2015-03-02T13:34:20-06:00 2014-04-30 341322309 CIUNI & PANICHI INC 25201 CHAGRIN BLVD 200 CLEVELAND OH 441225683 990 2013-05-01 450593187 OHIO CARPENTERS' HEALTH FUND OHIO 6142362440 1909 ARLINGATE LANE COLUMBUS OH 43228 DOUG REFFITT CHAIRMAN 6142362440 2015-02-23 1 DAVID M REAPE CPA P00068117 2168317171 2013 2016-03-07 17:11:31Z X DOUG REFFITT 1909 ARLINGATE LANE COLUMBUS OH 43228 212873195 0 X N/A X 2008 OH THE PLAN IS A MULTIEMPLOYER HEALTH AND WELFARE PLAN COVERING ELIGIBLE MEMBERS OF VARIOUS LOCAL UNIONS OF THE OHIO AND VICINITY REGIONAL COUNCIL OF CARPENTERS, PRIMARILY IN OHIO, WHICH WAS MERGED INTO THE INDIANA/KENTUCKY REGIONAL COUNCIL OF CARPENTERS. THE PLAN PROVIDES HEALTH, VACATION, DENTAL, VISION, PRESCRIPTION DRUG, AND DEATH BENEFITS TO ITS MEMBERS. 18 18 0 0 0 0 0 0 106053177 105478432 5370478 6864657 118148 0 111541803 112343089 0 0 106815775 96880646 1965060 8788 0 0 0 6571847 5879594 115352682 102769028 -3810879 9574061 180673257 185852428 5860394 5613744 174812863 180238684 X THE PLAN IS A MULTIEMPLOYER HEALTH AND WELFARE PLAN COVERING ELIGIBLE MEMBERS OF VARIOUS LOCAL UNIONS OF THE OHIO AND VICINITY REGIONAL COUNCIL OF CARPENTERS, PRIMARILY IN OHIO, WHICH WAS MERGED INTO THE INDIANA/KENTUCKY REGIONAL COUNCIL OF CARPENTERS. THE PLAN PROVIDES HEALTH, VACATION, DENTAL, VISION, PRESCRIPTION DRUG, AND DEATH BENEFITS TO ITS MEMBERS. 0 0 102769028 THE PLAN IS A MULTIEMPLOYER HEALTH AND WELFARE PLAN COVERING ELIGIBLE MEMBERS OF VARIOUS LOCAL UNIONS OF THE OHIO AND VICINITY REGIONAL COUNCIL OF CARPENTERS, PRIMARILY IN OHIO, WHICH WAS MERGED INTO THE INDIANA/KENTUCKY REGIONAL COUNCIL OF CARPENTERS. THE PLAN PROVIDES HEALTH, VACATION, DENTAL, VISION, PRESCRIPTION DRUG, AND DEATH BENEFITS TO ITS MEMBERS. AS OF 04/30/2014 THE PLAN COVERS 11,579 PARTICIPANTS. 102769028 0 0 0 0 0 0 0 0 0 1 1 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 18 18 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X MARY WEIR 2488139800 700 TOWER DRIVE SUITE 300 TROY MI 48098 X MIKE GIBSON TRUSTEE 1.00 X 0 0 0 BOB ELLIOTT TRUSTEE 1.00 X 0 0 0 MARK MOEN TRUSTEE 1.00 X 0 0 0 MARK MCGRIFF TRUSTEE 1.00 X 0 0 0 DAVE MEIER TRUSTEE 1.00 X 0 0 0 JOE MILLER TRUSTEE 1.00 X 0 0 0 DONALD CRANE TRUSTEE 1.00 X 0 0 0 AARON HALL TRUSTEE 1.00 X 0 0 0 JAMES MELARAGNO TRUSTEE 1.00 X 0 0 0 DOUG REFFITT CHAIRMAN 1.00 X 0 0 0 KEVIN REILLY SECRETARY 1.00 X 0 0 0 DAVID GIORGI TRUSTEE 1.00 X 0 0 0 TIM LINVILLE TRUSTEE 1.00 X 0 0 0 KEN LYONS TRUSTEE 1.00 X 0 0 0 JIM FOX TRUSTEE 1.00 X 0 0 0 JOE BEISCHEL TRUSTEE 1.00 X 0 0 0 ANDREW GOETZ TRUSTEE 1.00 X 0 0 0 PAM HEPBURN TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 MEDICAL MUTUAL OF OHIO 23700 COMMERCE PARK BEACHWOOD OH 44122 CLAIMS FEES 3079785 BENESYS 700 TOWER DRIVE SUITE 300 TROY MI 48098 PLAN ADMINISTRATION 805336 CONSUMERS LIFE INSURANCE 17800 ROYALTON ROAD STRONGSVILLE OH 44136 CLAIMS FEES 347708 SHUMAKER LOOP & KENDRICK 1000 JACKSON STREET TOLEDO OH 43604 ATTORNEY 295369 DELTA DENTAL OF OHIO 5600 BLAZER PARKWAY SUITE 150 DUBLIN OH 43017 CLAIMS FEES 285073 8 EMPLOYER CONTRIBUTIONS 900099 91114156 91114156 MEMBER CONTRIB-HEALTH 900099 17173471 17173471 LESS:RECIPROCITY TRANSFERS 900099 -2809195 -2809195 105478432 5559045 5559045 101835718 100530106 1305612 1305612 1305612 112343089 105478432 0 6864657 96880646 8339 449 204350 67561 201462 902750 106 9833 53000 18964 32521 MEDICAL NETWORK & REPRI 3654007 PREMIUMS PAID FOR LIFE 347708 PRINTING 199744 POSTAGE 71363 116225 102769028 7542058 11669007 23653020 