2014-07-15T12:38:16-05:00 2013-11-30 510435869 Needles & Associates LLC 350 Interlocken Blvd STE 220 Broomfield CO 80021 990 2012-12-01 736104291 Mid-South Iron Workers Welfare Plan MID- 4056822323 1300 South Meridian Street Oklahoma City OK 73108 Walter Ashford 4056822323 2014-06-26 Kurt Needles P00850236 3034304225 2014-07-15 2012 2015-11-30 17:44:51Z Walter Ashford 1300 South Meridian Street Oklahoma City OK 73108 2620359 0 X N/A X 1964 OK To provide health benefits to participants and their dependents. 5 0 0 0 2508652 0 0 0 2949407 2508652 57611 52280 39089 59427 3046107 2620359 0 0 3259404 2484071 0 0 0 0 0 385242 351059 3644646 2835130 -598539 -214771 4305389 3614468 1737998 1337205 2567391 2277263 To provide health benefits to participants and their dependents. 0 0 2626435 Benefits paid. 283677 Insurance premiums. -426041 Change in hour bank liability and claims incurred but not reported. 2484071 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 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 5 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X Board of Trustees 4056822323 1300 South Meridian Street Oklahoma City OK 73108 X Michael Richards 1.00 X 0 0 0 Tom Lambert 1.00 X 0 0 0 Ivan B Williams 1.00 X 0 0 0 Walter Ashford 1.00 X 0 0 0 Kenneth Beatty 1.00 X 0 0 0 0 0 0 0 0 0 0 Zenith American Solutions 1300 S Meridian Street Oklahoma City OK 73108 Administrative 123530 Blue Cross Blue Shield 225 North Michigan Ave Chicago IL 60601 PPO/Access Fees 113589 2 Employers' Contributions 525100 2299350 2299350 Reciprocity In 525100 169127 169127 Retiree Contributions 525100 100650 100650 COBRA Contributions 525100 31370 31370 Reciprocity Out 525100 -91845 -91845 2508652 52280 52280 Sav-RX Rebates 525100 33715 33715 Stop Loss Recoveries 525100 25712 25712 59427 2620359 59427 2508652 52280 2484071 2484071 123530 123530 22735 22735 24910 24910 165535 165535 12939 12939 Claims Review 1410 1410 2835130 2484071 351059 0 409014 349936 978596 951285 367368 351721 0 2550411 1961526 4305389 3614468 116676 141924 1621322 1195281 1737998 1337205 X 2567391 2277263 2567391 2277263 4305389 3614468 -214771 -75357 0 X 0 1 X 1 0 0 Hour Bank Liability 735281 Claims Incurred but Not Reported 460000 1195281 X 2545474 -75357 -75357 2620831 -472 -472 2620359 3261643 0 3261643 -426513 -426513 2835130 Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: The Trust, established under the Plan to hold the Plan's assets, is qualified under Section 501(c)(9) of the Internal Revenue Code, and, accordingly, the Trust's net investment income is exempt from income taxes. The Plan has obtained a favorable tax determination letter. The Plan has been amended since receiving the determination letter. Management has evaluated the Plans tax positions and concluded that the Plan had maintained its tax exempt status and had taken no uncertain tax positions that required adjustments to the financial statements. With few exceptions, the Plan is no longer subject to income tax examinations by tax authorities for years preceding December 31, 2009. Part XI, Line 4b - Other Adjustments: Subrogation recoveries netted with benefits paid on 990, income on FS. Part XII, Line 4b - Other Adjustments: Increase in Hour Bank and Change in IBNR Subrogation recoveries netted with benefits paid on 990, income on FS. Subrogation recoveries netted with benefits paid on 990, income on FS. Form 990, Part VI, Section B, line 11 Form 990 was provided to the Trustees prior to filing. Form 990, Part VI, Section B, line 12c During Board of Trustee meetings, Trustees discuss and enforce compliance with the conflict of interest policy. Form 990, Part VI, Section C, line 18 The Form 990 is available for public inspection upon request. Form 990, Part VI, Section C, line 19 Governing documents are available to the public upon request. Oklahoma Iron Workers Direct Contribution Plan 1300 S Meridian STE 200 Oklahoma City OK 73108 736278639 The Plan provides pension benefits. OK 501c9 0 Info not available for Sch R Part III & IV N/A NA OK 73108 000000000 N/A OK 0 0 Info not available for Sch R Part III & IV N/A NA OK 73108 000000000 N/A OK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0