2015-01-14T10:19:42-06:00 2014-05-31 391531945 FREYBERG HINKLE ASHLAND POWERS & STOWELL 15420 W CAPITOL DR BROOKFIELD WI 530052621 990 2013-06-01 396095127 FOX VALLEY SHEET METAL HEALTH FUND FOXV 2627981838 2201 SPRINGDALE ROAD WAUKESHA WI 531862855 NICHOLAS LIESCH SECRETARY 2627981838 2015-01-14 1 2627846210 2013 2016-04-25 22:37:26Z NICHOLAS LIESCH 2201 SPRINGDALE ROAD WAUKESHA WI 531862855 20802384 0 X N/A X 1981 WI TO PROVIDE WELFARE BENEFITS, SUCH AS LIFE INSURANCE, ACCIDENTAL DEATH AND DISMEMBERMENT, LOSS OF TIME, DISABILITY, DENTAL, VISION, HOSPITAL, AND SURGICAL BENEFITS FOR UNION MEMBERS AND THEIR SPOUSE AND/OR DEPENDENTS 6 6 0 0 0 0 0 0 7728811 8116332 495107 841756 53265 134699 8277183 9092787 0 0 7268842 7282246 0 0 0 0 0 1481022 1261805 8749864 8544051 -472681 548736 11375854 12215237 3664982 4257223 7710872 7958014 PROVIDE HEALTH AND WELFARE BENEFITS FOR PARTICIPANTS AND THEIR BENEFICIARIES. 0 0 8102919 TO PROVIDE HEALTH, LIFE, DENTAL, VISION, PRESCRIPTION DRUG, AND DISABILITY BENEFITS TO ELIGIBLE PARTICIPANTS, SPOUSES, AND DEPENDENTS. 8102919 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 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 59 0 1 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X SUZANNE TAZALLA 2627981838 2201 SPRINGDALE ROAD WAUKESHA WI 531862855 CARVEN BLANCK CHAIRMAN 1.00 X X 0 0 0 NICHOLAS LIESCH SECRETARY 1.00 X X 0 77817 46217 PATRICK LANDGRAF UNION TRUSTEE 1.00 X 0 109548 50292 TOM FELDMANN EMPLOYER TRUSTEE 1.00 X 0 0 0 JEFFREY GAECKE EMPLOYER TRUSTEE 1.00 X 0 0 0 PAUL HANSEN UNION TRUSTEE 1.00 X 0 0 0 CHARLES SCHUSTER FORMER CHAIRMAN 1.00 X 0 0 0 0 187365 96509 0 0 1 0 RELIASTAR LIFE INSURANCE COMPANY 20 WASHINGTON AVENUE SOUTH MINNEAPOLIS MN 55401 STOP LOSS, LIFE AND ACCIDENTAL DEATH & D 534821 UNITED HEALTH CARE INSURANCE COMPANY 10701 W RESEARCH DRIVE MILWAUKEE WI 53226 CLAIMS PROCESSING 245551 BENEFIT PLAN ADMINISTRATION 11270 WEST PARK PLACE SUITE 950 MILWAUKEE WI 53224 THIRD PARTY ADMINISTRATOR 161439 3 EMPLOYER CONTRIBUTIONS 900099 7807178 7807178 PARTICIPANT CONTRIBUTIONS 900099 279720 279720 STOP LOSS REIMBURSEMENTS 900099 29434 29434 8116332 243475 243475 12307878 11709597 598281 598281 598281 MEDICAL/SUBROGATION REFUNDS 900099 118412 118412 SHARED EXPENSE REIMBURSEMENTS 900099 16287 16287 134699 9092787 8714613 0 378174 7282246 7282246 150530 150530 61403 61403 25490 25490 43230 43230 107626 107626 12305 12305 3700 3700 5793 5793 STOP LOSS PREMIUMS 520923 520923 PPO SERVICE ADMINISTRAT 245923 245923 EMPLOYEE ASSISTANCE PRO 23320 23320 BANK CHARGES 23004 23004 38558 30507 8051 8544051 8102919 441132 0 481908 1162630 37119 1068775 711912 764418 16237 3914 10101985 9183223 26693 32277 11375854 12215237 84282 281923 3580700 3975300 3664982 4257223 X 0 