2014-06-23T09:00:45-05:00 2013-08-31 BENDA GRACE STULZ & COMPANY PC 38800 VAN DYKE AVE STE 100 STERLING HEIGHTS MI 48312 990 2012-09-01 386058383 MICHIGAN CARPENTERS' HEALTH CARE FUND MICH 5173217502 6525 CENTURION DRIVE LANSING MI 489170000 TYLER MCCASTLEROBERT ROOT 5173217502 2013-12-19 false BRYAN STULZ 5868836240 2014-06-23 2012 2015-11-30 17:44:51Z SAME AS ABOVE 21258720 false X X 1952 MI PROVIDE HEALTH AND WELFARE BENEFITS. 12 2 0 0 0 20799320 19874259 1487107 1374307 30067 10154 22316494 21258720 0 16414738 21098289 0 0 0 1102707 2660619 22200996 19075357 115498 2183363 26990535 26650895 11616482 10109915 15374053 16540980 PROVIDE HEALTH AND WELFARE BENEFITS. false false TO PROVIDE HEALTH CARE BENEFITS FOR ELIGIBLE PLAN PARTICPANTS. false false false false false false false false false false false false false true false true false false false false false false false false false false false false true 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 12 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 DR LANSING MI 48917 X MICHAEL J JACKSON SR 1.00 40.00 X 0 212733 0 KEVIN KLINGLER 1.00 40.00 X 0 89932 48978 BRIAN KERRIGAN 1.00 40.00 X 0 84915 39000 TYLER MCCASTLE 1.00 40.00 X 0 81266 36322 CHAD MILLER 1.00 40.00 X 0 76004 33020 TRAVIS FAIRBANKS 1.00 40.00 X 0 74194 33103 LEON TURNWALD 1.00 40.00 X 0 71917 40073 ROBERT ROOT 1.00 40.00 X 0 0 0 TRACE HENDRICK 1.00 40.00 X 0 0 0 STANLEY BUELL 1.00 40.00 X 0 0 0 GARY BENJAMIN 1.00 40.00 X 0 0 0 SCOTT FISHER 1.00 0.00 X 0 0 0 BART CARRIGAN 1.00 0.00 X 0 0 0 DUANE BREMER 1.00 40.00 X 0 0 0 690961 230496 false true false BLUE CROSS BLUE SHIELD 600 EAST LAFAYETTE DETROIT MI 48226 CLAIMS ADMIN 1613115 TIC INTERNATIONAL CORPORATION 6525 CENTURION DRIVE LANSING MI 48917 ADMINISTRATION 769513 2 EMPLOYER CONTRIBUTIONS 230000 14028672 14028672 PARTICIPANT SELF-PAYMENTS 900099 5845587 5845587 19874259 1374307 1374307 LIQUIDATED DAMAGES 900099 9778 9778 OTHER 900099 376 376 10154 21258720 19884413 1374307 16414738 2214778 28435 118603 8417 114001 46504 49576 12214 10373 MEMBER COMMUNICATIONS 21105 BANK SERVICE CHARGES 15179 ACTUARIAL FEE 11000 NOTICES TO PARTICIPANTS 4702 5732 19075357 0 0 0 1367814 1174178 1536413 1498030 895570 861681 23384374 22923370 26990535 26650895 336360 468276 11280122 9641639 11616482 10109915 X 15374053 16540980 15374053 16540980 26990535 26650895 2183363 -1016436 X false true X true false ACCUMULATED ELIGIBILITY CREDITS 8392000 CLAIMS INCURRED BUT NOT REPORTED 1098000 ADVANCED SELF PAYMENTS 151639 9641639 20233867 -1016436 -1016436 21250303 8417 8417 21258720 19066940 19066940 8417 8417 19075357 false false false MICHAEL J JACKSON SR 212733 212733 ADDITIONAL INFORMATION FORM 990, PART VI LINE 2 - FAMILY RELATIONSHIP OR BUSINESS RELATIONSHIP - 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 ACUTAL CONFLICTS OF INTEREST. LINE 15 - THE FUND DID NOT HAVE A CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL, OR OTHER OFFICERS OR KEY EMPLOYEES, AS THOSE TERMS ARE DEFINED. ELECTION OF MEMBERS AND THEIR RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A ALL BOARD MEMBERS ARE ELECTED BY THE MEMBERSHIP INTO THEIR OFFICER POSITIONS. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS PRESENTED AND APPROVED AT MEETING OF THE BOARD OF TRUSTEES, SUBJECT TO REVIEW BY AND APPROVAL OF THE FUND LEGAL COUNSEL. IN ADDITION, EACH TRUSTEE IS PROVIDED A COPY OF THE FUND'S FINAL FORM 990 (INCLUDING REQUIRED SCHEDULES), AS ULTIMATELY FILED WITH THE IRS. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION 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 I ERISA WITH RESPECT TO DISCLOSURE OF ITS GOVERNING DOCUMENTS AND FINANCIAL INFORMATION. IT OPERATES IN COMPLIANCE WITH THE FIDUCIARY RESPONSIBILITY REQUIREMENTS OF SUBTITLE B, PART 4 OF ERISA. ADDITIONAL INFORMATION FORM 990, PART VII LINE 1A- MICHAEL JACKSON SR, TYLER MCCASTLE, BRIAN KERRIGAN, LEON TURNWALD, CHAD MILLER, TRAVIS FAIRBANKS, AND KEVIN KLINGLER SERVED AS TRUSTEES OF THE FUND WITHOUT COMPENSATION FROM THE FUND FOR THOSE SERVICES. HOWEVER, THEY WERE COMPENSATED AS EMPLOYEES OF THE MICHIGAN REGIONAL COUNSIL OF CARPENTERS, WHICH WAS A CONTRIBUTING EMPLOYER TO THE FUND AND, AS SUCH, A "RELATED ORGANIZATION" AS THAT TERM IS DEFINED IN THE INSTRUCTIONS. SEE PART VII N/A false SEE PART VII N/A false false SEE PART VII N/A false false false false false false false false false false false false false false false false false false false false ADDITIONAL INFORMATION SCHEDULE R SCHEDULE R PARTS II III IV IDENTIFICATION OF RELATED ORGANIZATIONS THE FILING ORGANIZATION IS A MULTIEMPLOYER TRUST FUND AS DEFINED IN THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 AS AMENDED THE FUND PROVIDES HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS AND THEIR DEPENDENTS AS OF AUGUST 31 2013 THERE WERE 267 CONTRIBUTING EMPLOYERS TO THE FUND UNDER THE INSTRUCTIONS TO SCHEDULE R THOSE EMPLOYERS ARE CONSIDERED RELATED ORGANIZATIONS THE FUNDS ADMINISTRATIVE OFFICE MAINTAINS A DATABASE OF ALL CONTRIBUTING EMPLOYERS THE FOLLOWING IS A LISTING OF THOSE CONTRIBUTING EMPLOYERS A F CONSTRUCTION A C P OF LENAWEE INC AZCO INC ACOUSTICAL ARTS INC ADVANTAGE INDUSTRIAL SYS LLC ALBERICI CONSTRUCTORS ALFREDSON BROS CONSTRUCTION AMALIO CORPORATION AMERICAN INDUSTRIAL 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