2015-12-03T13:20:08-06:00 2015-03-31 550526247 WILSON KOZICKI & GWYNN PLLC 32 TWENTIETH STREET SUITE 300 WHEELING WV 26003 990 2014-04-01 510168650 IRON WORKERS LOCALS 549 & 550 MEDICAL & BENEFIT FUND IRON 2488139800 700 TOWER DRIVE SUITE 300 TROY MI 48098 BENGY SWANSON CO-CHAIRMAN OF THE BOARD 3042322660 2015-11-30 NANCY J GWYNN CPA P00726879 3042322280 2015-11-30 2014 2016-03-07 17:11:31Z BENGY SWANSON 2350 MAIN STREET WHEELING WV 26003 19272678 0 X WWW.IW549-550BENEFITS.ORG X 1975 WV TO PROVIDE ACCIDENT, HOSPITAL, MEDICAL, SURGICAL, DISABILITY, DENTAL, PRESCRIPTION AND DEATH BENEFITS TO ELIGIBLE MEMBERS OF IRON WORKERS LOCALS 549 & 550 AND THEIR SPOUSES AND DEPENDENTS. 12 10 7 0 0 0 0 0 7586901 7396758 860560 600835 340 531 8447801 7998124 0 0 7182549 8488548 0 0 0 0 0 1208806 1139979 8391355 9628527 56446 -1630403 15784011 13968010 169084 129866 15614927 13838144 THE TRUST FUND IS CREATED, ESTABLISHED AND MAINTAINED, (AND THE TRUSTEES AGREE TO RECEIVE, HOLD AND ADMINISTER), TO PROVIDE BENEFITS FOR MEMBERS AND THEIR BENEFICIARIES IN ACCORDANCE WITH THE PLAN DOCUMENT. 0 0 THE IRON WORKERS LOCALS 549 & 550 MEDICAL & BENEFIT PLAN IS A DEFINED BENEFIT HEALTH AND WELFARE PLAN THAT PROVIDES BENEFITS TO ELIGIBLE MEMBERS OF IRON WORKERS LOCALS 549 AND 550 WHO HAVE COMPLETED THE REQUIRED SERVICE HOURS FOR AN EMPLOYER WHO IS SUBJECT TO THE TERMS OF THE COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE INTERNATIONAL ASSOCIATION OF BRIDGE, STRUCTURAL AND ORNAMENTAL IRONWORKERS LOCALS UNIONS 549 AND 550 AND THE OHIO VALLEY CONSTRUCTION EMPLOYERS COUNCIL INC AND THE STRUCTURAL CONTRACTORS AND INDEPENDENT EMPLOYERS ASSOCIATION OF CANTON OHIO. THE PLAN PROVIDES FOR ACCIDENT, HOSPITAL, MEDICAL, SURGICAL, DISABILITY, DENTAL, PRESCRIPTION AND DEATH BENEFITS COVERING APPROXIMATELY 887 ELIGIBLE MEMBERS AND THEIR SPOUSES AND DEPENDENTS. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 56 0 1 7 1 0 0 0 0 0 0 0 0 X 12 10 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X MARY WEIR (BENESYS) 2488139800 700 TOWER DRIVE SUITE 300 TROY MI 48098 BENGY SWANSON CO-CHAIRMAN/EMPLOYEE TRUST 0.50 48.00 X X 0 0 0 WILLIAM SHERER II CO-CHAIRMAN/EMPLOYEE TRUST 0.50 48.00 X X 0 78908 62446 RICK MOSS EMPLOYEE TRUSTEE 0.50 48.00 X 2597 71371 60185 THERON HEDGE EMPLOYEE TRUSTEE 0.50 X 174 0 0 KELLY DIERKES EMPLOYEE TRUSTEE 0.50 X 2395 0 0 KRISTOFER FORBES EMPLOYEE TRUSTEE 0.50 X 0 0 0 KEITH LEPAGE SECRETARY/EMPLOYER TRUSTEE 0.50 X 0 0 0 KIM CARFAGNA EMPLOYER TRUSTEE 0.50 X 0 0 0 BRIAN SELINSKY EMPLOYER TRUSTEE 0.50 X 0 0 0 JOHN HUMPE EMPLOYER TRUSTEE 0.50 X 0 0 0 THOMAS LISTON EMPLOYER TRUSTEE 0.50 X 0 0 0 JOHN SELINSKY EMPLOYER TRUSTEE 0.50 X 1003 0 0 KEITH HUGHES FORMER CO CHAIRMAN/EMPLOYEE TRUSTEE 0.50 48.00 X 901 101315 69168 7070 251594 191799 0 1 1 0 HUMANA HEALTH INSURANCE PO BOX 514 CAROL STRAM IL 60132 MEDICAL INSURANCE ADMINISTRATION FEES 1666262 BENESYS 700 TOWER DRIVE SUITE 300 TROY MI 48098 ADMINISTRATION FEES 318246 HCC LIFE INSURANCE COMPANY PO BOX 402032 ATLANTA GA 30384 STOP LOSS INSURANCE 196089 CIGNA HEALTH AND LIFE INSURANCE CO PO BOX 644546 PITTSBURGH PA 15264 MEDICAL INSURANCE ADMINISTRATION FEES 149038 4 EMPLOYER CONTRIBUTION 525120 6241256 6241256 RETIREE AND MEMBER SELF-PAY 525120 1141729 1141729 GOVERNMENT SUBSIDIES 525120 13773 13773 7396758 453666 453666 11421723 11274554 147169 147169 147169 MISCELLANEOUS INCOME 525120 531 531 531 7998124 7397289 0 