0 0 0 7710872 7958014 7710872 7958014 11375854 12215237 548736 -301594 0 X X 0 1 X 1 0 0 BENEFIT CLAIMS PAYABLE AND IBNR 716300 ESTIMATED LIABILITY FOR FUTURE BENEFITS 3259000 3975300 X 8747963 -301594 -301594 9049557 43230 43230 9092787 8106221 0 8106221 43230 394600 437830 8544051 PART X, LINE 2: U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES 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'S MANAGEMENT BELIEVES THE PLAN IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO MAY 31, 2011. PART XII, LINE 4B - OTHER ADJUSTMENTS: INCREASE IN HEALTH CLAIMS PAYABLE 142,600. INCREASE IN ESTIMATED LIABILITY FOR FUTURE BENEFITS 252,000. 0 0 0 PATRICK LANDGRAF UNION TRUSTEE 0 109548 0 0 0 0 0 31272 0 19020 0 159840 0 0 PART I, LINE 3: COMPENSATION WAS PAID BY A RELATED ORGANIZATION - SHEET METAL WORKERS INTERNATIONAL ASSOCIATION LOCAL UNION NO. 18, AFL-CIO COMPENSATION WAS ESTABLISHED BY APPROVAL OF THE BOARD OR COMPENSATION COMMITTEE. OFFICERS ARE COMPENSATED IN ACCORDANCE WITH THE LOCAL ELECTION STANDARDS. FORM 990, PART VI, SECTION B, LINE 11 REVIEWED BY THE ADMINISTRATIVE MANAGER AND PRESENTED TO TRUSTEES FOR APPROVAL PRIOR TO SIGNING AND FILING. FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES ARE EXPECTED TO DISCLOSE ANY OWNERSHIP OR OTHER FINANCIAL RELATIONSHIPS THAT THEY HAVE WITH PARTIES THAT DEAL WITH THE PLAN. FORM 990, PART VI, SECTION C, LINE 19 THE PLAN MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST THROUGH THE PLAN OFFICE. PART XII, LINE 2C THE BOARD OF TRUSTEES REVIEWS AND APPROVES A DRAFT OF THE AUDITED FINANCIAL STATEMENTS AT THE MEETING. THESE ARE PRESENTED BY THE ACCOUNTANT TO THE BOARD. FORM 990, SCHEDULE R: THE PLAN MADE A REASONABLE EFFORT TO OBTAIN THE FEDERAL TAX CLASSIFICATION FROM ALL CONTRIBUTING EMPLOYERS BUT WAS UNABLE TO OBTAIN A RESPONSE FROM TWO EMPLOYERS. SHEET METAL WORKERS INTERNATIONAL ASSOCIATION LOCAL UNION NO 18 AFL-CIO 2201 SPRINGDALE ROAD WAUKESHA WI 53186 391419063 LABOR UNION WI 501(C)(5) N/A 0 SHEET METAL WORKERS LOCAL 18 & EAST CTRL WI SHEET METAL JRNYMN & APPR TRNG 2201 SPRINGDALE ROAD WAUKESHA WI 53186 391627344 APPRENTICESHIP TRAINING WI 501(C)(5) N/A 0 NATIONS ROOF AUGUST WINTER & SONS INC AZCO INC B&P MECHANICAL INC BASSETT MECHANICAL BAUMGART MECHANICAL BEST MECHANICAL CENTRAL HEATING SERVICE INC COENEN MECHANICAL EGI MECHANICAL INC FELDMANN INC FOREFRONT FOX CITIES SHEET METAL INC GARTMAN HEATING & AC GREAT LAKES MECHANICAL HURCKMAN MECHANICAL INDUSTRIAL VENTILATION INC J&B HVAC JAMAR COMPANY JOHNSON CONTROL MARX MECHANICAL INC MECHANICAL TECHNOLOGIES INC MUZA SHEET METAL CO STAINLESS SPECIALTIES TWEET GAROT MECHANICAL #1 VAL FAB INC VALLEY MECHANICAL CONSTRUCTION SUPPLY & ERECTING 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0