16740246 19509 24016 729590 729590 0 0 7136306 8477288 142322364 148941871 180673257 185852428 1816656 2807407 4043738 2806337 5860394 5613744 X 174812863 180238684 174812863 180238684 180673257 185852428 9574061 -4148240 0 X 0 1 X 1 0 729590 729590 0 0 CORPORATE DEBT SECURITIES 16257590 F GOVERNMENT AND RELATED DEBT SECURITIES 27932124 F MUTUAL AND EXCHANGE TRADED FUNDS 84454023 F SHORT TERM INVESTMENT FUNDS 20298134 F 148941871 UNREMITTED FRINGE BENEFIT CONTRIBUTIONS COLLECTED 2548067 DUE TO BROKERS FOR SECURITIES PURCHASED 258270 2806337 X 107993387 -4148240 -4148240 112141627 201462 201462 112343089 102567566 0 102567566 201462 201462 102769028 PART X, LINE 2: THE VOLUNTARY EMPLOYEE BENEFICIARY ASSOCIATION ("VEBA") TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS IS INTENDED TO QUALIFY PURSUANT TO SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE ("IRC"), AND ACCORDINGLY, THE TRUST'S NET INVESTMENT INCOME IS EXEMPT FROM INCOME TAXES. THE TRUST HAS OBTAINED A FAVORABLE TAX DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE ("IRS"), AND PLAN MANAGEMENT BELIEVES THAT THE TRUST, AS AMENDED, CONTINUES TO QUALIFY AND TO OPERATE IN ACCORDANCE WITH APPLICABLE PROVISIONS OF THE IRC. HOWEVER, AS A RESULT OF THE PLAN'S FUNDING POLICY, FROM TIME TO TIME THE TRUST MAY BE SUBJECT TO INCOME TAXES. NO FEDERAL OR STATE INCOME TAXES HAVE BEEN RECORDED IN FISCAL 2014 OR 2013 FOR UNRELATED BUSINESS TAXABLE INCOME. IN ADDITION, THE PLAN AND TRUST ARE REQUIRED TO OPERATE IN CONFORMITY WITH THE IRC TO MAINTAIN THE TAX-EXEMPT STATUS OF THE TRUST. THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC AND, THEREFORE, BELIEVES THAT THE RELATED TRUST IS TAX-EXEMPT. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR FISCAL YEARS PRIOR TO APRIL 30, 2011. FORM 990, PART VI, SECTION B, LINE 11 THE COMPLETED FORM 990 IS SENT TO THE PLAN ADMINISTRATOR WHO REVIEWS THE RETURN AND CONSULTS WITH THE PREPARER ON ANY QUESTIONS. ONCE ALL OF THE QUESTIONS ARE ANSWERED, THE PLAN ADMINISTRATOR PRESENTS THE FORM 990 TO THE TRUSTEES AND EXPLAINS THE PROPOSED FILING. THE TRUSTEES WILL DISCUSS ANY QUESTIONS WITH THE PLAN ADMINISTRATOR BEFORE GIVING THEIR APPROVAL TO ADOPT AND FILE THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C YEARLY DISCLOSURES ARE MADE AND PRESENTED TO THE TRUSTEES FOR REVIEW AND CONFIRMATION. THE PROCESS IS REFLECTED IN THE MINUTES OF THE TRUSTEE'S MEETING. FORM 990, PART VI, SECTION B, LINE 15 THE ADMINISTRATIVE COMMITTEE REVIEWS AND MAKES SALARY DECISIONS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. OHIO & VICINITY CARPENTERS' FRINGE BENEFITS FUNDS INC 3611 CHESTER AVE CLEVELAND OH 441144622 203330679 TO PROCESS EMPLOYER CONTRIBUTIONS TO BENEFIT PLANS OH 501(C)(5) 0 OHIO CARPENTERS' ANNUITY PLAN 3611 CHESTER AVE CLEVELAND OH 441144622 341778747 TO PROVIDE RETIREMENT BENEFITS OH 401(A) 0 OHIO CARPENTERS' PENSION PLAN 3611 CHESTER AVE CLEVELAND OH 441144622 346574360 TO PROVIDE RETIREMENT BENEFITS OH 401(A) 0 INDIANA KENTUCKY OHIO REGIONAL COUNCIL OF CARPENTERS 771 GREENWOOD SPRINGS DR GREENWOOD IN 46143 351074694 LABOR ORGANIZATION OH 501(C)(5) 0 JOINT BOARD OF TRUSTEES OHIO CARPENTERS' SUPP BENEFIT FUND 3611 CHESTER AVE CLEVELAND OH 441144622 341927123 MULTI-EMPLOYER BENEFIT PLAN OH 401(A) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 OHIO & VICINITY CARPENTERS' FRINGE BENEFITS FUNDS INC N OHIO CARPENTERS' ANNUITY PLAN N OHIO CARPENTERS' PENSION PLAN N OHIO & VICINITY CARPENTERS' FRINGE BENEFITS FUNDS INC O