false false false false false false