600835 8488548 143630 15013 35419 47103 507725 40270 19763 254321 TRANSITIONAL REINSURANC 75374 OTHER TAXES 1098 DUES AND SUBSCRIPTIONS 263 9628527 48629 156816 2197253 2291724 553884 507469 5585 10457 12825091 10949588 153569 51956 15784011 13968010 169084 129866 169084 129866 X 0 0 0 0 15614927 13838144 15614927 13838144 15784011 13968010 -1630403 -146380 0 X 0 1 X 1 0 0 7804641 -146380 -146380 7951021 47103 47103 7998124 9581424 0 9581424 47103 47103 9628527 0 0 0 WILLIAM SHERER II CO-CHAIRMAN/EMPLOYEE TRUST 0 78908 0 0 0 0 0 48080 0 14366 0 141354 0 0 RICK MOSS EMPLOYEE TRUSTEE 0 71371 0 0 2597 0 0 45819 0 14366 2597 131556 0 0 KEITH HUGHES FORMER CO CHAIRMAN/EMPLOYEE TRUSTEE 0 86760 0 0 901 14555 0 54802 0 14366 901 170483 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE TRUSTEES FOR THE FUND ENGAGED BENESYS INC TO PROVIDE ADMINISTRATIVE SERVICES FOR THE PLAN EFFECTIVE 4/1/10. FORM 990, PART VI, SECTION B, LINE 11 THE COMPLETED 990, IN DRAFT VERSION, IS EMAILED TO ALL GOVERNING BODY MEMBERS PRIOR TO ITS FINALIZATION. ANY QUESTIONS, COMMENTS, AND CONCERNS ARE DISCUSSED AND RESOLVED PRIOR TO THE FILING OF THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ANY DIRECTOR, PRINCIPAL OFFICER, TRUSTEE OR ADMINISTRATOR OF THE ORGANIZATION HAS A DUTY TO DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST AND IS GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE GOVERNING BOARD. THE GOVERNING BOARD THEN DISCUSSES AND VOTES UPON THE DETERMINATION OF A CONFLICT OF INTEREST. IF THE BOARD BELIEVES THAT AN ACTUAL OR POSSIBLE CONFLICT WAS NOT DISCLOSED AND UPON FURTHER EXPLANATION DETERMINES THAT THERE WAS A FAILURE TO DISCLOSE, APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION WILL BE TAKEN. EACH DIRECTOR, PRINCIPAL OFFICER, TRUSTEE OR ADMINISTRATOR OF THE GOVERNING BOARD IS REQUIRED TO SIGN AN ANNUAL STATEMENT. PERIODIC REVIEWS WILL ALSO BE CONDUCTED WHICH MAY INCLUDE THE USE OF OUTSIDE EXPERTS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART VII BENGY SWANSON - 2350 MAIN STREET, WHEELING, WV 26003. WILLIAM SHERER II - 618 HIGH AVENUE NW, CANTON, OH 44703. RICK MOSS - 618 HIGH AVENUE NW, CANTON, OH 44703. THERON HEDGE - 618 HIGH AVENUE NW, CANTON, OH 44703. KELLY DIERKES - 45565 SR 78, WOODSFIELD, OH 43793. KRISTOFER FORBES - 229 BLACKS RUN ROAD, CORE, WV 26541. KEITH LEPAGE - PO BOX 8444, CANTON, OH 44711. KIM CARFAGNA - 200 GC&P ROAD, WHEELING, WV 26003. BRIAN SELINSKY - 2009 QUIMBY AVENUE SW, CANTON, OH 44706. JOHN HUMPE - 1B-31 KINGSDALE ROAD, STEUBENVILLE, OH 43952. THOMAS LISTON - 210 WASHINGTON, PO BOX 490, DRAVOSBURG, PA 15034. JOHN SELINSKY - 7778 HEARTHSTONE AVENUE NW, NORTH CANTON, OH 44720. IRON WORKERS LOCAL 549 2350 MAIN STREET WHEELING WV 26003 550241628 LOCAL LABOR UNION PROVIDING SERVICES TO MEMBERS AND ASSISTANCE TO EMPLOYERS WV 501(C)(5) 0 IRON WORKERS LOCAL 550 618 HIGH AVENUE NW CANTON OH 44703 340225474 LOCAL LABOR UNION PROVIDING SERVICES TO MEMBERS AND ASSISTANCE TO EMPLOYERS OH 501(C)(5) 0 IRON WORKERS LOCALS 549 & 550 SECURITY PLAN 700 TOWER DRIVE SUITE 300 TROY MI 48098 341399439 DEFINED CONTRIBUTION PLAN COVERING ELIGIBLE WORKERS UNDER LOCAL AGREEMENT WV 401(A)/501(A) 0 IRON WORKERS LOCALS 549 & 550 PENSION PLAN 700 TOWER DRIVE SUITE 300 TROY MI 48098 556027928 DEFINED BENEFIT PENSION PLAN COVERING ELIGIBLE MEMBERS OF LOCAL UNIONS WV 401(A)/501(A) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0